Chapter 40 | Highway Safety and Vehicle Extrication

Question 1

True or false:

On limited-access highways, only the primary or first-due units should proceed directly to the scene.

Answer 1

true

Question 2

True or false:

On limited-access highways, the first-arriving units should proceed directly to the scene.

Answer 2

false

only the primary or first-due units should proceed directly to the scene

Question 3

Fill in the blank:

On limited-access highways, the first-arriving units should [BLANK] and [BLANK].

Answer 3

On limited-access highways, the first-arriving units should establish command and block traffic.

Question 4

Define:

upstream blocking

Answer 4

using apparatus to strategically block flow of oncoming traffic toward scene

Question 5

Fill in the blank:

[BLANK] is ideal to use in blocking traffic on roadway scenes.

Answer 5

Fire apparatus is ideal to use in blocking traffic on roadway scenes.

Question 6

True or false:

Any first-arriving unit can institute traffic blocking.

Answer 6

true

Question 7

Fill in the blank:

In relation to a traffic incident scene, Incident Command and EMS should be located [BLANK].

(where)

Answer 7

Incident Command and EMS should be located downstream.

Question 8

Fill in the blank:

The apparatus that is used to block traffic should be positioned to create [BLANK] lanes of blockage.

(how many lanes to block off)

Answer 8

The apparatus that is used to block traffic should be positioned to create 1.5-2 lanes of blockage.

Question 9

True or false:

At traffic incident scenes, responders who are exiting apparatus are at high risk of being struck by a passing vehicle.

Answer 9

true

Question 10

True or false:

At night, headlights or flashing lights can temporarily blind drivers who are approaching an emergency scene, preventing them from seeing emergency workers.

Answer 10

true

Question 11

True or false:

At night, drivers of emergency apparatus parked at highway incidents should turn off vehicle headlights to prevent blinding drivers.

Answer 11

true

At night, headlights or flashing lights can temporarily blind drivers who are approaching an emergency scene, preventing them from seeing emergency workers.

Question 12

True or false:

At night, drivers of emergency apparatus parked at highway incidents should leave vehicle headlights on for improved visibility.

Answer 12

false

…should turn off vehicle headlights to prevent blinding drivers

Question 13

Fill in the blank:

To be seen and warn oncoming traffic, all responders should be in full protective clothing or, at a minimum, [BLANK].

Answer 13

To be seen and warn oncoming traffic, all responders should be in full protective clothing or, at a minimum, ANSI-approved safety vests and helmets.

Question 14

Explain:

how to place cones on roadway scene

Answer 14

place flares or traffic cones to slow traffic and channel it away from incident lane

Question 15

Fill in the blank:

At a crash, any personnel working in the “inner circle” should wear [BLANK] to avoid being injured.

Answer 15

At a crash any personnel working in the “inner circle” should wear full protective turnout gear to avoid being injured.

Question 16

List:

protective gear for EMS responders at vehicle crashes

4 points

Answer 16

• helmets
• eye protection
• hand protection
• body protection

Question 17

Fill in the blank:

[DO/DON’T] throw flares out of moving vehicles.

Answer 17

Do not throw flares out of moving vehicles.

Question 18

True or false:

[DO/DON’T] use a flare as a traffic wand.

Answer 18

Never use a flare as a traffic wand.

Question 19

True or false”

Airbags may create “smoke” in the vehicle.

Answer 19

true

Question 20

True or false:

Spectators at a vehicle collision may interfere with rescue and emergency care efforts in addition to traffic.

Answer 20

true

Question 21

True or false:

Spectators at a vehicle collision may possibly be helpful on scene.

Answer 21

true

ask responsible-looking bystanders to keep spectators away

Question 22

Define:

“try before you pry”

Answer 22

reminder to try the doorhandle before jumping straight to using tools for extrication

Question 23

List:

means of gaining access to vehicle in crash

2 points

Answer 23

• simple access: opening door/window for entrance
• complex access: utilizing tools/equipment for entrance

Question 24

List:

steps of patient extrication from MVC

2 points

Answer 24

• gain access by disposing of roof and doors
• disentangle occupants by displacing front-end

Question 25

Choose:

When placing cribbing:

A: always squat, so you can move away quickly.

B: kneel or squat as necessary.

C: kneel on one knee only so you can move away quickly.

D: kneel on both knees for stabilization.

Answer 25

A

to avoid not being able to move

Question 26

Choose:

When disconnecting a battery cable to disrupt a vehicle’s electrical system, the EMT should disconnect the:

A: positive cable from the alternator.

B: positive cable from the battery.

C: negative cable from the alternator.

D: negative cable from the battery.

Answer 26

D

Question 27

Choose:

Which of the following is adequate protection for the EMT’s head while at the scene of an auto extrication?

A: NFPA standard rescue helmet

B: Firefighting helmet

C: Nomex hood

D: Watch cap

Answer 27

A

Question 28

Choose:

You are assessing a patient in the front seat of a vehicle that was involved in a head-on collision. As you examine the interior of the vehicle, you notice the airbags have not deployed.

What action should you take in order to render the scene safe to work?

A: Disconnect the battery and wait 2 minutes before entering the vehicle.

B: Turn the ignition to the “off” position and wait 2 minutes before entering the vehicle.

C: Use a long spine board to shield yourself from the undeployed airbag.

D: Disconnect the battery and continue assessing the patient.

Answer 28

A

Question 29

Choose:

Which of the following is not an example of a specialty rescue team?

A: Water rescue

B: High-angle rescue

C: Advanced cardiac life support

D: Confined-space rescue

Answer 29

C

Question 30

Choose:

When extrication will involve cutting the roof off a vehicle, stabilization of the vehicle should include:

A: deflating all tires by pulling the valve stems.

B: deflating all tires by slashing them.

C: placing wheel chocks on both sides of all wheels.

D: placing chocks on both sides of at least two wheels.

Answer 30

A

Question 31

Choose:

Which of the following is the first concern when you are caring for a patient who has been in a vehicle collision?

A: Treating life-threatening injuries

B: Your own safety

C: Helping law enforcement get the driver’s name and insurance information

D: Preserving evidence, such as alcohol beverage bottles and vehicle positioning

Answer 31

B

Question 32

Choose:

Which of the following should be used to protect a patient during extrication?

A: Plastic blanket

B: Netting

C: Goggles

D: None of these

Answer 32

C

Question 33

Choose:

On arrival at a vehicle collision, you observe a small fire in the engine compartment. A bystander is attempting to smother the fire with a jacket as you approach with an A-B-C extinguisher from your ambulance.

Which of the following is the best method of extinguishing the fire?

A: Close the hood to contain the fire within the engine compartment.

B: Aim at the base of the fire and use short bursts until the fire is out.

C: Sweep the nozzle of the extinguisher left and right using short bursts until you are out of extinguishing agent.

D: Aim the nozzle to the side of the fire and, with a sweeping motion, push the fire at its base.

Answer 33

B

Question 34

Choose:

One of the greatest hazards that emergency responders face on a daily basis is/are:

A. high rising flood waters.

B. oncoming traffic at highway incidents.

C. acts of terrorism in our cities.

D. routine calls involving anxious patients.

Answer 34

B

One of the greatest hazards regularly faced by emergency responders is that of oncoming traffic at highway incidents. The other possibilities are certainly dangerous but are not that common.

Question 35

Choose:

The phases of extrication include all of the following except:

A. gaining access to the patient.

B. defining patient care.

C. disentangling the patient.

D. sizing up the situation.

Answer 35

B

Defining patient care is not a phase of extrication. The phases of extrication encompass ten steps that include gaining access to the patient, disentangling the patient, and sizing up the situation.

Question 36

Choose:

On arrival at the scene of a three-car motor vehicle crash, you and your crew ensure that the location is safe and begin to size up the situation.

An important part of a rescue scene size-up is:

A. determining the extent of entrapment.

B. sweeping up all the broken glass.

C. removing shattered glass from around the patient.

D. informing the patient about the extent of vehicle damage.

Answer 36

A

An important part of a scene size-up at a motor vehicle crash is determining the extent of entrapment. Starting IVs on the patient is not part of the size-up and is a paramedic skill. Removing shattered glass, if needed, should be done as far away from the patient as possible. Informing the patient about the extent of vehicle damage will make the patient more anxious. Don’t lie if asked, but focus on treating the patient.

Question 37

Choose:

During size-up of a collision, you must be able to “read” a collision and develop an action plan based on your knowledge of rescue operations and your:

A. previous experience at collision scenes.

B. judgment of the extent of vehicle damage.

C. estimation of the patient’s condition and priority.

D. evaluation of the resources available.

Answer 37

C

During size-up of a collision, you must be able to “read” a collision and develop an action plan based on your knowledge of rescue operations and estimate of the patient’s condition and priority.

Question 38

Choose:

You are on the scene of a car that crashed into a bridge overpass abutment. The patient is trapped and seriously injured.

When developing an action plan for patient extrication, always keep in mind:

A. the potential for observation by bystanders.

B. that time is very critical to some patients’ trauma management.

C. the cost of further damage to the vehicle.

D. the type of vehicle that is involved in the incident.

Answer 38

B

When developing an action plan for patient extrication, always keep in mind that time is important to the critical trauma patient’s management. The cost of vehicle damage or the type of vehicle is less relevant to the extrication as is the presence of bystanders, although they should not interfere with your operations.

Question 39

Choose:

If a vehicle has an airbag that deployed, the manufacturer recommends:

A. airing out the car for 15 minutes before treating the patient.

B. placing masks on patients before treating.

C. lifting the bag and examining the steering wheel and dash.

D. using HEPA masks before gaining access.

Answer 39

C

If a vehicle has an air bag that deployed, the manufacturer recommends lifting the bag and examining the steering wheel and dash. If either is damaged, it is likely that the patient’s chest is damaged, which would mean great potential for internal injury. The use of a HEPA mask is not required; gloves and eye protection are recommended.

Question 40

Choose:

The unsafe act that contributes most to injuries at collision scenes is:

A. crossing over lanes of still flowing traffic on foot.

B. wearing too much protective gear during rescue operations.

C. not recognizing the mechanisms of injury right away.

D. selecting the wrong tool for the task.

Answer 40

A

Of those listed, the unsafe act that contributes most to collision scene injuries is crossing over lanes of traffic on foot when the traffic has not yet been controlled or stopped.

Question 41

Choose:

Every year, EMTs and rescuers are injured at the scene of collisions. Factors that may contribute to injuries of rescuers at a collision include all of the following except:

A. a careless attitude toward personal safety.

B. a lack of skill in tool and equipment use.

C. physical problems that impede strenuous effort.

D. limiting the inner circle to rescuers who are in protective gear.

Answer 41

D

By limiting the inner circle to rescuers who are in protective gear, you help to decrease potential injuries, not contribute to them. Factors that may contribute to injuries of rescuers at a collision include a careless attitude toward personal safety, a lack of skill in tool use, and physical problems that impede strenuous effort.

Question 42

Choose:

Good protective gear at the scene of a collision includes all of the following except:

A. firefighter or leather gloves.

B. fire-resistant trousers or turnout pants.

C. steel-toed, high-top work shoes.

D. plastic “bump caps.”

Answer 42

D

Plastic “bump caps” do not provide adequate protection; use high-quality headgear. Good protective gear at the scene of a collision includes fire-resistant trousers or turnout pants; steel-toed, high-top work shoes; and firefighter or leather gloves.

Question 43

Choose:

During extrication, an aluminized rescue blanket may be used to:

A. maintain the rescuer’s body heat.

B. smother fire in the engine compartment.

C. protect the patient from poor weather and flying particles.

D. none of these.

Answer 43

C

An aluminized rescue blanket may be used to protect your patient from poor weather and flying particles.
The rescuer should be properly attired for cold weather conditions.

Question 44

Choose:

The police have not arrived at the scene of a collision, and you have positioned your ambulance to temporarily block the traffic until flares have been set up.

When using flares, the EMT should:

A. watch for spilled fuel or other combustibles before igniting.

B. throw them out of the moving vehicle to save time.

C. use them as a traffic wand to divert traffic.

D. always walk with oncoming traffic while positioning them.

Answer 44

A

The EMT should watch for spilled fuel or other combustibles before igniting flares. Do not throw flares out of the moving vehicle or use them as a traffic wand. Never turn your back on traffic; walk toward the traffic so that you can observe oncoming vehicles.

Question 45

Choose:

You are just arriving on the scene of a car that crashed into a utility pole. The pole is broken in half, and the wires are down in the street.

When there is an electrical hazard, the safe zone:

A. should be established as soon as the power company arrives.

B. does not exist because of the numerous dangers of an electrical hazard.

C. should be far enough away to ensure that an arcing wire does not cause injury.

D. is located at least 10 feet from the ground gradient.

Answer 45

C

When there is an electrical hazard, such as a broken utility pole, the safe zone should be far enough away to ensure that an arcing wire does not cause injury. If you feel a ground gradient, you are already too close to the electricity.

Question 46

Choose:

As of 2009, federal highway standards have required that all emergency responders:

A. take the incident command course.

B. comply with NFPA 1500.

C. wear ANSI Class 2 safety vests when working in highway operations.

D. don PPE prior to touching bleeding patients.

Answer 46

C

Question 47

Choose:

If a vehicle has been involved in a front-end collision and you notice that the airbag did not deploy, for safety of the crew working around the airbag, you should consider:

A. immediately putting the vehicle in neutral with the parking brake on.

B. telling all the rescuers ro stay out of the vehicle until the airbag explodes.

C. disconnecting the power and checking the airbag deactivation time on the Internet.

D. chaining down the steering column as soon as possible.

Answer 47

C

If a vehicle was involved in a front-end collision and the airbag has not deployed and you need to be working around it, consider disconnecting the power and checking the deactivation time chart at www.nhtsa.dot.gov on your smart phone.

Question 48

Fill in the blank:

In wet weather, a phenomenon known as [BLANK] may provide the first clue that a wire is down.

Answer 48

In wet weather, a phenomenon known as a ground gradient may provide the first clue that a wire is clown.

Question 49

Choose:

You are on the scene of a collision between a car and a utility pole. The pole is literally split in two and hanging by the wires. As you approach the vehicle, you feel a tingling sensation in your legs and lower torso.

Which action should you take?

A. Turn 180 degrees and shuffle with both feet together to safety.

B. Turn 90 degrees and walk as quickly as possible to safety.

C. Ask your partner for his hand and have him pull you to safety.

D. Turn 180 degrees and crawl to safety.

Answer 49

A

If you feel a tingling sensation in your legs and lower torso, you should turn 180 degrees and shuffle with
both feet together (or hop on one foot) to safety. Either technique helps to prevent your body from completing
a circuit with the energized ground, which can cause electrocution. Hopping is much more dangerous because of the likelihood of falling, which may complete the circuit.

Question 50

Choose:

If there is a fire in the car’s engine compartment and people are trapped in the vehicle, you should do all of the following except:

A. quickly and carefully removing the patients.

B. ensuring that the fire department has been called.

C. donning protective gear and using your fire extinguisher.

D. applying a short spine board to the driver right away.

Answer 50

D

Do not apply a short spine board to the driver; this is the time for a quick removal. If there is a fire in the car’s engine compartment and people are trapped within the vehicle, you should quickly and carefully remove the patient, ensure that the fire department has been called, don protective gear, and use your fire extinguisher.

Question 51

Choose:

When a vehicle’s hood is closed and there is an engine fire, you should do all of the following except:

A. using emergency moves to remove occupants.

B. letting the fire department extinguish the fire.

C. fully opening the hood to extinguish the fire.

D. letting the fire burn under the closed hood.

Answer 51

C

When a vehicle’s hood is closed and there is an engine fire, you should not attempt to open the hood; this will fuel the fire with oxygen, and the fire will flare up.

Question 52

Choose:

When a vehicle rolls off the roadway into a field of dried grass, a fire may be caused by the:

A. catalytic converter.

B. leaking radiator fluid.

C. ground gradient.

D. airbag deployment.

Answer 52

A

When a vehicle rolls off the roadway into dried grass in a field, a fire may occur from the catalytic converter. The catalytic converter is under the car, and its temperature can reach over 1,200°F.

Question 53

Choose:

You are on the scene of a two-car, high-speed, head-on collision. The scene is safe, and the traffic has been diverted by the police. Once the vehicle to which you were assigned is stabilized and an entry point has been gained, you should immediately do all of the following except:

A. begin the primary assessment.

B. crawl inside the vehicle.

C. provide manual cervical stabilization.

D. pull the patient out of the access hole.

Answer 53

D

Once a vehicle has been stabilized and an entry point has been gained, do not pull a patient out of an access hole before spinal immobilization.

Question 54

Choose:

You are on the scene of a two-car, high-speed, head-on collision. The scene is safe, and the traffic has been diverted by the police. On evaluation of the vehicle and once you have gained access to the second automobile, you find an unconscious 28-year-old female who is in a sitting position behind the wheel with both her legs pinned.

Which is the best approach to disentanglement of this patient?

A. Displace the doors, cut the roof, and then displace the dash.

B. Pull the dash, cut the doors, and then push the seat.

C. Cut the roof, displace the doors, and then displace the dash.

D. Cut the roof, displace the dash, and then displace the doors.

Answer 54

C

If an unconscious patient is in a sitting position
behind the wheel with legs pinned by the vehicle, the best approach to disentanglement is to cut the roof, displace the doors, and then displace the dash. This allows for plenty of room to work and for rapid vertical extrication if the patient’s condition deteriorates.

Question 55

Choose:

You are on the scene of a two-car, high-speed, head-on collision The scene is safe, and the traffic has been diverted by the police. The decision is made to remove the roof of one of the vehicles from the crash.

Which of the following is not a reason for removing the roof to access a patient?

A. It makes the entire interior of the vehicle accessible.

B. It creates a large exit through which to remove a patient.

C. It provides fresh air and helps cool off the patient.

D. It helps to stabilize the vehicle quickly.

Answer 55

D

not fast nor stabilizing

Question 56

Choose:

You have received a call of a motor vehicle collision in a rural area. The caller states that one of the vehicles has struck a trailer being pulled by a pickup truck and is emitting a cloud. You notify dispatch that you are responding and begin driving toward the location.

What should be your next course of action?

A. Continue to the incident location, but stop when you can see the cloud. From there you can decide the next appropriate course of action.

B. Continue to the incident, no additional resources will likely be needed.

C. Continue to the incident while asking the dispatcher to determine more information about the cloud.

D. Request additional resources for a potential hazardous material release, respond to a safe location away from the incident and wait for additional resources.

Answer 56

D

In general, clouds emitting from motor vehicle collisions are not a normal occurrence and are probably related to some form of hazardous material release. In this situation, the combination of a vapor cloud in a predominately rural area should lead responders to suspect a ruptured vessel. Immediately requesting additional resources and responding to a safe location upwind should be your next course of action.

REMEMBER, if you can hold your thumb up at arms length and see any portion of the scene around your thumb, YOU ARE TO CLOSE!