Phx Fire Vol 2 (Deck 11)

Question 1

202.20C

Answer 1

Personal Mobility Devices & Lithium-Ion Batteries

Question 2

203.01

Answer 2

EMS Responsibilities

Question 3

Scope of the SOPs for multi-patient/mass casualty incidents.

Answer 3

Incidents of any size and aim to guide the operation of FD units at such incidents, including major TRx incidents, explosions, fires with multiple injuries, haz mat incidents, and structural collapse incidents.

Question 4

Responsibility of the first-arriving company officer in EMS incidents requiring the commitment of a 2n1 or greater?

Answer 4

Implement the multi-patient/mass casualty procedures.

Question 5

General tactical objectives listed in order of priority for the first-arriving company officer at the scene of a multi-patient or mass casualty incident?

Answer 5

1. Remove endangered occupants and treat the injured.
2. Stabilize the incident and provide for life safety.
3. Ensure the functions of triage, extrication, Tx, and TRx are established as needed and performed appropriately.
4. Provide for the safety, accountability, and welfare of rescue personnel and victims.
5. Conserve property.

Question 6

How is the IMS used during multi-patient/mass casualty incidents?

Answer 6

Facilitate the completion of the tactical objectives, with the IC driving the Command system towards that end.

Question 7

Describe the EMS tactical objectives to be completed during any multi-patient/mass casualty incident.

Answer 7

‘Triage Report’ and the declaration of ‘All IMMEDIATES Trx’.

Question 8

Priority order for treating and transporting patients.

Answer 8

1. IMMEDIATE
2. DELAYED patients upgraded to IMMEDIATE
3. DELAYED
4. MINOR

Question 9

Initial actions of the first arriving officer at a multiple patient incident?

Answer 9

On-scene report, assume command, initiate triage, perform a rapid hazard assessment, establish a safe zone, provide occupant protection, call for additional resources, radio a Triage Report to Dispatch, stabilize hazards, assign crew specific tasks, initiate patient assessment and treatment functions, and coordinate patient Trx.

Question 10

How are responding personnel encouraged to handle smaller multi-patient incidents?

Answer 10

Triage tags and IMMEDIATE labels on smaller multi-patient incidents, and to use the Central Arizona triage system for initial scene organization and mass casualty incidents.

Question 11

Define the rRarriving company officer at a multiple patient incident according to the.

Answer 11

Assume Command, give an on-scene report, identify hazards, establish a safe zone, request additional assistance, and communicate the situation and PT conditions to Dispatch.

Question 12

What should the first arriving company officer communicate to Dispatch as soon as possible at a multiple patient incident?

Answer 12

The type of situation and the approximate number and condition of PTs.

Question 13

Use of triage tags and IMMEDIATE labels.

Answer 13

Any time there are 3 or more IMMEDIATE PTs or more than 10 PTs . IMMEDIATE labels are encouraged on smaller multi-patient incidents.

Question 14

What should Command do to establish a safe zone for crews to operate at a multiple patient incident?

Answer 14

Rapidly survey the scene to identify hazards or safety concerns, and establish a safe zone through proper defensive rig positioning, use of flashing lights, and the placement of flares or reflectors. Additional traffic control should be requested from law enforcement through Dispatch.

Question 15

Purpose of initiating triage early in an incident.

Answer 15

When the number of PTs and/or the severity of their injuries exceeds the capabilities of the on scene personnel to provide effective extrication, Tx, and TRx.

Question 16

How is a Triage Report communicated to Alarm after completion of triage?

Answer 16

Providing essential information regarding the size of the major medical incident and decisions to call for additional resources or to scale back the response.

Question 17

Purpose of establishing Tx areas in EMS incidents with a greater number of patients.

Answer 17

In incidents with a greater number of PTs, a Tx area should be established to effectively Tx PTs, and multiple Tx areas may be needed if distinct groups of PTs are separated by distance.

Question 18

Recommended approach for requesting additional resources in EMS incidents?

Answer 18

Standard assignments and alarms as much as possible (e.g., 2-1 Medical, 1st Alarm Medical, 2nd Alarm Medical, etc.) to facilitate an incremental approach to the incident and provide predictable resources.

Question 19

Staging process for the first arriving company and other responding units in EMS incidents.

Answer 19

Quickly determine the most effective means to Tx PTs, and all other companies will use Level I staging upon their arrival, while Command should consider implementing Level II Staging early in the incident for First-Alarm-Medical Incidents (or greater).

Question 20

Responsibilities of the IC.

Answer 20

Determining strategy, establishing incident objectives, setting priorities, developing an action plan, obtaining and assigning resources, communicating objectives to tactical units, and initiating a Unified Command with other agencies.

Question 21

Natural basic sectors for the IMS?

Answer 21

Triage Sector, Extrication Sector, and Tx Sector.

Question 22

How does the Triage Sector contribute to the incident management?

Answer 22

Determines the location, number, and condition of PTs, supervises triage teams, ensures triage is done according to procedures, and provides a ‘Triage Report’ to the Command.

Question 23

203.02

Answer 23

Triage Sector

Question 24

Purpose of the Extrication Sector.

Answer 24

Determine the location, number, and condition of PTs, supervise extrication teams, extricate and deliver PTs to the Tx area, and notify Command when all PTs have been removed from the impact area.

Question 25

203.03

Answer 25

Extrication Sector

Question 26

Responsibilities of the Tx Sector.

Answer 26

Assigning and supervising treatment teams, ensuring all PTs are triaged, assessed, and Tx as needed, and coordinating patient allocation with the TRx Sector.

Question 27

203.04

Answer 27

Tx Sector

Question 28

What are the responsibilities of the TRx Sector for EMS?

Answer 28

Obtaining necessary TRx modes, determining staging areas and hospital availability, coordinating PT allocation with Tx Sector, supervising PT movement, determining hospital destination, and maintaining PT accounting.

Question 29

Role of the Safety Sector for EMS.

Answer 29

Ensure safety at the incident scene once the basic sectors have been established.

Question 30

203.05

Answer 30

TRx Sector

Question 31

203.05A

Answer 31

Trx Sector Branch

Question 32

203.06

Answer 32

Medical Supply Sector

Question 33

Medical Supply Sector for EMS?

Answer 33

Procuring, delivering, and stockpiling medical supplies needed at the scene, particularly on 3rd Alarm Medical or greater incidents.

Question 34

Purpose of the LZ Sector for EMS?

Answer 34

Establishing a safe landing zone at a distance from the scene for helicopters, keeping track of PT destination, and communicating landing instructions.

Question 35

Responsibilities of the Medical Branch Director for EMS.

Answer 35

Ensuring the functions of triage, extrication, and Tx are carried out, supervising and coordinating personnel, determining and requesting needed resources, recommending the expansion of the command organization, communicating direction and objectives to tactical units, ensuring objectives are completed, and maintaining incident documentation.

Question 36

Additional positions within the Medical Branch?

Answer 36

Immediate, Delayed, and Minor Tx Sector Officers, Medical Communications Sector, Medical Supply Sector, Ground Ambulance Coordinator, and Morgue Officer.

Question 37

How does resource commitment typically follow PTs?

Answer 37

As PTs are extricated and moved to Tx, resources for extrication will decrease, and these crews can be reallocated to the Tx function.

Question 38

What may happen to FD resources in a disaster level incident?

Answer 38

May need to be allocated to receiving hospitals until those facilities can obtain adequate hospital staff.

Question 39

Responsibilities of the EMS sector during a multi-patient incident response.

Answer 39

Triage, extrication if needed, Tx in a designated area or in-place as directed by Command, and managing TRx sector function.

Question 40

Recommended duration for the triage function during a multi-patient incident?

Answer 40

4-6 minutes.

Question 41

Role of the Level II Staging area in a multi-patient incident response.

Answer 41

Balance of the assignment after the Level 1 approach, and all resources must stage there.

Question 42

How is the TRx Sector function managed during a multi-patient incident?

Answer 42

By Command or assigned to a designated member, depending on the complexity of the incident.

Question 43

Preferred location for Tx during a multi-patient incident response?

Answer 43

Designated Tx area, or it can be performed in-place as directed by Command.

Question 44

Responsibilities of the Triage Sector in a multi-patient EMS response.

Answer 44

Assessing and categorizing patients based on the severity of their injuries to prioritize Tx.

Question 45

Responsibilities of the Extrication Sector in a multi-patient EMS response?

Answer 45

Managing the physical disentanglement or removal of patients from the impact site to a Tx area.

Question 46

Purpose of colored salvage covers in a Tx Sector during a multi-patient EMS response.

Answer 46

Identify Immediate, Delayed, and Minor Tx areas within the Tx Sector.

Question 47

How is the TRx Sector organized in a multi-patient EMS response?

Answer 47

Minimum of one company assigned to perform its functions and be assigned a separate tactical channel, in addition to Med-9.

Question 48

Role of the LZ Sector in a multi-patient EMS response?

Answer 48

Helicopter operations and requires at least one engine company to be assigned, with the Company Officer becoming ‘LZ Sector.’

Question 49

Responsibilities of Trx Branch during a MCI.

Answer 49

Assigning a Loading Coordinator to the Tx area, ensuring a minimum of one company is assigned, and operating on a separate tactical radio channel.

Question 50

Key considerations for the Medical Branch during a MCI?

Answer 50

Consider Medical Support 19 and one medical supply truck when a Third Alarm is requested, and should work closely with the TRx Branch and the Hospital Communication Coordinator.

Question 51

Role of the LZ Sector during a MCI.

Answer 51

Assigning a minimum of 1 engine to the LZ and overseeing the arrival and departure of rescues, with the Company Officer assigned as the LZ Sector.

Question 52

How should the Hospital Communication Coordinator ensure hospital availability during a MCI?

Answer 52

Check and re-check hospital availability through Dispatch on Med-9.

Question 53

Key responsibilities of the Triage sector during a MCI?

Answer 53

Continue as a Sector, identify the Tx area early, involve several companies, and include PT re-evaluation.

Question 54

Role of the Loading Coordinator within the TRx Branch during a MCI.

Answer 54

Loading of PTs, ensuring no more than two rescues are sent to the loading area at a time.

Question 55

Key responsibilities of the Medical Branch and TRx Branch during a MCI with a large number of PTs?

Answer 55

Both should be considered, and the TRx Branch will need a minimum of 1 company assigned and should operate on a separate tactical radio channel, in addition to Med-9.

Question 56

Responsibilities of the Triage Sector officer?

Answer 56

Determining the location and condition of PTs, coordinating with the Extrication Sector, assigning and supervising triage teams, ensuring patient triage is based on START, providing progress reports to Command, and coordinating activities with other sectors.

Question 57

How should the Triage Sector officer coordinate with the Extrication Sector?

Answer 57

To determine if triage will be performed in place or at the entrance to the Tx area.

Question 58

Define ‘IMMEDIATE’ in the context of triage.

Answer 58

Those who require immediate life-saving emergency medical care.

Question 59

Triage handling; smaller vs. larger incidents.

Answer 59

Smaller incidents (<=10 PTs), triage may be handled by the first arriving company officer and his/her crew.
Larger incidents (10+ PTs), the first arriving company officer should assume Command and assign Triage to the next arriving fire company.

Question 60

Purpose of the Triage Report in the AZ Triage System.

Answer 60

Communicates the # of PTs and their classification to Command, providing essential information for decision-making and resource allocation.

Question 61

Role of the Triage Sector Officer in the Triage Report process?

Answer 61

Arranges the tracking slips, determines the # of PTs and their condition, and radios Command with the Triage Report.

Question 62

How is the completion of triage communicated to Command in the AZ Triage System?

Answer 62

Triage Report, which includes the # of PTs and their classification.

Question 63

Purpose of the red fanny packs located on all fire apparatus in the AZ Triage System.

Answer 63

Contain the necessary materials for completing triage, ensuring that the triage crew(s) have access to the required resources.

Question 63

Role of the Triage Report in decision-making in the AZ Triage System?

Answer 63

Provides essential information for decisions regarding the need for additional resources or scaling back the response.

Question 64

Significance of the Triage Report in the context of a major medical incident.

Answer 64

Completion of initial triage using the START criteria and communicates the size of the major medical incident to all responding crews.

Question 65

What happens to crews after the completion of triage?

Answer 65

Command may reassign triage crews to other functions as necessary.

Question 66

Responsibilities of the Extrication Sector.

Answer 66

Determining the location, number, and condition of PTs, coordinating with Triage, assigning and supervising extrication teams, extricating and delivering PTs to Tx areas, providing progress reports to Command, ensuring safety and accountability of PTs and personnel, coordinating with other sectors, and notifying Command when all PTs have been removed.

Question 67

How is the Extrication Sector Officer identified?

Answer 67

Wearing an Extrication Sector vest.

Question 68

How should comms be conducted within the Extrication Sector?

Answer 68

Face-to-face communications should be used within the sector, and company officers should use messengers to relay information to the sector officer.

Question 69

Distinction between the roles of the Extrication Sector and Triage Sector.

Answer 69

The Extrication Sector is responsible for victim disentanglement and removal to a Tx area, while the Triage Sector is responsible for identifying PT # and severity.

Question 70

Recommended position for the Extrication Officer?

Answer 70

Readily visible location that is accessible to arriving companies and maintains a view of the scene.

Question 71

Process for moving non-ambulatory PTs during extrication.

Answer 71

Moved on backboards, with cervical spine precautions if indicated. Companies may be assigned as ‘litter bearers’ to assist in this movement. Pick-up trucks, baggage carts, or similar conveyances may also be used.

Question 72

Immediate priority for the Extrication Officer?

Answer 72

Evaluate the # of PTs involved and the complexity of extrication requirements.

Question 73

How should responsibility be divided if the incident site involves a large area?

Answer 73

Necessary to create more than one Extrication Sector, with responsibility divided geographically and appropriate sector designations.

Question 74

Do ALS personnel need to be assigned to the Extrication Sector?

Answer 74

Some paramedics may need to be assigned to the Extrication Sector to provide ALS Tx for critical PTs undergoing extended extrication efforts.

Question 75

Role of ladder companies during extrication.

Answer 75

When victims require forcible extrication, ladder companies should be assigned. Ladder apparatus should be brought in close to the scene while other apparatus is parked at a distance to avoid congestion.

Question 76

Responsibilities of the Tx Sector in a MCI.

Answer 76

Establishing a Tx area, providing stabilization and continuing care for PTs, coordinating Tx resources, assigning and supervising Tx teams, ensuring PT triage and assessment, providing progress reports to Command, ensuring PT and personnel safety, verifying TRx priorities, and coordinating with other sectors.

Question 77

Objective of the Tx Sector in a MCI?

Answer 77

Rapidly Tx and TRx all PTs.

Question 78

How does the Tx Sector determine whether PT Tx will occur ‘in place’ or in a designated Tx area?

Answer 78

Coordinates with Triage and Extrication Sectors to identify Tx location.

Question 79

Role of the Tx Sector officer in an MCI.

Answer 79

Responsible for wearing a sector vest for identification, determining PT Tx location, coordinating with Command, establishing Tx areas, and preparing for PT arrivals.

Question 80

Key responsibilities of Tx teams in a MCI?

Answer 80

Aggressive Tx and rapid packaging of PTs, communication with Command to obtain additional resources, and focusing efforts on Tx and TRx IMMEDIATE PTs.

Question 81

Process for assigning resources to PTs in a MCI.

Answer 81

Tx Sector officer directs companies to specific PTs or vehicles, assigning 1 ALS or BLS company and 1 Rescue to each PT, with the goal of initially focusing on Tx and TRx IMMEDIATE PTs.

Question 82

Actions to be taken if PT Tx will occur in a designated ‘Tx area’ in a MCI?

Answer 82

Sector officer should establish a Tx area and prepare for the arrival of PTs from other sectors.

Question 83

Describe how the Tx area(s) should be identified at an incident scene.

Answer 83

Readily identifiable entrance using traffic cones, signs, or other markers. Red and yellow salvage covers can also be used to identify the IMMEDIATE care and DELAYED care areas.

Question 84

Recommended initial objective for the number of rescuers per PT in the Tx Sector during major incidents?

Answer 84

1 company per 4 patients, which equates to 1 rescuer per patient.

Question 85

How should PTs be arranged in the Tx area?

Answer 85

Orderly manner with adequate space provided between PTs to allow working room for Tx personnel. First arriving PTs should be placed near the exit point.

Question 86

Action should be taken for non-triaged patients arriving at the Tx area?

Answer 86

Must be triaged and tagged at the entrance. A triage team should be located at the entrance for this purpose.

Question 87

Role of ALS Tx in the Tx area.

Answer 87

Given primarily in the ‘IMMEDIATE’ Tx area, which is for PTs requiring more intensive care.

Question 88

Responsibilities of the Tx Sector officer.

Answer 88

Aggressive Tx and packaging of PTs with a focus on rapid TRx, maintaining awareness of PTs ready for TRx, ensuring rapid and adequate Tx, coordinating with the TRx Sector, consulting on PT allocation, and requesting additional medical supplies.

Question 89

Priority when TRx is immediately available in the Tx Sector procedures?

Answer 89

TRx a priority over extended on-site Tx, with rapid TRx being of the essence.

Question 90

Role of the Medical Supply Sector.

Answer 90

Determining the need for additional medical supplies at the scene and requesting their delivery through Command, automatically occurring on all 3rd Alarm incidents and being established near the Tx area.

Question 91

How should the Tx Sector officer coordinate with the TRx Sector?

Answer 91

Maintain close coordination with the TRx Sector officer to ensure rapid TRx of PTs.

Question 92

Reporting responsibilities of the Tx Sector officer.

Answer 92

Forward progress reports/triage updates to Command as needed, responsible for determining need for additional medical supplies & requesting delivery through Command.

Question 93

Responsibilities of TRx Sector managing PT TRx during a multiple-patient incident.

Answer 93

Arranging all TRx needs, coordinating PT allocation and destination with the Tx Sector, maintaining an accounting of all PTs and destinations, providing progress reports to receiving hospitals, ensuring the safety and accountability of assigned personnel, and coordinating activities with other sectors.

Question 94

Role of the TRx Sector Officer during a multiple-patient incident.

Answer 94

Assume a visible position in the Tx area or PT loading area, wear a sector vest, assess TRx needs, and communicate those needs to Command.

Question 95

How does the TRx Sector coordinate with other sectors, especially the Tx Sector, during a multiple-patient incident?

Answer 95

Coordinates PT allocation and destination with the Tx Sector, provides progress reports to receiving hospitals, and ensures the safety and accountability of all assigned personnel.

Question 96

Additional personnel roles to assist the TRx Sector during a multiple-patient incident?

Answer 96

Hospital Comms Coordinator, Loading Coordinator, Charting Officer, LZ Sector for air medical transport coordination, and Staging personnel.

Question 97

Process for establishing a LZ by the TRx Sector.

Answer 97

In concert with Command, determines the location for staging and aero-medical transport, establishes a LZ a safe distance from the scene, and assigns at least 1 Engine.

Question 98

Process for establishing a PT loading area.

Answer 98

Determine a suitable location next to Tx to establish a PT loading area, staging rescues off site and bringing them in as needed, with close coordination with Tx.

Question 99

How does the TRx Sector coordinate with medical facilities during an incident?

Answer 99

Early contact with to determine their capabilities, advise hospitals of the incident location and type, and initiate medical facility inventory through the Dispatch Center on Med-9.

Question 100

Define the priority for TRx patients in the TRx Sector.

Answer 100

IMMEDIATE PTs receive priority.
DELAYED and MINOR PTs. MINOR PTs may be TRx using city buses or vans, and it is preferred to ‘leap-frog’ MINOR PTs to distant hospitals to minimize TRx times for DELAYED PTs.

Question 101

Role of personnel assigned to TRx?

Answer 101

Remove PTs from Tx area and deliver them to selected TRx units, maintaining close coordination with Tx to determine the most appropriate allocation for each PT.

Question 102

Process for documenting PT TRx in the TRx Sector.

Answer 102

Prior to TRx, the TRx Sector Officer (or designee) will remove a TRx tracking slip from each triage tag and write in the TRx unit and hospital destination on the slip, keeping these tracking slips.

Question 103

Responsibilities of the TRx Branch in a large, complex medical incident.

Answer 103

Ensuring TRx functions are carried, supervising and coordinating TRx functions and personnel, determining/requesting resource needs, communicating direction to tactical units, maintaining incident documentation, and providing frequent progress reports to Command.

Question 104

What are standard operations performed by the Trx Branch?

Answer 104

Coordinating rescues to various sectors, determining hospital availability status, coordinating PT allocation and hospital destination, coordinating PT movement, maintaining PT accounting, ensuring safety and accountability of personnel, providing progress reports to Command, notifying hospitals of estimated arrival times, and notifying Command when all IMMEDIATE PT have been TRx.

Question 105

Role of the TRx Branch Director in a medical incident.

Answer 105

Coordinates TRx functions for all Tx locations, assigns TRx sector personnel, and ensures the necessary resources are assigned to each sector. They also station themselves at a central location, preferably at or close to the Command Post.

Question 106

Staffing requirements for each sector within the TRx Branch.

Answer 106

Each sector within the TRx Branch, such as ‘East TRx Sector’ and ‘West TRx Sector,’ will require at least one full company of personnel.

Question 107

Responsibility of the TRx Branch Director regarding the LZ?

Answer 107

Assigns necessary resources to the LZ to move PTs from Tx areas, which may involve the use of a rescue, and ensures that helicopters are used to TRx IMMEDIATE PTs to more distant medical facilities.

Question 108

Purpose of TRx tracking slips.

Answer 108

Record TRx unit, hospital destination, and other PT information, serving as a means to maintain an accounting of all PTs leaving the Sector and can be verified by Command.

Question 109

Do TRx Sector officers complete all PT info on the TRx tracking slip immediately?

Answer 109

Prioritize noting TRx unit and hospital destination and complete other info as time permits.