"Over-Represented" topics (MCI, soft skills, etc.)

Question 1

What are the four major sections/divisions of an incident command system?

Answer 1

1. Operations
2. Planning
3. Logistics
4. Finance

Question 2

What are the two major divisions of the operations section in an incident command system?

Answer 2

1. Rescue
2. Medical

Question 3

What are the two major roles of the rescue branch in an incident command system?

Answer 3

1. Extrication
2. Hazmat

Question 4

What are the three major roles of the medical branch in an incident command system?

Answer 4

1. Triage
2. Treatment
3. Transport

Question 5

Which section of ICS is responsible for directly supervising people working at the scene of an incident?
a. command section
b. logistics section
c. operations section
d. rescue section

Answer 5

c. Operations Section
The operations section chief will supervise the people working at the scene of the incident in cases where a response is sufficiently complex that the incident commander is saturated with other tasks

The operations section may be seen as the “eyes, ears, and voice” of the incident commander

Question 6

Is the incident commander a member of the medical branch?

Answer 6

Not necessarily. The incident commander may be part of the rescue branch, or part of another agency altogether. It depends on the nature of the response.

Question 7

Who is responsible for finding food, shelter, and health care for responders at the scene of a complex/protracted incident?
a. Logistics officer
b. Finance officer
c. Operations officer
d. Planning officer

Answer 7

a. Logistics officer

Question 8

Whose role is it to seperate patients by each priority category and assign crews to treat patients?
a. Incident Commander
b. Operations Commander
c. Triage Officer
d. Treatment Officer

Answer 8

d. Treatment Officer
The role of the triage officer is to triage and tag patients, but not to seperate them by priority once they are ready for treatment

Question 9

You are responding to a multi-agency MCI with 6 other ambulances. Who should you report to when arriving on scene initially?
a. Incident Commander
b. Staging Officer
c. Transportation Officer
d. Operations Officer

Answer 9

b. Staging Officer
Vehicles can not and should not drive into the scene of the MCI without direction from the staging officer

Report to the appropriate officer after parking on scene, but always check in with the staging officer FIRST, so as not to disrupt access/egress

Question 10

Where should the staging area be established in a large-scale MCI?
a. As close to the scene as possible to facilitate early transport
b. Wherever the staging officer deems appropriate
c. Away from the scene to avoid parked vehicles getting in the way
d. Next to the joint information centre (JIC)

Answer 10

c. Away from the scene to avoid parked vehicles getting in the way

Question 11

Which of the following is NOT a role of the transportation officer?
a. Establishing a landing zone
b. Tracking all patient movement
c. Establish and determine the destination for patients
d. Track the arrival of vehicles, equipment, and responders

Answer 11

d. Track the arrival of vehicles, equipment, and responders
these are roles of the staging officer

Question 12

While at the scene of an MCI, you learn some new and important information about one of your patients who has already been transported to a local hospital. Who should you contact to find out what the destination hospital was?
a.Transportation Officer
b. Communications Officer
c. Treatment Officer
d. Incident Commander

Answer 12

a.Transportation Officer

Question 13

In situations which require a reponse lasting an extended period of time, who is responsible for ensuring the reponsders’ needs for rest, fluids, food, and protection from the environment are met?
a. Incident Commander
b. Rehabilitation Officer
c. Logistics officer
d. All responders are responsible for their own well-being at an MCI

Answer 13

b. Rehabilitation Officer
This role is shared to a degree with the logistics section, whose job it is to locate food and shelter, but it is the job of the rehabilitation officer to ensure that individual needs on scene are met

Question 14

The “delayed” treatment category is represented by which color in triage?
a. Red
b. Yellow
c. Green
d. Black

Answer 14

d. Yellow
Use the mnemonic “IDME”; Immediate (red), Delayed (yellow), Minimal (Green), Expectant (Black)

Question 15

Whose role is it to sort patients according to treatment needs as they arrive in the treatment area?
a. Treatment Officer
b. Triage Officer
c. Incident Commander
d. Operations Officer

Answer 15

a. Treatment Officer

Question 16

You are serving the role of triage officer on an MCI. You come across a patient with severe neck/back pain and loss of sensation to both legs, with no signs of hypoperfusion. They should be categorized as which priority?
a. Red
b. Yellow
c. Green
d. Black

Answer 16

b. Yellow

Question 17

You are serving the role of triage officer on an MCI. You come across a patient who is not breathing despite efforts to open their airway. They should be categorized as which priority?
a. Red
b. Yellow
c. Green
d. Black

Answer 17

d. Black

Question 18

You are serving the role of triage officer on an MCI. You come across a patient with severe burns over 40% of their body. They should be categorized as which priority?
a. Red
b. Yellow
c. Green
d. Black

Answer 18

a. Red

Question 19

You are serving the role of triage officer on an MCI. You come across a patient who is apneic at first, but breaths once their airway is opened. They should be categorized as which priority?
a. Red
b. Yellow
c. Green
d. Black

Answer 19

a. Red

Question 20

You are serving the role of triage officer on an MCI. You come across a patient who has an obviously deformed fracture of their right forearm, with no other significant findings. They should be categorized as which priority?
a. Red
b. Yellow
c. Green
d. Black

Answer 20

c. Green

Question 21

Describe major differences between the START and JumpSTART triage protocols for MCIs

Answer 21

• JumpSTART is for pediatric patients (less than 8 yrs), while START is for adolescents/adults
• In START, if a patient is apneic after opening their airway they are considered Expectant (black tag). In JumpSTART, if a child is apneic after opening the airway, you check for a pulse. If they have a pulse, first give 5 rescue breaths. If they remain apneic they are black-tagged, if they begin to breathe they are red-tagged.
• In JumpSTART, any child with a resp rate less than 15 or greater than 45 is considered a Red. In START, the range is 10-30

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Question 22

What are the three major steps in both the START and JumpSTART Algorithms for triage?

Answer 22

1. Check Breathing
2. Check Circulation
3. Check Mental Status

Question 23

You are the triage officer at an MCI. You find a 7YO child who is apneic. What should you do next?
a. Check for a pulse
b. Label them as “Expectant” (black tag)
c. Open the Airway
d. Lable them as “Immediate” (Red tag)

Answer 23

c. Open the Airway
according to JumpSTART, your next steps should be: open the airway. If no breathing is present, check a pulse. If no pulse is present, label them expectant. If a pulse is present, give 5 rescue breaths and reassess.

p. 1736

Question 24

You are serving the role of triage officer on an MCI. You come across the driver of a vehicle who is breathing spontaneously at a rate of 36, with minor cuts and scrapes. They have a strong, rapid pulse, and are able to follow simple commands. They should be categorized as which priority?
a. Red
b. Yellow
c. Green
d. Black

Answer 24

a. Red
according to START principles, any adult patient with a resp rate greater than 30 or less than 10 is considered a red

Question 25

Using START principles of triage, what findings in Breathing, Circulation, and mental status would warrant a “red tag”?

Answer 25

• Breathing: need to reposition airway to establish breathing. Any respiratory rate less than 10 or greater than 30.
• Circulation: Absent or weak radial pulse.
• Mental Status: Fails to follow simple commands

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Question 26

While working at the scene of an MCI, your partner is struck by a piece of debris, causing a painful injury of their leg. What is the most appropriate next step?
a. Triage them according to START principles
b. Mark them as “minimal” priority (green tag) and encourage them to wait until other crews can assist them to the treatment are
c. Mark them as “immediate” priority (red tag) and have them transported off the site as soon as possible to avoid negative impact to the morale of remaining rescuers
d. Provide emergency treatment on scene and encourage them to continue with their duties if they feel able to do so

Answer 26

c. Mark them as “immediate” priority (red tag) and have them transported off the site as soon as possible to avoid negative impact to the morale of remaining rescuers
This seems like a bizarre response, but it’s straight out of Caroline’s. Verbatim

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Question 27

You respond to the scene of a warehouse collapse. You are the third ambulance on scene and there are active rescue efforts occuring, along with multiple walking wounding, and several patients already moved to the treatment area. The numbmer of occupants of the warehouse prior to its collapse is unknown. This scene may be considered a(n):
a.Closed Incident
b. Open Incident
c. Active Incident
d. High-risk Incident

Answer 27

b. Open Incident
an open incident is one in which the total number of patients is still unknown and may be expected to rise

Question 28

Which of the following is NOT considered a vesicant (blister agent)?
a. sulfur mustard (mustard gas)
b. V agent (VX gas)
c. Lewisite
d. Phosgene oxime

Answer 28

b. V agent (VX gas)
VX is a nerve agent

Question 29

You are responding to a terrorist incident where it is suspected that sulfur mustard (mustard gas) was released into a public space. Following decontamination of the patient, what are your priorities?
a. Apply high-flow oxygen, initiate IV access and provide a N/S bolus
b. Initiate transport and obtain IV access as soon a possible
c. Obtain IV access and provide high-dose atropine to target reversal of bradycardia and hypotension
d. Obtain IV access and provide 1.0mEq/Kg NaHCO3 to reverse acidosis

Answer 29

b. Initiate transport and obtain IV access as soon a possible
There is no field treatment for vesicants (except lewisite) other than decontamination, transport, and supportive care

Question 30

You have just informed the family of your patient that your patient has died and you have discontinued resucitation. The family is clearly distraught, and your partner states “I’m really sorry for your loss, I wish there was something more we could do”. This MOST represents the expression of:
a. compassion
b. empathy
c. tact
d. sympathy

Answer 30

d. sympathy
*sympathy, empathy, and compassion all involve identifying another person’s emotions, but vary in response. Symathy involves expressing regret or condolence for grief, but does not involve understanding and/or sharing the other person’s emotions or experience. Empathy involves both an identification AND understanding of the other person’s emotions. Compassion further involves a desire to alleviate suffering and provide assistance *

Question 31

You have just informed the family of your patient that your patient has died and you have discontinued resucitation. The family is clearly distraught, and your partner states “I can see that you’re upset, this must have been a very difficult experience for you. Losing a loved one is really hard”. This MOST represents the expression of:
a. compassion
b. empathy
c. tact
d. sympathy

Answer 31

b. empathy
*sympathy, empathy, and compassion all involve identifying another person’s emotions, but vary in response. Symathy involves expressing regret or condolence for grief, but does not involve understanding and/or sharing the other person’s emotions or experience. Empathy involves both an identification AND understanding of the other person’s emotions. Compassion further involves a desire to alleviate suffering and provide assistance *

Question 32

You have just informed the family of your patient that your patient has died and you have discontinued resucitation. The family is clearly distraught, and your partner states “This has been a traumatic experience, losing a loved one can be very difficult. My partner and I are here to answer any questions you have and we can refer you to counselling services, which may be helpful following your loss”. This MOST represents the expression of:
a. compassion
b. empathy
c. tact
d. sympathy

Answer 32

a. compassion
*sympathy, empathy, and compassion all involve identifying another person’s emotions, but vary in response. Symathy involves expressing regret or condolence for grief, but does not involve understanding and/or sharing the other person’s emotions or experience. Empathy involves both an identification AND understanding of the other person’s emotions. Compassion further involves a desire to alleviate suffering and provide assistance *