Chapter 40 - Incident Management

Question 1

The JumpSTART triage system is intended to be used for children younger than _____ years or who appear to weigh less than _____.

Select one:

A. 8; 100 lb
B. 5; 50 lb

C. 6; 70 lb

D. 7; 90 lb

Answer 1

A. 8; 100 lb

Question 2

In preparing for a disaster, EMS systems should have enough supplies for at least a ______ period of self-sufficiency.

Select one:

A. 96-hour

B. 48-hour

C. 72-hour

D. 24-hour

Answer 2

C. 72-hour

Question 3

The FIRST step in the START triage system is to:

Select one:

A. focus on the patients who are unconscious

B. get a quick head count of all the patients involved

C. scan the area for patients with severe bleeding

D. move all walking patients to a designated area

Answer 3

D. move all walking patients to a designated area

Question 4

You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients should be assigned the highest (red) triage category?

Select one:

A. A 29-year-old male with bilaterally closed femur deformities

B. A 50-year-old male with an open head injury and no pulse

C. A 49-year-old female with diabetes and difficulty breathing

D. A 36-year-old female with back pain and numb extremities

Answer 4

C. A 49-year-old female with diabetes and difficulty breathing

Question 5

The function of the National Incident Management System (NIMS) is to:

Select one:

A. prepare for the potential of a nuclear attack against the United States

B. prepare for, prevent, respond to, and recover from domestic incidents

C. facilitate a standard method of incident command for natural disasters

D. educate city and county governments regarding foreign terrorist attacks

Answer 5

B. prepare for, prevent, respond to, and recover from domestic incidents

Question 6

The term used when individual units or different organizations make independent, and often inefficient, decisions regarding an incident is called:

Select one:

A. logistical chaos

B. undermining

C. single command

D. freelancing

Answer 6

D. freelancing

Question 7

Upon arriving at the scene of a possible hazardous materials (HazMat) incident involving several patients, you should:

Select one:

A. carefully assess the situation

B. rope off the entire perimeter

C. divert traffic away from the scene

D. retrieve all critical patients

Answer 7

A. carefully assess the situation

Question 8

As a triage supervisor, you:

Select one:

A. should communicate with area hospitals regarding their capabilities

B. are responsible for providing initial treatment to all patients

C. must not begin treatment until all patients have been triaged

D. must prepare patients for transport before they leave the triage area

Answer 8

C. must not begin treatment until all patients have been triaged

Question 9

While triaging patients at the scene of a building collapse, you encounter a young child who is conscious, alert, and breathing; has bilateral radial pulses; and has a severely angulated leg, which is not bleeding. According to the JumpSTART triage system, you should:

Select one:

A. apply high-flow oxygen, obtain baseline vital signs, and continue triaging

B. evacuate him to a designated area and assign him a minimal (green) category

C. quickly bind his legs together to stabilize the fracture, and continue triaging

D. assign him a delayed (yellow) category and continue triaging the other patients

Answer 9

D. assign him a delayed (yellow) category and continue triaging the other patients

Question 10

According to the START triage system, what should you do if a patient is found to have a respiratory rate of 24 breaths/min?

Select one:

A. Assess for bilateral radial pulses

B. Administer high-flow oxygen

C. Assess his or her neurologic status

D. Triage the patient as delayed

Answer 10

A. assess for bilateral radial pulses

Question 11

What is the purpose of the incident command system (ICS)?

Select one:

B. Ensuring responder and public safety

B. Achieving incident management goals

C. Ensuring the efficient use of resources

D. All of the above.

Answer 11

D. all of the above

Question 12

Upon arriving at a scene in which the incident command system has been activated, you should expect to:

Select one:

A. be passed from sector to sector, as needed, in between assignments.

B. report directly to the incident commander in between assignments.

C. be assigned a specific responsibility for the duration of the incident.

D. be given general directions and allowed to function independently.

Answer 12

A. be passed from sector to sector, as needed, in between assignments.

Question 13

When EMS responds to a disaster, as part of their response within the ICS, EMS would start with a scene size-up. What is the next step for the first-responding units?

Select one:

A. Communicating with additional units

B. Establishing command

C. Caring for any injuries

D. Stabilizing the incident

Answer 13

B. establishing command

Question 14

Which of the following statements BEST describes a mass-casualty incident?

Select one:

A. At least half of the patients are dead.

B. Either a bus or an airplane has crashed.

C. You have more than two critical patients.

D. The patient count exhausts your resources.

Answer 14

D. The patient count exhausts your resources.

Question 15

Which of the following patients would have the HIGHEST treatment priority at the scene of a mass-casualty incident?

Select one:

A. 24-year-old man who is unconscious, has snoring respirations, and severe burns

B. 32-year-old woman who is pulseless and apneic with an abdominal evisceration

C. 29-year-old woman who is in full cardiac arrest with massive open chest trauma

D. 32-year-old man with an open head injury, exposed brain matter, and no carotid pulse

Answer 15

A. 24-year-old man who is unconscious, has snoring respirations, and severe burns

Question 16

How does a disaster differ from a mass-casualty incident?

Select one:

A. Disasters may not involve personal injuries.

B. In a disaster, EMS may be on the scene for days or weeks.

C. Only an elected official can declare a disaster.

D. All of the above.

Answer 16

D. All of the above

Question 17

A large tanker truck has overturned on a highway. When you arrive, you see a clear liquid leaking from the rear of the tanker. The driver, who appears to be unconscious, is still in the vehicle and is bleeding heavily from the face. You should:

Select one:

A. immediately notify law enforcement for traffic control.

B. fully assess the situation and request the appropriate assistance.

C. put on gloves, a gown, and a mask and quickly remove the driver.

D. go to the rear of the tanker and determine what type of fluid is leaking.

Answer 17

B. fully assess the situation and request appropriate assistance.

Question 18

Which of the following situations MOST likely involves a hazardous material?

Select one:

A. Milk truck that overturned and is leaking fluid

B. Tractor-trailer rig that is emitting a visible cloud

C. Moving van that collided head-on with a small car

D. Pickup truck from the gas company that struck a tree

Answer 18

B. Tractor-trailer rig that is emitting a visible cloud

Question 19

When dealing with a hazardous materials incident, where should you set up your decontamination area?

Select one:

A. Inside the hazard zone

B. Inside the treatment area

C. Between the hazard zone and treatment area

D. Between the treatment and transportation zone

Answer 19

C. Between the hazard zone and treatment area

Question 20

Which toxicity level would you assign a hazardous material spill that could cause a person temporary damage or residual injury unless prompt medical treatment is given?

Select one:

A. level 1

B. level 2

C. level 3

D. level 4

Answer 20

B. level 2

Question 21

Which of the following statements regarding transport of patients from a multiple-casualty incident or disaster site is correct?

A. Delayed-priority patients should be transported five at a time.

B. Immediate-priority patients should be transported two at a time.

C. Walking wounded patients should be taken to the closest hospitals.

D. Patients who are in cardiac arrest should clearly be transported first.

Answer 21

B. Immediate-priority patients should be transported two at a time.

Question 22

As the first-arriving senior EMT at the scene of an incident, you should perform a scene size-up and then:

A. establish command.

B. begin the triage process.

C. call for additional resources.

D. quickly identify the walking wounded.

Answer 22

A. establish command.

Question 23

Which of the following is NOT a common role of the EMT at the scene of a HazMat incident?

A. Rehabilitation

B. Decontamination

C. Transportation

D. Triage and treatment

Answer 23

B. Decontamination

Question 24

The process of removing or neutralizing and properly disposing of a hazardous material is called:

A. neutralization.

B. decontamination.

C. antidotal treatment.

D. chemical containment.

Answer 24

B. decontamination.

Question 25

During a motor vehicle collision involving multiple patients, the incident commander would MOST likely:

A. delegate all of the command functions to the appropriate personnel.
B. maintain responsibility for all of the command functions.
C. designate a safety officer, but retain other command functions.
D. relinquish command when a senior EMS provider arrives at the scene.

Answer 25

C. designate a safety officer, but retain other command functions.

Question 26

Interoperability, an important feature of the NIMS, refers to the ability of:

A. EMS systems and fire departments in the same jurisdiction to effectively work as a team.
B. agencies of different types or from different jurisdictions to communicate with each other.
C. the federal government to intervene during any large- or small-scale incident involving terrorism.
D. county and state law enforcement agencies to acquire information and pass it along to EMS personnel.

Answer 26

B. agencies of different types or from different jurisdictions to communicate with each other.

Question 27

A 49-year-old man has been removed from his overturned tanker, which was carrying a hazardous material. The tank ruptured and he was exposed to the material. When rescue personnel bring him to the decontamination area, they note that he is unconscious and has slow, shallow breathing. They should:

A. decontaminate the patient as they would any other patient and then move him to the area where EMTs are waiting.
B. defer the decontamination procedure and bring the patient directly to awaiting EMS personnel for immediate treatment.
C. request that EMS personnel don standard precautions, enter the warm zone, and begin immediate treatment of the patient.
D. cut away all of the patient’s clothing and do a rapid rinse to remove as much of the contaminating matter as they can.

Answer 27

D. cut away all of the patient’s clothing and do a rapid rinse to remove as much of the contaminating matter as they can.

Question 28

According to the JumpSTART triage system, infants or children not developed enough to walk or follow commands, including children with special needs:

A. are treated immediately in the primary triage area and then transported.
B. are the first to be transported, regardless of the severity of their injuries.
C. are initially triaged on the basis of whether or not they have distal pulses.
D. should be taken to the treatment area for immediate secondary triage.

Answer 28

D. should be taken to the treatment area for immediate secondary triage.

Question 29

The reference used as a base for your initial actions at a HazMat incident is:

A. The bill of lading

B. Your local EMS protocols

C. The material safety data sheet (MSDS)

D. The emergency response guidebook

Answer 29

D. The emergency response guidebook

Question 30

You and your partner arrive at the scene where a truck has crashed into a small building, injuring eight people. You immediately request additional ambulances and begin the triage process. The first patient that you triage is a young female who is unconscious and apneic. She has an open head injury and her pulse is weak and thready. You should:

A. assign her a low priority and continue triaging.
B. assess the severity of her open head injury.
C. begin ventilating her with a bag-mask device.
D. place a red tag on her and continue triaging.

Answer 30

A. assign her a low priority and continue triaging.

Question 31

General principles for approaching a potential HazMat incident include:

A. parking the ambulance in a location that is upwind and downhill.

B. taking standard precautions before entering any HazMat scene.

C. asking for wind direction from dispatch and entering downwind.

D. maintaining a safe distance and viewing the scene with binoculars.

Answer 31

D. maintaining a safe distance and viewing the scene with binoculars.

Question 32

According to the START triage system, what should you do if you encounter an unresponsive patient who is not breathing?

A. Assign the patient in the “immediate” category.
B. Triage the patient as “expectant” and move on.
C. Ventilate the patient for 2 minutes and reassess.
D. Open the airway and reassess breathing status.

Answer 32

D. Open the airway and reassess breathing status.

Question 33

A carboy is a container that would MOST likely be used to store and transport:

A. corrosives.
B. flammable liquids.
C. combustible materials.
D. explosives.

Answer 33

A. corrosives.

Question 34

The purpose of the incident command system (ICS) is to:

A. quickly and efficiently respond to natural disasters and terrorist incidents, regardless of the complexity of the incident.
B. protect the public from the effects of large- and small-scale disasters and to minimize the financial impact from such incidents.
C. ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources.
D. reduce overall mortality and morbidity from large-scale mass-casualty incidents and to restore key infrastructure.

Answer 34

C. ensure responder and public safety, achieve incident management goals, and ensure the effective use of resources.

Question 35

A Level 4 hazardous material:

A. requires specialized gear designed for protection against that particular hazard.
B. is mildly toxic but still requires the use of a self-contained breathing apparatus (SCBA).
C. requires protective gear to ensure that no part of the skin’s surface is exposed.
D. causes temporary damage or injury unless prompt medical care is provided.

Answer 35

A. requires specialized gear designed for protection against that particular hazard.

Question 36

Which of the following is NOT a responsibility of the treatment supervisor?

A. patient packaging
B. secondary triage
C. communication with the medical branch director
D. primary assessment

Answer 36

D. primary assessment

Question 37

Injuries or conditions that would be classified as first priority (red tag; immediate) include all of the following, EXCEPT:

A. severe medical problems.

B. fractures of multiple long bones.

C. any airway or breathing difficulty.

D. uncontrolled or severe hemorrhage.

Answer 37

​B. fractures of multiple long bones.

Question 38

The MOST appropriate location to park your ambulance at a HazMat incident is:

A. downwind at least 200′ from the scene.
B. uphill at least 25′ from the incident site.
C. upwind at least 100′ from the incident.
D. downhill at least 100′ from the incident.

Answer 38

C. upwind at least 100′ from the incident.

Question 39

You have a critically injured patient in the back of your ambulance, ready to be transported. There are other injured patients at the scene and it will be approximately 10 minutes before other ambulances will arrive. Law enforcement personnel are at the scene. You should:

A. assign the least injured patient the task of caring for the others.
B. remain at the scene until at least one other ambulance arrives.
C. direct a police officer to monitor the patients as you transport.
D. transport the critically injured patient to a trauma center.

Answer 39

B. remain at the scene until at least one other ambulance arrives

Question 40

You and your partner are the first to arrive at the scene of a motor vehicle accident. As you approach the scene, you can see multiple patients, some walking and others who are still in their vehicles. You should:

A. declare a mass-casualty incident and request additional resources.
B. immediately move all ambulatory patients to a designated area.
C. establish an incident command post until you are relieved of your duties.
D. begin rapidly triaging all patients before requesting additional help.

Answer 40

A. declare a mass-casualty incident and request additional resources.

Question 41

When victims involved in a mass-casualty incident are moved to the treatment area:

A. definitive care is provided and preparations for transport will be made.
B. secondary triage is performed and the appropriate treatment is rendered.
C. they will be rapidly assessed and prioritized according to their injuries.
D. all uninjured patients are placed in a holding area and closely observed.

Answer 41

B. secondary triage is performed and the appropriate treatment is rendered.

Question 42

According to the JumpSTART triage system, if a pediatric patient is not breathing, you should:

A. Look for posturing

B. Assess for a distal pulse

C. Assess neurologic status

D. assign an immediate category

Answer 42

B. Assess for a distal pulse

Question 43

Your work uniform is an example of what level of protection?

A. Level A protection

B. Level B protection

C. Level C protection

D. Level D protection

Answer 43

D. Level D protection

Question 44

The _______ supervisor is responsible for notifying area hospitals and determining their availability and capabilities.

A. Treatment

B. Medical

C. Triage

D. Transportation

Answer 44

D. Transportation

Question 45

During a HazMat incident, you are working in the treatment area. As patients are removed from the danger zone, you should:

A. remain where you are and have the patients brought to you.
B. quickly decontaminate the patients and begin assessing them.
C. perform a rapid assessment and then have them decontaminated.
D. retrieve patients from the decontamination area and begin treatment.

Answer 45

A. remain where you are and have the patients brought to you.

Question 46

Level _____ hazardous materials would cause irritation on contact but only mild residual injury, even
without treatment.

A. 0
B. 1
C. 2
D. 3

Answer 46

B. 1

Question 47

Which of the following questions is of LEAST pertinence when the EMT is determining whether or not to declare a mass-casualty incident and activate the ICS?

A. What will happen if there are more than two patients that require emergency care?
B. How long will it take for additional resources to arrive at the scene once requested?
C. How many paramedics are able to respond to the scene and provide advanced care?
D. How many seriously injured patients can be effectively cared for in my ambulance?

Answer 47

C. How many paramedics are able to respond to the scene and provide advanced care?

Question 48

A patient who has experienced a back injury, with or without spinal cord damage, would be triaged with a __________ tag during a mass-casualty incident.

A. red
B. green
C. black
D. yellow

Answer 48

D. yellow

Question 49

A critical function of the safety officer is to:

A. determine the most efficient approach to extricate a victim.
B. stop an emergency operation whenever a rescuer is in danger.
C. monitor emergency responders for signs of stress and anxiety.
D. brief responders during the demobilization phase of an incident.

Answer 49

B. stop an emergency operation whenever a rescuer is in danger.

Question 50

Command functions under the ICS include all of the following, EXCEPT:

A. triage officer.
B. safety officer.
C. liaison officer.
D. public information officer

Answer 50

A. triage officer.

Question 51

Which of your senses can be safely used to identify a HazMat incident?

A. sight and sound
B. sound and smell
C. smell and sight
D. sight and touch

Answer 51

A. sight and sound

Question 52

After primary triage, the triage supervisor should communicate all of the following information to the
medical branch officer, EXCEPT:

A. the total number of patients that have been triaged.
B. the recommended transport destination for each patient.
C. recommendations for movement to the treatment area.
D. the number of patients that are in each triage category.

Answer 52

B. the recommended transport destination for each patient.

Question 53

Unlike a mass-casualty incident, a natural disaster:

A. often requires personnel to remain on scene for several days.
B. exists when there are more than 100 critically injured patients.
C. is typically short-lived and does not require as much manpower.
D. usually does not require the ICS process.

Answer 53

A. often requires personnel to remain on scene for several days.

Question 54

Following proper decontamination, a 30-year-old male is brought to you. He is semiconscious and has rapid, shallow respirations. A quick visual assessment reveals no obvious bleeding. You should:

A. begin some form of positive-pressure ventilation.
B. ask a fire fighter what the patient was exposed to.
C. administer 100% oxygen via a nonrebreathing mask.
D. perform a rapid assessment to locate critical injuries.

Answer 54

A. begin some form of positive-pressure ventilation.

Question 55

Which of the following is probably NOT a multiple-casualty incident?

A. A loss of power to a hospital or nursing home with ventilator-dependent patients

B. A motor vehicle crash with two critically injured patients and two ambulances

C. An apartment fire with one patient and the possibility of others trapped in the building

D. Rollover crash of a school bus with eight children who have entries of varying severity

Answer 55

B. A motor vehicle crash with two critically injured patients and two ambulances

Question 56

A supervisor who has more than seven people reporting to him or her:

A. is more beneficial to the overall effort than a supervisor with fewer personnel because his or her team can accomplish more tasks.
B. should regularly report to the incident commander (IC) to inform him or her of the functions that his or her team is performing.
C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person.
D. should assign a specific task to each person reporting to him or her and regularly follow up to ensure that the tasks were carried out.

Answer 56

C. has exceeded an effective span of control and should divide tasks and delegate the supervision of some tasks to another person.

Question 57

The development of an incident action plan is the responsibility of the:

A. planning section.
B. logistics section.
C. operations section.
D. finance section.

Answer 57

A. planning section.

Question 58

Which of the following statements regarding communications at a disaster or mass-casualty incident is correct?

A. Each command group should utilize a separate radio frequency.
B. Ten-codes or signals should be used when communicating via radio.
C. When possible, all communication should occur via two-way radio.
D. If possible, use face-to-face communications to minimize radio traffic.

Answer 58

D. If possible, use face-to-face communications to minimize radio traffic.

Question 59

According to the JumpSTART triage system, if a pediatric patient is not breathing, you should:

A. Immediately check for pulse

B. Give 5 rescue breaths and reassess

C. Triage him or her as expectant

D. Open the airway and reassess breathing

Answer 59

A. Immediately check for pulse

Question 60

Which of the following statements regarding storage containers and hazardous materials is correct?

A. the emergency response guide tells you the type and color container used to store hazardous materials

B. Red phosphorus from a drug laboratory found in the blue container that is clearly labeled

C. Steel utility drums are used to contain acid spaces and other corrosive chemicals and substances

D. In most cases, there is no correlation between the color of the container and the possible contents

Answer 60

D. In most cases, there is no correlation between the color of the container and the possible contents

Question 61

Historically, the weak point at most major incidents has been:

A. Communications

B. Lack of personnel

C. Accountability

D. Incident briefing

Answer 61

A. Communications

Question 62

A tour bus has overturned, resulting in numerous patients. When you arrive, you are immediately assigned to assist in the triage process. Patient 1 is a middle-aged male with respiratory distress, chest pain, and a closed deformity to his right forearm. Patient 2 is a young female who is conscious and alert, but has bilateral femur fractures and numerous abrasions to her arms and face. Patient 3 is an older woman who complains of abdominal pain and has a history of cardiovascular disease. Patient 4 is unresponsive, is not breathing, has a weak carotid pulse, and has a grossly deformed skull. What triage categories should you assign to these patients?

A. Patient 1, delayed (yellow); Patient 2, delayed (yellow); Patient 3, minimal (green); Patient 4, immediate (red)

B. Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black)

C. Patient 1, delayed (yellow); Patient 2, immediate (red); Patient 3, delayed (yellow); Patient 4, immediate (red)

D. Patient 1, immediate (red); Patient 2, minimal (green); Patient 3, delayed (yellow); Patient 4, expectant (black)

Answer 62

B. Patient 1, immediate (red); Patient 2, delayed (yellow); Patient 3, immediate (red); Patient 4, expectant (black)

Question 63

After recognizing that an incident involves a hazardous material, you should contact the hazardous materials team and then:

A. Identify the chemical using the emergency response guidebook

B. Not allow anyone within 25 feet to 50 feet of the incident scene

C. Don standard equipment before gaining access to the patient’s

D. Take measures to ensure the safety of yourself and others

Answer 63

D. Take measures to ensure the safety of yourself and others

Question 64

When a rehabilitation area is established at the scene of a mass-casualty incident, it should:

A. Be in a location that prevents visualizing of the scene itself

B. Provide rehabilitative services to both responders and patients

C. Be mandated that responders participate in the diffusing session

D. Be staffed by the treatment supervisor and at least one physician

Answer 64

A. Be in a location that prevents visualizing of the scene itself

Question 65

A patient in respiratory arrest at the scene of a mass-casualty incident would typically be classified as a fourth priority (black tag; expectant) patient, unless:

A. he or she has external signs of severe thoracic trauma.
B. there are enough resources to provide care for him or her.
C. he or she has signs of an injury to the cervical spine.
D. there are at least three other patients in respiratory arrest.

Answer 65

B. there are enough resources to provide care for him or her.

Question 66

Which of the following MOST accurately describes a mass-casualty incident?

A. an incident that greatly taxes or depletes a system’s available resources
B. an incident that involves more than five critically injured or ill patients
C. an incident in which at least half of the patients are critically injured
D. an incident where patients have been exposed to hazardous materials

Answer 66

A. an incident that greatly taxes or depletes a system’s available resources

Question 67

Which of the following chemicals requires identification with a placard, regardless of how many pounds the shipment weighs?

A. flammable liquids
B. water-reactive solids
C. air-reactive solids
D. nonflammable gases

Answer 67

B. water-reactive solids

Question 68

Placards and labels on a storage container are intended to:

A. give a general idea of the hazard inside that particular container

B. Advise responders of the appropriate neutralizing measures

C. Provide specific information about the chemical being carried

D. Broadly classify chemicals as being explosive or nonexplosive

Answer 68

A. give a general idea of the hazard inside that particular container

Question 69

You are triaging four patients who were involved in a head-on motor vehicle crash. Which of the following patients should be assigned the highest (red) triage category?

A. A 49-year-old female with diabetes and difficulty breathing

B. A 29-year-old male with bilaterally closed femur deformities

C. A 50-year-old male with an open head injury and no pulse

D. A 36-year-old female with back pain and numb extremities

Answer 69

A. A 49-year-old female with diabetes and difficulty breathing

Question 70

You are approaching an overturned tanker truck to assess the driver, who appears to be unresponsive. As you get closer to the vehicle, you note the smell of noxious fumes and find that you are in the midst of a vapor cloud. What should you do?

A. Exit the area immediately and gather information for the HazMat team

B. Cover your face with your shirt and quickly extricate the interim driver

C. Remain where you are and perform a visual assessment of the patient

D. Realize that you are in danger and prevent others from entering

Answer 70

A. Exit the area immediately and gather information for the HazMat team

Question 71

Which of the following duties or responsibilities does NOT fall within the realm of the medical branch of the incident command system?

A. Extrication

B. Triage

C. Treatment

D. Transport

Answer 71

A. Extrication