Chapter 40: Incident Management

Question 1

Describe the purpose of the National Incident
Management System (NIMS) and its major
components. (pp 1486–1487)

Question 2

Describe the purpose of the incident command
system (ICS) and its organizational structure.
(pp 1487–1491)

Question 3

Explain the role of EMS response within the
ICS. (pp 1491–1493)

Question 4

Describe how the ICS assists EMS in ensuring
both personal safety and the safety of
bystanders, health care professionals, and
patients during an emergency. (pp 1492–1493)

Question 5

Describe the role of the EMT in establishing
command under the ICS. (p 1493)

Question 6

Describe the purpose of the medical branch
of the ICS and its organizational structure.
(pp 1493–1495)

Question 7

Describe the specific conditions that would
define a situation as a mass-casualty incident
(MCI); include examples. (pp 1496–1497)

Question 8

Describe what occurs during primary and
secondary triage, how the four triage categories
are assigned to patients on the scene, and how
destination decisions regarding triaged patients
are made. (pp 1497–1499)

Question 9

Explain how to perform the START and
JumpSTART triage methods. (pp 1499–1501)

Question 10

Contrast a disaster with a mass-casualty
incident. (p 1502)

Question 11

Describe the role of EMTs during a disaster
operation. (p 1502)

Question 12

Recognize the entry-level training or experience
requirements identified by the HAZWOPER
regulation for EMTs to respond to a hazmat
incident. (p 1503)

Question 13

Define hazardous material; include the
classification system used by the National Fire
Protection Association (NFPA). (pp 1503, 1516)

Question 14

Discuss the specific reference materials that
EMTs use to recognize a hazmat incident.
(pp 1510–1513)

Question 15

Explain the role of EMTs during a hazmat
incident both before and after the hazmat team
arrives; include the precautions required to
ensure the safety of civilians and responders.
(pp 1514–1515)

Question 16

Describe how the three control zones
are established at a hazmat incident, the
characteristics of each zone, and the
responders who work within each one.
(pp 1514–1515

Question 17

Describe the four levels of personal protective
equipment (PPE) required at a hazmat incident
to protect responders from injury by or
contamination from a particular substance.
(pp 1516–1517)

Question 18

Explain patient care at a hazmat incident;
include the special requirements that are
necessary for those patients who require
immediate treatment and transport prior to full
decontamination. (pp 1517–1519)

Question 19

What does IDME mnemonic stand for?

Answer 19

Triage categories:

• Immediate (red)
  Your first priority
  These patients need immediate care and transport.
  They usually have problems with the ABCs, head trauma, or signs and symptoms of shock.
• Delayed (yellow)
  The second priority
  The patients need treatment and transport, but it can be delayed.
  Patients usually have multiple injuries to bones or joints, including back injuries with or without spinal cord injury.
• Minor or Minimal (green; hold)
  Patients may require only minimal treatment.
  If patients have any apparent injuries, they are usually soft-tissue injuries such as contusions, abrasions, and lacerations.
• Expectant (black; likely to die or dead)
  This category includes patients who are in cardiac arrest or who have an open head injury.
  It may also include patients in respiratory arrest.
  Patients receive treatment and transport only after patients in the other three categories have received care.

Question 20

What is START triage and what are the steps?

Answer 20

The first step is to call out to patients at the disaster site and direct them to an easily identifiable landmark.

The injured people in this group are considered minimal-priority (green), or third-priority, patients.

The second step is directed toward nonwalking patients.

Move to the first nonambulatory patient and assess the respiratory status.
If the patient is not breathing, open the airway by using a simple manual maneuver.
    A patient who still does not begin to breathe is triaged as expectant (black).
If the patient begins to breathe, tag him or her as immediate (red), place the patient in the recovery position, and move on to the next patient.
If the patient is breathing, make a quick estimation of the respiratory rate.
    A patient who is breathing faster than 30 breaths/min or slower than 10 breaths/min is triaged as an immediate priority (red).

The next step is to assess hemodynamic status by checking for bilateral radial pulses.

An absent radial pulse implies the patient is hypotensive; tag him or her as an immediate priority.

The final assessment focuses on the patient’s neurologic status.

A patient who is unconscious or cannot follow simple commands is an immediate-priority patient.
A patient who complies with a simple command should be triaged in the delayed category (yellow).