Exam 5 Flashcards
Whatistheminimumnumberofsafetypinsforeachtriangularbandageona
basiclifesupportambulance?
Three
Fortonsillarandflexiblesuctioncatheters,
whattwosizerangesshouldbe
equippedonabasiclifesupportambulance?
6F−10F;12F−16F
Whichreferenceisrecommendedforeverybasiclifesupportambulance?
Hazardous Material Guide
Whatcolorshouldbiohazardbagsbe?
Red
Alights-and sirenresponse
toanemergencycallisappropriate
when: A. lossoflifeorlimbispossible. B. nosafetyconcernsarevisible. C. trafficisheavy. D. morethanonevehicleresponds.
A
Moststatesallowanemergencyvehicleoperatortodoallofthe
followingEXCEPT: A. passaschoolbuswhoselightsareflashing. B. passothervehiclesinano-passingzone. C. proceedpastredlights. D. exceedthespeedlimits.
A
Toalertavehicleimmediatelyinfrontoftheambulancetoclear
theway,thebestthingadrivercanusuallydoisto:
A. turnonthesiren.
B. usethepublicaddresssystem.
C. usethehorn.
D. usetheflashers.
C
Whichlightsshouldnotbeusedasemergencylights?
A. Strobes
B. Rotatinglights
C. Four-wayflashers
C
Thesafestbackingupoftheambulanceisperformedwhen:
A. backupalarmsareoperational.
B. backuplightsarelit.
C. thedriver’smirrorsareproperlyadjusted.
D. thedriverhasaspotter.
D
Acommondangerwhenanambulancefollowsanescortvehicleis:
A. losingcontactwiththeescort.
B. creatingadditionalstressforthepatient.
C. confusionfortheemergencydispatchers.
D. followingtheescorttooclosely.
D
Thefirstemergencyvehicleonthesceneatacarwreckshould
park:
A. offtheroad.
B. onthesideofthecrashawayfromtraffic.
C. inawaythatblocksthewreckage.
D. ascloseaspossibletothewreckage.
C
Thefourstepsoftransferringapatienttoanambulanceinclude
selectingtheproperpatient-carryingdevice,packagingthe
patient,movingthepatienttotheambulance,
and:
A. informingdispatch.
B. contactingthehospital.
C. loadingthepatientintotheambulance.
D. performinganongoingassessment.
C
Thefourstepsoftransferringapatienttoan
ambulanceinclude
selectingtheproperpatient-carryingdevice,packagingthe
patient,movingthepatienttotheambulance,
and loadingthepatientintotheambulance.
Ifthepatientislikelytodevelopcardiacarrest,positionashort
spineboardorCPRboardunderneaththe
patient’smattress:
A. priortoinitiatingtransport.
B. ifthepatient’svitalsignsdeteriorate.
C. aftertransporthasbegun.
D. atthefirstsignofarrest.
A
Atthereceivingfacility,failuretotransfercareofthepatientto
hospitalstaffcouldresultinchargesof:
Accosting
Anambulancerunisnotoveruntil:
A. careofthepatienthasbeentransferred.
B. thePCRisfiled.
C. thevehicleisreadyforthenextresponse.
D. thevehiclehasreturnedtobase.
C
Whentheambulanceisreadytoreturnto quarters,thefirststepshouldbe to: A. informthedispatcher. B. completethelogentry. C. refuelthevehicle. D. checkthelightsandsiren.
A
Whencleaningambulancesurfacesthatwereincontactwith bloodorbodyfluids,use: A. ahigh-pressurehose. B. aninfraredlamp. C. soapandwater. D. anEPA-approvedgermicide.
D
Thefirststepofcleaninganyequipmentthattouchedthepatientisto: A. hoseitdown. B. sprayitwithagermicide. C. immerseitinsoapandwater. D. brushitclean.
D
Anoperationalreasontorequestairrescueis:
A. aGlasgowComaScalescoreoflessthan13.
B. prolongedextrication.
C. aheadinjurywithalteredmentalstatus.
D. apenetratinginjurytothebodycavity.
B
Ifyouhavetosetupahelicopterlandingzone,
itsminimum
sizeshouldbe:
100by100feet.
TheAmericanCollegeofSurgeonsisoneoftheorganizationsthathascreateda
listofrecommendedsuppliesfor .
Ambulances
Allemergencyvehicleoperatorsmust
demonstrate___ forthesafetyofthepublicwhen
drivingtheirvehicles.
Due regard
Anambulanceapproachingastoppedschool
busshouldwaituntilthebus’s flashingredlightsare
Turned off
Thebestplacementforthespeakerofan
ambulancesirenisinthevehicle’s
Grill
Most accidents involving ambulances occur on
Dry clear roads during daylight and in intersections
sequenceofoperationsrequiredtoreadythe
Patient to be moved
Packaging
Minimum of __ straps on stretcher
3
Theunconsciouspatientwhoisnotsuspectedofhavingaspinalinjuryshouldbe
shiftedintothe__ positiononceonboardtheambulance.
Recovery
Theminimumstaffingforthepatient
compartmentofanambulanceis
consideredtobe .
1 EMT
Ifapatient’spersonaleffectshavebeentransported,theEMTmayneedtogeta___
fromemergencydepartmentpersonnel
Written receipt
Theambulanceenginemustberunningif
coolantlevelsaretobeproperlychecked.
False
Ifapatientislikelytodevelopcardiacarrestduringtransport,placea___underthemattressbeforebeginningthetrip.
shortspineboard
What solution used to clean up blood
1:100 bleach/water
What ambulance most used
Type 1
Two components of ambulance readiness
Vehicle (driver) and equipment (crew leader)
Vehicle should be easily seen from __ degrees in
emergency response mode.
360°
To speed transport to distant trauma center, When extrication of high-priority patient is prolonged
and air rescue can speed transport, When patient must be rescued from remote location
Operational reasons
Call air rescue with GCS
10
A __ response means using lights and siren
Hot
Area of contamination or danger=
Decontamination corridor=
Where equipment and emergency rescuers are
staged=
Hot zone
Warm zone
Cold zone
Decontaminate people in the
Warm zone
▪ Residual product contamination ▪ More thorough
Secondary decontamination
Decontamination for patients not wearing P P E: Receive __ water rinse, starting at the head.
2- to 5-minute
NIMS is in charge of
Command
Senior person on first-arriving E M S will assume
Incident Command
• Foundation of system is speed, simplicity, consistency of application • Simple commands to patients • Patient evaluation based on R P M
START triage
Only three treatments provided during S T A R T triage
– Open an airway and insert an oropharyngeal airway.
– Apply pressure to bleeding.
– Elevate an extremity.
If pulse less than __ check pulse
30
If respirations more than __, priority 1
30
Not breathing and attempts to open airway do not start
breathing
Priority 4
Breathing, no radial pulse
Priority 1
Alert=
Altered mental status=
Priority 2
Priority 1
SALT triage
• Sort • Assess • Lifesaving Interventions • Treatment/Transport
Severe injuries who are likely to survive with
treatment
Immediate (color code red)
Serious injuries but are not tagged as Immediate
Delayed (color code yellow)
– Unlikely to survive given the available resources
– Receive treatment only after Immediate patients have
been moved forward
Expectant (color code gray)
performed at a patient collection point
or triage area
Secondary triage
arranges transport of patients
from the scene to the hospital
Transportation supervisor
The biggest problem in most
H A Z M A T incidents is
identifying the offending substance
You want to block scene
Upstream
How long is blockage
One and a half to two lanes
Position ambulances, command vehicles, and other
units
downstream from crash
Responders should always exit into the
safe zone
In close proximity to fires, emergency responder should
approach vehicle at a
45-degree angle (not head-on)
15- or 20-pound class A:B:C dry chemical fire extinguisher extinguishes almost anything burning.
Small fire
Utilize 4 × 4 wood blocks to build crib box if
Vehicle on its roof
Steps one and two: disentanglement
gain access by disposing of doors
and the roof
Step three: Disentanglement
disentangle occupants by displacing the front
end
Groups or individuals whose terrorist activities are
directed their own government or population
Domestic Terrorism
Groups or individuals whose terrorist activities are foreign
based and/or directed by countries or groups outside the targeted country or whose activities cross national
boundaries.
International Terrorism
principal
targets of terrorist attacks.
Emergency Medical Responders
Recognizing O T T O signs may help protect against
secondary attack.
– Occupancy or location – Type of event – Timing of event – On-scene warning signs
Anniversary dates of previous attacks
April 19
Caused by lack of oxygen in atmosphere
Asphyxiation
Results from any violent event
Psychological harm
Secondary and either at the scene or some time after
the event
Psychological harm
Systemic effects
Chemical harm
Sudden demand upon public health infrastructure
with no apparent explanation
Public health emergency
▪ Potential or actual point of origin located ▪ Attempts made to prevent or minimize damage and spread
Focused emergency
What is an exposure?
Dose or the concentration of the agent multiplied by
time
Four major routes of entry
Absorption, ingestion, injection, inhalation
– Material is present where it does not belong
– Material that is harmful to persons, animals, or the
environment
contamination
occurs when a substance is taken into the body through one of the routes
Exposure
Movement of a substance through a surface or, on
a molecular level, through intact materials
Permeation
Agents classified as poisons
Etiologic harm
Scene of clandestine laboratory
Chemical harm
Self protection measures at nuclear or radiologic incident
Time, distance, shielding
Possibility of extremely dusty conditions
Asphyxiation
Typically seen at bombing incidents
Mechanical harm
Operations occurring after written or verbal warning
received but before explosion takes place
Preblast
Operations occurring after at least one detonation
Postblast
Most effective, most common means
Respiratory Route
Weaponization most effective when targeted through
Inhalation route
Weaponization particles are __ microns in diameter
3-5
Airborne dissemination can be created by applying
energy
to material
__ boiling point and __ vapor pressure will evaporate more readily.
Low, high
Nerve agent poisoning acronym
SLUDGEM
Classification of chemical agents: choking agents
Predominately respiratory
Classification of chemical agents: vesicating agents
Cause chemical changes in cells of exposed tissue
Inhibit enzyme critical to proper nerve transmission,
causing out of control parasympathetic nervous system
Nerve agents
Riot control agents
Irritating materials and lacrimators (tear-flow
increasers)
Small, free-living microorganism
Bacteria
Organisms that requires a host cell inside which to
live and reproduce
Viruses
Like human body cells, they have an internal cytoplasm
surrounded by a rigid cell wall; unlike human body cells,
they lack an organized nucleus and other intracellular
structures.
Bacteria
Anthrax, cholera, plaque, Q fever, and tularemia are all examples of
Bacteria
Do not replicate, chemical compounds produced by living organisms
Toxins
• Botulinum • Ricin • Staphylococcal Enterotoxin B (S E B) • Trichothecene Mycotoxins (T 2)
Examples of
Toxins
Simplest microorganisms
Viruses
Replicate only inside host cells, not easy to manufacture in large quantities
Viruses
• Smallpox • Encephalitis • The Viral Hemorrhagic Fevers (V H F s)
Examples of
Viruses
Effects of radiation
– Bone marrow
– Gastrointestinal system
– Central nervous system
• Use more plausible than the use of nuclear devices • Not hard to obtain or initiate items • Specialized teams generally available to deal with
incendiary devices
Blast injury lung injuries
Bradycardia, apnea, and hypotension from blast wave
Blast injury for ears
Rupture of tympanic membrane
Abdominal blast injury
Rupture of gas-containing section of intestine
Blast injury brain
Concussion or MTBI
provides information for the common terrorist weapons
D O T Emergency Response Guidebook
Broad general plans designed to achieve desired
outcomes
Strategies
Specific operational actions responders take to
accomplish assigned tasks
Tactics
stockpile of
pharmaceuticals and medical supplies to be used when
local resources are used up
Strategic National Stockpile
There are many different types of agents and weapons
that can be used by terrorists. ___ is used to
remember the different types. ___ is used to
remember the types of hazards posed by these agents.
C B R N E, T R A C E M-P
Whichofthefollowingroutesofentryintothebodyfora biologicagentisseldomused inaterroristsituation? A. Absorption B. Ingestion C. Injection D. Inhalation
A
Tacticsarespecificoperationalactionsresponderstaketoaccomplishtheirassignedtasks.Whichofthefollowingis consideredatacticinregardto dealingwithterrorism? A. Process B. Protection C. Preparation D. Protocols
B
Whichofthefollowingistheprimaryharmassociatedwithanuclearblast? A. Chemicalharm B. Psychologicalharm C. Pressureharm D. Thermalharm
D
Terrorismthatinvolvesgroupsorindividualswhoseterroristactivitiesaredirectedattheir owngovernmentiscalled: A. federalterrorism. B. domesticterrorism. C. internationalterrorism. D. territorialterrorism.
B
Adestructivedevice,suchasabomb,placedtobeactivated afteraninitialattackand timedtoinjureemergency respondersandothersis calleda: A. postincidentdevice. B. primarydevice. C. secondarydevice. D. tertiarydevice.
C
What does TRACEM-P stand for
Thermal harm, radiologic, asphyxiation, chemical, etiologic, mechanical, psychological harm
Three causative agents used for biologic weapons
Toxins, bacteria, viruses
What does SLUDGEM stand for
Salivation Lacrimation Urination Defecation GI upset Emesis Miosis
Seldom route through biological agents enter the body
Skin
Therecommendedmethodofstabilizingavehicleonits wheelsistouse: A. three-stepchocks. B. two-stepchocks. C. stabilizationstruts. D. ropes.
A
Whenplacingcribbingunderavehicle,rememberto:
A. kneeldownwhilekeepingonehandonthevehicle.
B. squatdownandremainontheballsofyourfeet.
C. kneeldownwhilekeepingonehandontheground.
D. liedownandslipthecribbinginplace.
C
Thetwotypesofvehicleglass
include:
laminated(containsaplastic
sheet)andtempered(breaksintoroundedpieces).
Ifyou“trybeforeyoupry,”youcanoftenachieve:
Simple access
Aflatheadaxisusuallyrequiredto: A. removeacrushedsteering wheel. B. breakthroughawindshield. C. pryopenadistortedcardoor. D. removeseatbacks.
B
Theroofsupportthatisbetweenthefrontdoorandtheback
doorofafour doorsedaniscalledthe:
B post
WhichofthefollowingisNOTanadvantagetodisposingofa
carroofduringextrication?
A. Itgivesaccesstotheentireinterior.
B. Itavoidsaccidentalairbagdeployment.
C. Itprovidesalargeexitforoccupantremoval.
D. Itprovidesfreshairforpatientandrescuers.
B
Thethirdandlaststepofthe three partactionplanfor disentanglinga patienttrappedinavehicleis to: A. displacethedoors. B. disposeoftheroof. C. disentanglethepatient. D. displacethefrontend.
D
Ifacar’sbatterymustbe disconnected,then: A. disconnectthepositivecable first. B. disconnectthenegativecable first. C. disconnectbothcables simultaneously. D. simplyturnofftheignition.
B
Whicharticleofprotectiveequipmentprovidesanacceptable levelofheadprotection? A. Bumpcap B. Firefighter’shelmet C. Uniformcap D. Bicyclist’shelmet
B
Thebesteyeprotectionatavehiclecollisionisprovidedby: A. sunglasses. B. safetyglasses. C.hingedplastichelmetshields D.safetygoggleswithsoftvinyl framesandindirectventing.
D
ThefirsttrafficwarningdevicethatanEMTusuallyplacesat thesceneofavehiclecollisionis: A. areflectiveroadsign. B. theflagperson. C. aflare. D. theambulance’sflashinglights.
D
A“groundgradient”atthe
sceneofawreckposestheriskof:
Electrocution
WhichburningmaterialCANNOTbeextinguishedwithan A:B:Cfireextinguisher? A. Acar’supholstery B. Fuel C. Magnesium D. Electricalcomponents
C
Whenencounteringanemptyvehiclewiththeengineonfire
andthehoodtightlyclosed,theEMTshould:
A. sprayafireextinguisherupfromunderneaththevehicle.
B. openthehoodfully,stand
closetotheA post,andsprayacrossthe
engine.
C. openthehooduptothesafetylatch,inserttheextinguisher
nozzleinanyopening,andspray.
D. leavethehoodclosedtight,andletthefireburn.
D
Gettingintoavehiclebyopeningadoororrollingdowna
windowiscalled
Simple access
preventscardoorsfromflyingopenduring
impact.
Nader pin
Thereare___________________ phasesofthepatientextricationorrescueprocess.
10
Withoutheavyhydraulicrescuetools,aroofcanberemovedquicklywith
___________________ andacanofspraylubricant.
Hacksaw
WhentheEMTisapproachingascenewithwiresdown,the
EMTmayfeelatingling
inthelegsasaresultofa
phenomenoncalled___________________ ___________________ .
Ground gradient
Two actions an EMT can take if they encounter a ground gradient is
Turn 180°, shuffle away from danger area
According to the Department of Transportation, a hazardous material is a
substance that:
A. can explode.
B. can cause death.
C. poses an unreasonable risk to health, safety, and property when transported.
D. does not meet O S H A guidelines for workplace and product safety.
C
Which minimum level of training should all E M S responders have according to the federal government? A. Hazardous Materials Specialist B. First Responder Operations C. Hazardous Materials Technician D. First Responder Awareness
D
A safe zone should NOT be
a chemical spill.
Downwind
The medical treatment area that E M S is responsible for setting up to receive
decontaminated patients is done in the:
Cold zone
Secondary contamination occurs when a: A. noncontaminated person enters the hot zone. B. patient has been exposed to two or more chemicals. C. contaminated person contacts a noncontaminated person. D. change in conditions—for example, a wind shift—enlarges the hot zone.
C
The U.S. Department of Transportation requires that vehicles carrying
hazardous materials display:
Labels or place cards
A common placarding system used to mark fixed structures that contain hazardous materials is the: A. N F P A 704 System. B. D O T U N System. C. C H E M T R E C System. D. S D S System.
A
The basic responsibilities of E M T s at a hazardous materials incident are to
take care of the injured and:
A. monitor and rehabilitate
H A Z M A T team members.
B. decontaminate those leaving the hot zone.
C. provide support to
H A Z M A T team members as requested in the hot zone.
D. all of the above.
A
The most common M C I (or M C S) is a:
Car crash w three or more patients
The manageable span of control over people involved in an M C I is: A. 3–74-8. B. 4–8. C. 5–105. D. 12–15.
A
During an M C I, as much communication as possible between Command and Command’s direct subordinates should be:
Face to face
A quick assessment of patients and assigning of priorities for treatment or
transport is called:
Triage
During an M C I, radio communications from the scene of the incident to the
receiving hospitals should be handled by the:
Transportation supervisor
The 24-hour emergency chemical information and assistance center reachable at
800-424-9300 is .
CHEMTREC
The N F P A 704 System is seen on
.
Fixed facilities
An event that by its nature challenges or hampers an
E M S system’s ability to
respond to it is a(n)
MCI
The organizational structure that provides a framework for managing large-scale
M C I s is the
ICS
Where does fertilization occur
Fallopian tubes
Uterus can hold ml normally and ml during pregnancy
5,500
Muscular ring separating uterus and vagina
Cervix
How many weeks gestation needed for survival
20
Fetal stage begins around
8
Heart beat forms
15-18 days after conception
How many weeks of pregnancy
40
Fluid that allows fetus to float, cushions fetus, maintains fetal body temperature
Amniotic sac
During pregnancy, CV system makes
50% more RBCs by 2nd tri
Pregnant women increased cardiac output more prone to
Pulmonary embolism
Placenta, infant, and fluid total
20-24 pounds
Irregular, non sustained, and not indicative of impending delivery-false pregnancy pains
Braxton hicks contractions
Fetus movement from high in abdomen down to birth canal
Lightening
Baby may be imminent when contractions last
30s-1 min and 2-3 mins apart
Meconium standing indicated
Fetal distress
Third labor stage lasts
10-20 mins
Gravita, pera
G: number of pregnancies
P: number of living children
Newborn=
Neonate=
Within two hours
28 days of life
Give narcan to pregnant women at what week and after
35
Deep fundus massage role
Release oxytocin for vasoconstriction to stop hemorrhage
Apply clamps on umbilical cord
10 and 7 inches from baby
If shallow, slow, gasping, or absent, provide pos. Pressure ventilations of neonate at
40-60 pre minute
In neonate, if less than __ bpm, continue pos pressure ventilations
If less than __ begin chest compressions at __
100
60,120
Most common abnormal delivery
Breech presentation
When placenta blocks birth canal
Placenta previa
Tearing pain, placenta prematurely separates from uterine wall, usually caused by trauma
Abruptio placenta
Ectopic pregnancy vitals
Low BP
Rapid weak pulse
Pain on one side
Seizure in pregnancy vitals
Preeclampsia, weight gain, swelling
Pregnant patients pulse beats __ faster
Blood loss may be __% before signs and symptoms appear
10-15
30-35
Displace uterus in cpr if child more than
20 weeks
Obesity is a body mass index (B M I) of
30 or more
BMI is
(weight in pounds/ height in Inches)^2 x 703
Use the mnemonic __when treating a patient with Autsim
ABCS
Awareness
Basic
Calm
Safety
occurs after birth and
may be cause by exposure, trauma, or a medical condition
Acquired diseases
present at birth that
may or may not be genetic
Congenital
Biphasic continuous positive airway pressure
(B i P A P) devices provide
Inhalation, exhaustion assistance
blow oxygen under constant low pressure
▪ They prevent collapse of airway passages
▪ They are often prescribed for sleep apnea
CPAP
ICS considers how many people manegable span
3-7
single incident managed by
unified incident command manged by
fire services
police, ems, public works
first steps of incident command phase
scene size up and triage
organization/delegation
uncoordinated or undirected activity at the scene
freelancing
SALT uses a ~~ of patients based on priority when moving them away from incident
forward movement
management system used by federal, state, and local government to manage emergencies in US
NIMS
subset of NIMS designed for MCIs
ICS
ambulances command vehicles etc should be positioned __ from crash
downstream
what class extinguisher should be used for nickels metal hydride batteries
class D
