Chapter 38 | EMS Operations

Question 1

List:

EMS system functions

5 points

Answer 1

• emergency
• non-emergency
• wilderness
• special event
• tactical

Question 2

Define:

Type 1 ambulance

Answer 2

ambulance box mounted on truck chassis

Question 3

Identify:

Answer 3

Type 1 ambulance

(ambulance box mounted on truck chassis)

Question 4

Define:

Type 2 ambulance

Answer 4

vanbulance

Question 5

Identify:

Answer 5

Type 2 ambulance

(vanbulance)

Question 6

Define:

Type 3 ambulance

Answer 6

ambulance box mounted on van chassis

Question 7

Identify:

Answer 7

Type 3 ambulance

(ambulance box mounted on van chassis)

Question 8

List:

start of shift checklist

4 points

Answer 8

• check truck
• check equipment
• get radio
• check in with dispatch or crew chief

Question 9

Define:

EMD

(abbreviation)

Answer 9

emergency medical dispatcher

Question 10

Define:

emergency medical dispatcher (EMD)

Answer 10

911 dispatcher who interrogates caller and assigns call priority

Question 11

Fill in the blanks:

A “hot” response means [BLANK].

A “cold” response means [BLANK].

Answer 11

A “hot” response means using lights and siren.

A “cold” response means no lights or siren.

Question 12

Fill in the blanks:

Hot responses [INCREASE/DECREASE] risk.

Cold responses [INCREASE/DECREASE] risk.

Answer 12

Hot responses increase risk.

Cold responses decrease risk.

Question 13

Fill in the blanks:

The laws in most states allow the driver of an emergency vehicle running [HOT/COLD] to break some vehicle and traffic laws.

However, it must be done with [BLANK].

Answer 13

The laws in most states allow the driver of an emergency vehicle running “hot” to break some vehicle and traffic laws.

However, it must be done with due regard for safety.

Question 14

List:

operational reasons for helicopter transport

3 points

Answer 14

• speeding up transport to distant special facility
• prolonged extrication time (allowing helicopter to speed up transport)
• remote location only accessible by helicopter

Question 15

Describe:

medical reason for helicopter transport

Answer 15

patients with high-priority for rapid transport

shock, GCS < 10, TBI/AMS, chest trauma/penetration, serious MOI, etc.

Question 16

Define:

LZ

(abbreviation)

Answer 16

landing zone

Question 17

Fill in the blanks:

A helicopter requires a landing zone of approximately [BLANK] feet by [BLANK] feet.

(easy way to measure it)

Answer 17

A helicopter requires a landing zone of approximately 100 feet by 100 feet.

(approximately 30 large steps on each side)

Question 18

Fill in the blanks:

The ground slope for a helicopter landing zone should not exceed [BLANK].

Answer 18

The ground slope for a helicopter landing zone should not exceed 8º.

Question 19

Fill in the blank:

The landing zone and approach/departure path should be clear of [BLANK].

Answer 19

The landing zone and approach/departure path should be clear of wires, towers, vehicles, people, and loose objects.

Make sure there’s not stuff in the way. It’s not that hard.

Question 20

True or false:

The landing zone should be marked with one extra flare in an upwind position.

Answer 20

true

Question 21

True or false:

The landing zone should be marked with one extra flare in a downwind position.

Answer 21

false

should be in upwind position.

Question 22

Fill in the blank:

During helicopter night operations, [DO/DON’T] shine a light into the pilot’s eyes during landing or takeoff, or while the aircraft is running on the ground.

Answer 22

During helicopter night operations, literally never shine a light into the pilot’s eyes during landing or takeoff, or while the aircraft is running on the ground.

Question 23

List:

considerations in describing landing zone to air rescue service

4 points

Answer 23

• terrain
• major landmarks
• estimated distance to nearest town
• other pertinent information

Question 24

True or false:

Do not approach a helicopter unless escorted by the flight personnel.

Answer 24

true

Question 25

True or false:

You may approach a helicopter once it has landed on the ground to proceed with patient transport.

Answer 25

false

do not approach a helicopter unless escorted by the flight personnel

Question 26

Fill in the blank:

The proper way to approach a helicopter on flat terrain is from the [BLANK].

Answer 26

The proper way to approach a helicopter is from the front.

Question 27

Explain:

how to approach helicopter on hillside

Answer 27

from the downhill side

Question 28

List (in order):

phases of ambulance call

5 points

Answer 28

1. preparing for ambulance call
2. receiving and responding to call
3. transferring patient to ambulance
4. tranferring patient to hospital staff
5. terminating call

Question 29

Answer:

What types of stretcher straps are essential to restrain and prevent a patient from becoming a projectile in a collision?

Answer 29

shoulder straps

Question 30

Fill in the blank:

The federal agency that develops specifications for ambulance vehicle designs is the [BLANK].

Answer 30

The federal agency that develops specifications for ambulance vehicle designs is the U.S. Department of Transportation.

Question 31

Choose:

The purpose(s) for carrying an EPA-registered, intermediate-level disinfectant on the ambulance is to:

A. clean up blood spills.

B. destroy mycobacterium tuberculosis.

C. disinfect patient wounds.

D. do all of these.

Answer 31

B

An EPA-registered, intermediate-level disinfectant is carried on the ambulance for the purpose of destroying mycobacterium tuberculosis.

Question 32

Choose:

Which of the following is not a piece of equipment that should be in the portable first-in kit, to be taken directly to a patient’s side?

A. Suction unit

B. Rigid cervical collar

C. Blood pressure cuff

D. Telemetry repeater

Answer 32

D

The telemetry repeater is used in the ambulance to boost the radio signal. The portable first-in kit to be taken directly to a patient’s side includes the suction unit, rigid cervical collar, and blood pressure cuff.

Question 33

Choose:

Supplies that are used for the “C” step of the primary assessment of a trauma victim include all of the following except:

A. disposable gloves.

B. occlusive dressings.

C. the AED.

D. a suction unit.

Answer 33

D

suction is used during “A” step

Question 34

Choose:

On each call, you will need to take in the kit that has the equipment necessary to take the patient’s baseline vital signs.

All of the following are pieces of equipment used to obtain vital signs except:

A. rubber bulb syringe.

B. adult and pediatric stethoscope.

C. sphygmomanometer.

D. penlight.

Answer 34

A

Question 35

Choose:

Which of the following pieces of patient transfer equipment is incorrectly matched with its function:

A. Wheeled ambulance stretcher: transporting patients in sitting, supine, or Trendelenburg position

B. Folding stair chair: moving patients down stairs in a sitting position

C. Reeves stretcher: carrying patients from a high-angle rescue

D. Scoop stretcher: picking up patients found in tight spaces

Answer 35

C

A Reeves® stretcher is used for carrying a patient who must lie supine down stairs when a cot is too heavy or wide, not for use in a high-angle rescue.

The Stokes basket (or basket stretcher) is used to carry patients in high-angle rescue.

Question 36

Choose:

Components of a typical fixed oxygen delivery system include:

A. a 3,000-liter reservoir.

B. a two-stage regulator.

C. the necessary reducing valve and yokes.

D. all of these.

Answer 36

D

A typical fixed oxygen delivery system consists of a 3,000-liter reservoir, a two-stage regulator, and the necessary reducing valve and yokes.

Question 37

Choose:

Which of the following devices carried on the ambulance or EMS vehicle for prehospital respiratory care is optional?

A. Six adult and four pediatric nasal cannulas

B. A flow-restricted, oxygen-powered ventilation device (FROPVD)

C. An automatic transport ventilator (ATV)

D. A plastic cup for blow-by oxygen

Answer 37

C

The automatic transport ventilator (ATV) is not an essential item to carry on the ambulance or EMS vehicle for prehospital respiratory care.

Question 38

Choose:

The fixed suction unit in the ambulance or EMS vehicle should:

A. provide an airflow of over 15 liters per minute.

B. be usable by a person seated beside the patient.

C. have a current hydrostat test date.

D. reach a vacuum of at least 300 mmHg within 4 seconds.

Answer 38

D

The fixed suction unit in the ambulance should reach a vacuum of at least 300 mmHg within 4 seconds. It should provide an airflow of 30 liters per minute and should be usable by a person at the patient’s head. Oxygen tanks, not suction units, require periodic hydrostatic testing.

Question 39

Choose:

Which of the following pieces of equipment carried on an ambulance or EMS vehicle for defibrillation or assisting with cardiopulmonary resuscitation is optional?

A. short or long spine board

B. mechanical CPR compressor

C. automated external defibrillator

D. kit with oral and nasal airways

Answer 39

B

The mechanical CPR compressor is a helpful device, but it is not essential for assisting with cardiopulmonary resuscitation.

Question 40

Choose:

Equipment that is carried on an ambulance or EMS vehicle for immobilization includes all of the following except:

A. a Hare® traction splint.

B. triangular bandages.

C. padded aluminum splints.

D. a burn sheet.

Answer 40

D

Question 41

Choose:

Supplies used for wound care should include all of the following except:

A. sterile burn sheets.

B. 5 x 9-inch combine dressings.

C. self-adhering roller bandages.

D. a Hare or Sager traction device.

Answer 41

D

Question 42

Choose:

What is the purpose of carrying sterilized aluminum foil on the ambulance or EMS vehicle?

A. To wrap body parts in

B. To maintain body heat

C. To make a shield over an avulsed eye

D. For warming minor abrasions

Answer 42

B

Sterilized aluminum foil is used to maintain body heat or as an occlusive dressing. Body parts should be wrapped in a plastic bag and kept cool. Use a paper cup over an avulsed eye. Never use aluminum foil to cover an injury directly because it can cut the patient.

Question 43

Choose:

The supplies for childbirth include all the following except:

A. a rubber bulb syringe.

B. sanitary napkins.

C. large safety pins.

D. sterile surgical gloves.

Answer 43

C

large safety pins are used with a sling (not for childbirth)

Question 44

Choose:

Of the following items checked on the ambulance or EMS vehicle, which is checked with the engine off?

A. Dash-mounted gauges

B. The battery

C. Windshield wiper operation

D. The vehicle’s warning lights

Answer 44

B

Question 45

Choose:

The responsibilities of the Emergency Medical Dispatcher (EMD) include all of the following except:

A. dispatching and coordinating EMS resources.

B. interrogating the caller and prioritizing the call.

C. coordinating with other public safety agencies.

D. advising the caller that an ambulance is not needed.

Answer 45

D

Question 46

Choose:

When an Emergency Medical Dispatcher (EMD) questions a patient or caller, which of the following is not routinely asked?

A. What is the exact location of the patient?

B. What is the problem?

C. Has the patient been in the hospital recently?

D. How old is the patient?

Answer 46

C

When an EMD questions a patient or caller, the EMD does not routinely ask whether the patient has been in the hospital recently. This is part of the EMT’s SAMPLE history taken at the scene.

Question 47

Choose:

When speaking with a caller who is at the scene of a traffic collision, the Emergency Medical Dispatcher (EMD) should ask all the following except:

A. Is traffic moving?

B. What brand of vehicle was involved in the collision?

C. How many lanes of traffic are open?

D. Are any of the vehicles on fire?

Answer 47

B

The brand of vehicle is not important to EMS, though it would be needed for the police report.

Question 48

Choose:

To be a safe ambulance operator, the EMT should:

A. be tolerant of other drivers.

B. always wear glasses or contact lenses if required.

C. have a positive attitude about his or her ability as a driver.

D. do all of these.

Answer 48

D

To be a safe ambulance operator, the EMT should be tolerant of other drivers, always wear glasses or contact lenses if required, and have a positive attitude about his or her ability as a driver.

Question 49

Choose:

Every state has statutes that regulate the operation of emergency vehicles. Under certain circumstances, vehicle operators can do all of the following except:

A. park the vehicle anywhere as long as it does not damage personal property.

B. proceed past red stop signals, flashing red stop signals, and stop signs.

C. exceed the posted speed limit as long as life and property are not endangered.

D. pass a school bus that has its red lights blinking.

Answer 49

D

Most state statutes prohibit passing of a school bus
that has its red lights blinking. The operator must stop and wait for the bus driver to shut off the red lights, which signals that all the children are in a safe position. Then proceed with caution. State statutes do allow emergency vehicle operators to do all of the following under certain conditions: park the vehicle anywhere as long as it does not damage personal property; proceed past red stop signals, flashing red stop signals, and stop signs; and exceed the posted speed limit as long as life and property are not endangered.

Question 50

Choose:

You were dispatched to a priority assignment involving a motor vehicle collision. Once at the scene, you find a 24-year-old female patient and determine that she is stable.

This situation is no longer a:

A. true emergency.

B. due regard.

C. cold response.

D. priority-one response.

Answer 50

A

This situation is no longer considered a true emergency. Further use of lights and siren would be inappropriate.

Question 51

Choose:

Which guideline for the use of the ambulance siren is inappropriate?

A. Use the siren sparingly.

B. Never assume that all motorists will hear your signal.

C. Be prepared for erratic movements of motorists.

D. Keep the siren on until the call is completed.

Answer 51

D

Do not use the siren throughout the call. Use the siren sparingly. Never assume that all motorists will hear your signal, and be prepared for erratic movements of motorists.

Question 52

Choose:

Which of the following is true about the use of lights and sirens?

A. Motorists are more inclined to give way to ambulances when sirens are con­tinually sounded.

B. The decision about the use of lights and sirens should be based on the patient’s medical condition.

C. The use of the siren has little effect on the ambulance operator.

D. Four-way flashers should be used in addition to emergency lights.

Answer 52

B

The decision about the use of lights and sirens should always be made with the medical condition of the patient in mind. The continuous sound of a siren may cause a sick or an injured person to suffer increased fear and anxiety, and the patient’s condition may deteriorate as stress increases.

Question 53

Choose:

Use of escorts or multivehicle responses is a:

A. very quick and successful means of response.

B. very dangerous means of response.

C. means of decreasing the chance of collision.

D. standard operating procedure in most communities.

Answer 53

B

Escorts or multivehicle responses are a very dangerous means of response. Motorists often do not expect to see the second emergency vehicle and may collide with it.

Question 54

Choose:

Factors that can affect ambulance response include all of the following except:

A. the time of day.

B. the weather.

C. road maintenance and construction.

D. the type of emergency.

Answer 54

D

The type of emergency does not affect ambulance response (except in some mass-casualty incidents). Factors that do affect ambulance response include time of the day, weather, and road maintenance and construction.

Question 55

Choose:

You are the first vehicle on the scene of an automobile collision in which one of the vehicles is on fire. You should park your vehicle [BLANK] the wreckage until the fire apparatus arrives.

A. 50 feet from

B. in front (upstream) of

C. beyond (downstream) of

D. downwind from

Answer 55

B

Park in front of the wreckage (upstream) if yours is the first emergency vehicle on the scene so that your flashing lights can warn approaching motorists until flares and other signals can be placed. Park 100 feet and uphill from a wreckage that involves fire.

Question 56

Choose:

The sequence of operations to ready a patient for transfer is called:

A. stabilization.

B. packaging.

C. transport.

D. removal.

Answer 56

B

Packaging is the sequence of operations required to ready the patient to be moved and to combine the patient and the patient-carrying device into a unit ready for transfer.

Question 57

Choose:

Which of the following is an action that you would not perform en route to the hospital?

A. Recheck the patient’s bandages and splints.

B. Form a general impression of the patient.

C. Perform reassessment and continue to monitor vital signs.

D. Notify the receiving facility of your estimated time of arrival.

Answer 57

B

Forming a general impression of the patient is done when you first see the patient, not en route to the hospital. En route, the EMT rechecks bandages and splints, provides reassessment, continues to monitor vital signs, and notifies the receiving facility of estimated time of arrival.

Question 58

Choose:

You are transporting a critically ill patient in severe respiratory failure to the nearest emergency department. If the patient develops cardiac arrest en route to the hospital, your first action should be to:

A. apply and operate the AED.

B. begin cardiopulmonary resuscitation.

C. notify the emergency department.

D. tell the operator to stop the ambulance.

Answer 58

D

If a patient develops cardiac arrest en route to the hospital, the EMT’s first action should be to tell the operator to stop the vehicle.

Question 59

Choose:

Which of the following patients is least likely to be transported in a helicopter?

A. A victim of carbon monoxide poisoning

B. A patient with a suspected stroke

C. A cardiac arrest patient

D. A patient with a critical burn

Answer 59

C

Question 60

Choose:

A large hurricane strikes a coastal city and destroys a large amount of communication and transport infrastructure. The national guard provides air and sea resources under the national incident management system (NIMS).

As an emergency medical services professional working in the field, how will this situation impact your pattern of practice?

A. You will be assigned to one of the helicopters or watercraft

B. The helicopters and watercraft will transport patients to you

C. The helicopters and watercraft will bring resources that allow you to overcome poor transport conditions

D. You will continue to respond to calls on-scene as usual

Answer 60

B

Large scale disaster that requires activation of the NIMS will almost always cause a significant disruption in ground ambulances ability to respond to the scene of injured patients requiring transport. Specialized resources are generally used to extradite patients from the scene to a central staging area where traditional ground transport can take them to receiving facilities.

Question 61

Fill in the blank:

The [BLANK] created the first ALS pilot programs with $142,000,000 in taxpayer funds and resulted in the creation of the NHTSA.

(legislation)

Answer 61

The Highway Safety Act of 1966 created the first ALS pilot programs with $142,000,000 in taxpayer funds and resulted in the creation of the NHTSA.

Question 62

Choose:

You are called to the scene of a passenger car train derailment.

Who has ultimate authority for all issues regarding patient care at the scene of a mass-casualty incident?

A. EMS medical director

B. Treatment officer

C. The senior paramedic on scene

D. Incident commander

Answer 62

A

For all issues regarding patient care, the EMS medical director has ultimate authority. Although the treatment officer is responsible for overseeing all emergency care provided at the scene, and EMTs working in the treatment area are providing direct patient care, these personnel are still functioning under the physician’s license.

Question 63

Choose:

In ICS, the manageable “span of control” of section chiefs should involve how many subordinate personnel under their command?

A. 1-2 Persons

B. 3-7 Persons

C. 5-10 Persons

D. 10-20 Persons

Answer 63

B

Span of control refers to the number of personal reporting to any given individual. Optional span of control in the ICS is 5, with an acceptable spread of 3-7.