Operations Study Center > Diagnostic Tests > Operations Step 1 of 40 2% You are triaging multiple patients from a fire in an apartment complex. Which of these patients is categorized appropriately?* Unconscious 34-year-old male with stridorous respirations and weak radial pulse – black Unconscious 12-year-old male with pulse of 84 and no respirations until a manual airway maneuver is performed - black Alert 17-year-old who follows commands, has a radial pulse, breathing 20 times per minute and with severe burns to 40% of her body – yellow Alert and oriented 22-year-old who has strong radial pulse, complaining of shortness of breath and breathing 24 times per minute- red Assigned to stand by at a suspected chlorine gas leak, you and your partner load your equipment onto the stretcher. In order to maintain safety and yet remain available for immediate treatment, where should you stand by?* Cold zone, upwind Decontamination zone, uphill Warm zone, uphill Hot zone, upwind You are first on the scene of a single vehicle collision where a 16-year-old male lost control and struck a tree with the driver’s door of his brand new sports car, then spun back into the roadway. The driver’s door is crushed in and will not open. You should* request additional resources for extrication. access the patient through the passenger door or window. crawl in through the broken rear window to begin treatment. use simple hand tools to attempt to pry the door open. Five ambulances are called to a serious structure fire with multiple entrapped occupants. After arriving at staging, each ambulance is directed to a treatment area to load a patient, begin treatment, and transport. Which person will tell them to which hospital the patient(s) should go and record this location and other information for future reference?* Senior paramedic Incident commander Transportation officer Logistics section chief Which of the following levels of hazardous materials certification is matched with its usual capabilities?* Technician – takes offensive actions to stop or remove hazard Awareness – takes defensive actions to limit or minimize hazard Specialist – identifies hazards and isolates scene Operations – serves as a subject matter expert, advises IC and Operations group Your 28-year-old male patient complains of shortness of breath after suffering multiple stab wounds to the chest and abdomen in a domestic dispute. During your primary assessment, you have applied oxygen, controlled all external bleeding, and ensured adequate ventilation. An air medical helicopter is en route and an ALS unit is arriving now. There is a non-trauma hospital approximately 15 minutes away by ground and a trauma center approximately 30 minutes away by ground. As you finish packaging the patient, how should you choose to transport this patient, and to which facility?* ALS ground transport to the trauma center BLS transport to the nearest ED ALS ground transport to the nearest ED air medical transport to the trauma center While evaluating patients at a multiple-patient shooting, which of the following should be prioritized as “Red” or “Immediate”?* A 15-year-old who is alert, breathing normally, and is controlling bleeding from his arm with direct pressure A 22-year-old with no breathing even after opening the airway manually A 42-year-old who is confused, unable to follow commands, pale, and breathing 28 times per minute A 58-year-old who is ambulatory but complains of severe “crushing” chest pain with normal breathing and pulse Attendants riding in the patient compartment should use seatbelts, tethers or other restraints* any time the vehicle is operating at more than 30 mph. whenever the vehicle is traveling with lights and sirens activated. any time the vehicle is in motion. whenever they are not providing patient care. You and your partner are first on the scene of a reported unconscious person. Other units are en route. At minimum, the equipment you bring to the patient’s side should include* defibrillator, airway equipment, suctioning equipment, and a portable radio. defibrillator and airway equipment. defibrillator, airway equipment, suctioning equipment, and a long spine board. defibrillator, airway equipment, and suctioning equipment. While responding to an emergency call, your vehicle must cross a busy intersection. Your direction of travel has a red light. To safely navigate the route, you should* approach the intersection at approximately half of the posted speed limit. change the siren tone repeatedly as you drive through the intersection. come to a complete stop before entering the intersection. activate the air horn continuously until all lanes are clear. You are standing by at a motor vehicle crash while another team is removing the driver’s door to facilitate removal of the unresponsive and cyanotic driver to a long spine board. The EMT inside the car is attempting to assist ventilations but cannot create an effective mask seal or insert an advanced airway because part of the vehicle is directly in front of the patient’s face. What action should be taken?* Discontinue resuscitative efforts since the patient’s prognosis is poor Immediately remove the patient from the vehicle without spinal precautions/restriction Attempt to place a simple airway and apply low-flow oxygen with a nasal cannula Call for ALS and provide blow-by oxygen while continuing extrication The 4 quadrants of the NFPA 704 diamond represent the level of hazard in which areas?* health, flammability, reactivity, water reactive health, respiratory, flammability, reactivity reactivity, special hazards, water solubility, respiratory health, flammability, reactivity, special hazards An incident commander is deciding how to organize resources on a large, complex scene. Which of the following would be an appropriate assignment to a section or division leader?* Four command staff Three ambulances with two EMTs per ambulance One rope rescue team with three members Twelve law enforcement officers You are assigned to prepare a landing zone for an incoming air medical helicopter. Which of the following would be the best choice?* A youth soccer field that is not currently being used A flat, level stretch of undivided highway between two curves A nearby livestock pasture that is 300’ x 300’ A nearby mall parking lot without overhead obstructions You are called for a "sick person." A police officer states he has felt nauseous since entering the residence and suddenly has a headache. You look beyond the officer and see that the male patient is vomiting into the sink. You should* don protective HEPA masks and retrieve the patient. call for a hazardous materials technician team. retreat from the house and yell for the police officer and patient to follow you. ask the police officer to carry the patient out as you retreat. In the National Incident Management System, which of the following is a recommended communication technique?* Face to face communications whenever possible or practical Use of technical jargon and well-known equipment “nicknames” Repeating all messages from your boss to the incident commander or operations chief, so they can monitor the actions of all participants Use of ten codes whenever possible to shorten radio messages After arriving at a multiple-vehicle collision, you establish command, verify that no scene hazards exist, and request additional resources. Prior to assessing any individual patients, you should* loudly ask all patients to move to a designated area. assign each incoming unit to a specific sector or division. establish the number and severity of patients that can be received by each hospital in your area. mark off treatment areas with tape, cones, flags, or other markings. You are called to the scene of a motor vehicle collision on a rural highway. As you approach the scene, you notice a fractured utility pole and multiple wires down in the roadway. The involved vehicle is several hundred feet further down the road. You should* continue on to the scene to alert the patient to stay in his vehicle. stay in your ambulance, back up until you reach the next intact pole, and block the roadway. back up at least twice the distance from pole to pole and block the roadway. continue past the scene to see if other poles are broken. When lighting a landing zone for an incoming air medical helicopter, which of the following is appropriate?* Shining a spotlight at the helicopter to attract attention Using headlights from two vehicles to indicate location and wind direction Turning off all lights when pilot signals his approach Activating as many flashing lights as possible around the perimeter Your unit is first to arrive at a motor vehicle collision on a busy highway. When parking, you should position your unit* “downstream” from the incident so that you are protected while loading. on the shoulder to leave room for fire apparatus. “upstream” from the incident, blocking at least two lanes. across all lanes of travel to completely shut down the highway. You are the first EMS unit on the scene where there was a large altercation at an outdoor music venue. Law enforcement has secured the scene and moved the rest of the crowd away. Fire department responders have established a command post, begun triage and are reporting at least ten patients. Before beginning treatment on any patients, you should* request additional units, designate a staging area and communicate ingress/egress routes. designate a safety officer, public information officer, and planning officer. rapidly transport the first patient you find tagged “immediate”. request additional units and take command of the scene. When driving in emergency mode, you should increase following distance because* it reduces the time needed to come to a complete stop. ambulances are heavier and braking is more frequent in emergency mode. you may need to change direction suddenly when navigating unfamiliar areas ambulances are lighter and therefore tend to lose traction when unloaded. While responding to an emergency call, you find yourself following another emergency vehicle. To best avoid confusing other motorists, you should* select a different route and use the lane beside the other responding vehicle. turn off your lights and siren and drive with the flow of traffic. follow as closely as possible and use the air horn as much as possible. follow at a distance of several hundred feet and choose a different siren tone. You and your partner are returning to the station after completing back-to-back calls for seriously injured trauma patients. He remarks that he can’t wait to get back since it is dinnertime and he is hungry. You remind him that prior to eating, you must* decontaminate by taking a shower and changing uniforms. restock all equipment used and ensure oxygen level is adequate. complete the daily run log. request audit and medical director follow-up on appropriate runs. A 19-year-old female is trapped in her car after a rollover collision and has come to rest on its roof. Before beginning any extrication tasks, the vehicle must first* be stabilized with cribbing, struts, or other devices. have all glass removed to reduce risk of puncture to patient and rescuers. be drained of fluids to reduce risk of fire or hazardous materials release. be sprayed with firefighting foam to prevent fire. A bombing has occurred at a public gathering. Among the dangers responders should be careful to look for and avoid, the most common is* biohazard contamination. radiation sources. tertiary bombs. secondary devices. A passenger vehicle has rolled over several times, trapping at least one occupant in the small car. The windows have been crushed down and you cannot see or reach your patient. The extrication team is preparing for a long extrication. You should expect to first make contact with your patient(s)* before the vehicle is stabilized. after disentanglement. before any tools are used. during the “gaining access” phase. Patients in the “green” or “walking wounded” treatment area* do not need further assessment. should be reassessed and re-triaged frequently. should be sorted by injury or pain severity. should be instructed to keep careful records of their symptoms and see their personal physician at their convenience. A 45-year-old female experiences a sudden onset of aphasia, left-sided facial droop and paralysis of the left arm. You are 25 minutes by ground from a stroke center. Reasons to choose the emergency mode for transportation would include* heavy rush hour traffic that may delay care. no air medical helicopter available. reducing time to in service for the next call. creating a smoother ride with less stops. You are assisting a paramedic in treating a 47-year-old male with crushing, substernal chest pain. As you prepare him for transport, you notice that the paramedic has applied multiple ECG patches to his chest. You should* secure the patient with all available restraints. secure the chest strap behind the patient’s body. secure the chest strap loosely around the abdomen. not secure the chest or shoulder straps. Under which of the following circumstances must you wear a reflective safety vest?* When loading or unloading a patient in the street When walking to a patient’s home from the ambulance When treating a trauma patient who is lying partially in the street When operating as the transportation section chief While triaging patients at a major motor vehicle accident scene, you are presented with a 17-year-old female who is unresponsive, apneic even after you open her airway manually, and who has a rapid, thready pulse. This patient would be tagged* green. yellow. red. black. You are the staging officer at a large MCI and receive two radio messages requesting your last remaining ALS unit for two separate severely injured children. One child is reported to have severe head injuries and is apneic with a heart rate of approximately 50. The other child is bleeding severely from a possible fractured femur and can be heard screaming in the background of the radio call. How should you utilize the ALS unit?* Remain in staging until the triage sector can advise which child is improving Assign it to the child with the head injury, because his injury may be more severe Assign it to split its crew and provide ALS to both patients Assign it to the child with the leg injury You and your partner are first to arrive at a motor vehicle collision involving three cars. There are several people walking around the scene and you see at least three patients still in their vehicles. The person you should triage first is* the pediatric patient who is unresponsive and prone. the patient of any age who appears most seriously injured. the adult patient covered in blood who is ambulating around the scene. the patient nearest you who doesn’t move when you announce that all patients should move to the side of the road. A 32-year-old, previously healthy police officer has just been removed from the scene of a “chemical suicide” at a nearby university. The hazardous materials team brings him to the warm zone and then returns to search for more patients. The officer’s partner pushes him toward the back of your ambulance. Before you can begin treatment, the patient must be* tested for hazardous exposures by another hazmat-certified responder. sprayed with a garden hose until no visible contaminants remain. stripped and redressed with non-contaminated clothing. decontaminated according to established procedures after being stripped of all clothing. Aside from speed, advantages of air medical transport include* ability to transport multiple patients decreased transportation risks availability of specialized care decreased cost An ambulance responding to a call with lights and sirens exceeds the posted speed limit on a long, straight stretch of highway and impacts a passenger car attempting to cross at an uncontrolled intersection. The attorney for the injured driver argues that the ambulance operator should be held responsible because he or she failed to drive with* correct speed. adequate warning distance. due regard. proper warning lights. Ideally, when standing by at a hazardous materials incident, you and your unit should be positioned* uphill, upwind. in the warm zone. at least one block away. Downhill, downwind. During triage, your goal is to rapidly assess patients and defer treatment as often as possible. Which interventions may be appropriate as you quickly move from patient to patient?* bleeding control, artificial ventilations, tourniquet application simple airway insertion, artificial ventilations, defibrillation tourniquets, artificial ventilations, suctioning bleeding control, simple airway insertion, body positioning While returning to station, you come upon an overturned truck. The driver appears to be lying supine in the grass next to the vehicle. After requesting additional resources and parking to “block” the scene, what is the best course of action?* Ask the driver for shipping papers as you begin to assess him. Have a bystander search the cab of the truck for shipping papers to identify the load. Examine the scene through binoculars looking for placards or tank ruptures Approach the vehicle watching for flames, smoke, or sparks indicating risk of fire