NREMT operations

Question 1

What are the criteria for START triage classification?

Answer 1

Respirations (greater than 30/min = RED)

Pulse (poor pulse, skin color or cap refill = RED)

Mental status (unable to follow simple directions = RED)

The “RPM” mnemonic is used to remember this.

Question 2

What are the risks for an unsecured EMT in the patient compartment of a moving ambulance in the event of a collision?

Answer 2

In the event of a collision the unsecured EMT will be thrown about and seriously injured or killed. The risk of being struck by unsecured equipment is also high in a collision.

Question 3

What is the transport officer responsible for at the MCI?

Answer 3

Tracking which patient goes to which hospital.

Assuring patients are sent to appropriate hospitals.

Seeing that no hospital gets overloaded with patients.

Notifying hospitals of incoming patients.

Question 4

What size should a helicopter landing zone be?

Answer 4

100 x 100 feet and a slope of less than 8 degrees.

The area should be clear of poles and electric or telephone lines.

Question 5

List the functions under the EMS branch in a major incident.

Answer 5

Triage
- Treatment
- Transportation
- Staging
- Rehabilitation
- Safety

Question 6

What effect does use of the siren during a call have on the patient and EMT operating the ambulance?

Answer 6

Use of the siren may increase patient anxiety.

It may also create a sense of urgency or excitement that causes the driver to drive at excessive and potentially dangerous speeds.

Question 7

What are the two types of decontamination from a hazardous material exposure?

Answer 7

Gross decontamination is removal or neutralization of a majority of the substance.

Secondary decontamination is the process of removing remaining material after gross decontamination. In many cases small amounts of the substance can remain even after secondary decon.

Question 8

You responded to a call on an interstate highway. Where do you park the ambulance when you are first to arrive?

Where do you park if other emergency vehicles are there first?

Answer 8

If you are first on the scene you should park between oncoming traffic and the accident to warn oncoming motorists and protect the scene.

If other units are there first you should park past the accident scene. This will allow safer access to remove and load the stretcher without risk from oncoming vehicles.

Question 9

List three concepts to reduce exposure from a terrorist attack.

Answer 9

Time - minimize your time at a scene or event

Distance - Maintain a safe distance

Shielding - keep objects between you and the hazard. This may be a physical structure or building, or approved personal protective equipment.

Question 10

List the components in the mnemonic CBRNE.

Answer 10

Chemical
- Biological
- Radiological
- Nuclear
- Explosive

Question 11

What is the difference between a dispatcher and an emergency medical dispatcher?

Answer 11

An emergency medical dispatcher is one who is specially trained to handle EMS calls. This usually involves training in obtaining the proper information from the caller and providing some type of pre-arrival instructions to the caller.

Someone who is a dispatcher may routinely handle calls from the public and/or radio dispatching but does not have the specific medical dispatch training.

Question 12

The four incident command branches under Command are:

Answer 12

• Planning
• Operations
• Logistics
• Finance

Question 13

What are the four colors of the NFPA 704 system?

What does each color signify?

Answer 13

Blue - health hazard

Red - fire hazard

Yellow - reactivity

White - specific hazard

Question 14

You must respond to a call in an adjoining district. It is a long response–and one you don’t do often. List several factors that will affect your choice of driving route.

Answer 14

Time of day and day of the week (anticipated traffic)

Road construction

Weather

Other delays (railroad crossings, bridges, school bus routes and times)

Question 15

What does NIMS stand for?

Answer 15

National Incident Management System

Question 16

How far should you park your ambulance from downed power lines?

Answer 16

You must park far enough so the down lines couldn’t reach the vehicle.

A general rule is to park two full telephone pole lengths from the downed wires.

Question 17

What do UHF and VHF stand for?

Answer 17

These are radio frequency bands:

Ultra High Frequency

Very High Frequency

Question 18

Define: Hazardous Material

Answer 18

Hazardous materials are solids, liquids, or gases that can harm people, other living organisms, property, or the environment

Question 19

What is the role of the person who assumes “Command” at an incident.

Answer 19

The incident commander, or “Command,” assumes overall responsibility for the incident.

Question 20

Provide an example of a “blocking” vehicle? What does it do at a crash scene?

Answer 20

A fire engine is an example of a blocking vehicle. A highway truck (e.g. dump truck) may also be used.

The purpose of a blocking vehicle is to provide a large physical barrier between traffic and the accident scene.

Question 21

Where are bloody bandages and disposable towels used to clean up blood or body fluids disposed of?

Answer 21

In a “red bag” indicating infectious waste.

Question 22

What is the staging officer responsible for at the MCI?

Answer 22

Staging is responsible for providing a place for incoming EMS units and personnel to wait prior to assignment. This prevents confusion and unnecessary personnel on the scene and assures people are ready and available when necessary.

The staging officer keeps track of the resources at hand and send equipment and personnel to other sectors as they are requested and assures adequate help is available for future requests.

Question 23

What is the difference between a type I and a Type III ambulance?

Answer 23

Both the Type I and Type III are a “box” design but in the type III the EMT can move from the cab back into the box.

Question 24

Ambulances may disregard some traffic devices and exceed the speed limit when on an emergency. What is the standard for caution that must be observed?

Answer 24

“Due regard for others” means that the ambulance can’t be driven recklessly, negligently or in a way that may harm others.

Question 25

List three types of radiation and the penetrating ability of each.

Answer 25

Alpha radiation doesn’t travel far and can be stopped by something as thin as paper.

Beta radiation can penetrate through some levels of human tissue.

Gamma radiation can penetrate all levels of the human body. In some cases they can actually penetrate a few layers of lead.

Question 26

What is the difference between simple access and complex access to a vehicle?

Answer 26

Means of access that don’t involve tools are called simple access. This usually involves trying doors, having the patient unlock doors or roll down windows.

Complex access involves the use of tools or hydraulics to access occupants of a vehicle.

Question 27

List the four levels of hazardous material training.

Answer 27

Awareness
- Operations
- Technician
- Specialist

Question 28

How and when should you approach a medical helicopter?

Answer 28

You should only approach a medical helicopter after being instructed or approved by the flight crew to do so.

The rear of the helicopter is the most dangerous because of the tail rotor. Approach crouching from the front or the side as instructed by the helicopter crew.

Question 29

Define: Terrorism

Answer 29

The use of violence, threats of violence or intimidation to create fear or further a political agenda.

Question 30

What treatments are allowed during the triage process?

Answer 30

Usually only simple, lifesaving and quickly applied treatments are allowed including opening the airway, inserting an OPA and controlling severe bleeding.

Question 31

List four types of blast injuries.

Answer 31

Primary - injuries from the blast wave (e.g. ear, lung and hollow organ damage)

Secondary - injury from projectiles (e.g. penetrating trauma)

Tertiary - injury caused when the blast displaces (throws or knocks down) the victim.

Quaternary - all other injuries (burns, asphyxia, toxic exposure)

Question 32

What are the five phases of an ambulance call?

Answer 32

• Preparing for the call
• Responding to the call
• Transferring the patient to the ambulance
• Transport to the hospital
• Terminating the call

Question 33

The mnemonic OTTO is used to help determine the impact of a terrorist threat. What does OTTO stand for?

Answer 33

• Occupancy or location
• Type of event
• Timing of the event
• On-scene warning signs

Question 34

What does the mnemonic TRACEM-P stand for?

Answer 34

TRACEM-P is used to remember the mechanisms that cause harm in terrorism.

• Thermal
• Radiological
• Asphyxiation
• Chemical
• Etiological
• Mechanical
• Psychological

Question 35

What is a “secondary device” and how does it affect emergency responders?

Answer 35

A secondary device is one which is designed to detonate sometime after the main blast. The intent may be to injure emergency responders and further damage the emergency infrastructure.