Five phases of operations responsibilities for the EMT include
Preparing for the call - receiving and responding to a call - transferring the patient to the ambulance -transporting the patient to the hospital - terminating the call. (Limmer & O'keefe pg 975)
When talking to children and community or school groups you should always refer to 911 as
Nine-one-one" because children cannot find "eleven". (Limmer & O'keefe pg 982)
You should receive the exact location of the call from
Emergency Medical Dispatcher. (Limmer & O'keefe pg 983)
The EMD receives the call and asks information about the patient that includes
Exact location, call back number, the problem, age and sex, level of consciousness and if patient is breathing. (Limmer & O'keefe pg 983)
An emergency vehicle operator must drive with.......for the safety of others
Due regard. (Limmer & O'keefe pg 984)
Privileges granted under the law to the operators of ambulances apply when the vehicle
Is responding to an emergency. (Limmer & O'keefe pg 984)
The exemptions granted during an emergency to ambulance operators do not provide immunity in cases of.......
Reckless driving. (Limmer & O'keefe pg 984)
The privileges granted during emergency situations apply only if the operator uses........in the manner prescribed by law
Warning devices. (Limmer & O'keefe pg 984)
When driving an ambulance during an emergency you are allowed to exceed the speed limit as long as....
Life and property are not endangered. (Limmer & O'keefe pg 984)
Passing other vehicles in no passing zones during an emergency does not include passing .................when red lights are blinking
A school bus. (Limmer & O'keefe pg 984)
If you become involved in an ambulance collision the laws will be interpreted by the court based upon two key issues:
1 )used due regard for others 2) was it a true emergency. (Limmer & O'keefe pg 984)
Studies show that other drivers do not see or hear an ambulance until it is within
50 to 100 feet. (Limmer & O'keefe pg 985)
The most misused warning device
The siren. (Limmer & O'keefe pg 985)
The sound of the siren may cause a patient's condition to....
Worsen due to anxiety. (Limmer & O'keefe pg 985)
Inexperienced ambulance operators tend to increase their driving speeds
when continuously sounding the siren. (Limmer & O'keefe pg 985)
Be prepared for erratic behavior of other drivers.Some drivers ----------when they hear a siren
Panic . (Limmer & O'keefe pg 985)
Alternating flashing headlights should be used only if
They are attached to secondary head lamps. . (Limmer & O'keefe pg 985)
The large lights on the outermost corners of the box should blink in tandem, or unison, rather than wigwagging or alternating. This helps other vehicles to identify the........
Full size of the vehicle. (Limmer & O'keefe pg 985)
Four-way flashers and directional signals should not be used as
Emergency lights. (Limmer & O'keefe pg 985)
When you drive an ambulance remember that Excessive speed increases the probability of a collision and ...
Speed increases stopping distance. (Limmer & O'keefe pg 986)
Be sure that the ambulance driver and all passengers wear...........whenever the ambulance is in motion
Seat belts. (Limmer & O'keefe pg 686)
Most EMS systems recommend the use of escorts only
When the operator is not familiar with the location of the patient. (Limmer & O'keefe pg 986)
Great care must be used at ---------especially during multiple-vehicle responses
Intersections. (Limmer & O'keefe pg 986)
The typical collision happens on a --------------- (60%) with --------weather (55%) during ----------------hours (67 %) in an -------------------(72 %)
Dry road with clear weather during daylight hours in an intersection. (Limmer & O'keefe pg 986)
Weekends or weekdays, Usually ----- have the heaviest traffic
Weekdays. (Limmer & O'keefe pg 986)
Drivers have to remember that bridges -----------during cold weather
Freeze before roadways. (Limmer & O'keefe pg 987)
Most systems require you to ----------------at intersections when driving an emergency
Come to a complete stop. (Limmer & O'keefe pg 987)
If you are not the primary or first-arriving unit, you should park or stage your unit
Off the highway near the on ramp. (Limmer & O'keefe pg 987)
If you are the first unit on -scene park the ambulance
upstream" from the incident. (Limmer & O'keefe pg 988)
Ideally the ambulances should be parked ---------------
Downstream" in a safe loading area. (Limmer & O'keefe pg 988)
If your are the first unit on the scene, you should conduct a ----------------- then --------------------------an arrival report
Scene size up and transmit an arrival report. (Limmer & O'keefe pg 988)
At highway incidents you should wear ---------------------------
An ANSI Class 2 safety vest and a helmet. (Limmer & O'keefe pg 988)
If extrication is required you should
Wear turnout gear. (Limmer & O'keefe pg 988)
If backing up is necessary use a ------------------to guide the process
Spotter. (Limmer & O'keefe pg 988)
Transfer to the ambulance is accomplished in four steps, regardless of the complexity of the operation
1-select proper patient-carrying device 2 package the patient to transfer 3-move the patient to the ambulance 4- load the patient into the ambulance . (Limmer & O'keefe pg 989)
The most commonly used device to transfer the patient to the ambulance is...
The wheeled ambulance stretcher . (Limmer & O'keefe pg 990)
A patient carrying device should have a minimum of --------straps for securely holding the patient
Three. (Limmer & O'keefe pg 990)
When traveling in an ambulance you should ----------wearing a------
Remain seated, wearing a seat belt. (Limmer & O'keefe pg 990)
A patient with breathing difficulty and no possibility of spinal injury may be more comfortable being transported in
A sitting position. (Limmer & O'keefe pg 991)
If the patient is likely to develop cardiac arrest during transport, position a -------------underneath the mattress
Short spine board or CPR board. (Limmer & O'keefe pg 991)
If a relative or friend wants to ride with the patient and your protocol allows, first encourage him to use alternative way of transportation, if unable, then let him ride in ----------------------
The operator's compartment. (Limmer & O'keefe pg 992)
If un uninjured child most come along in the ambulance bring
The car seat and use it. (Limmer & O'keefe pg 992)
While en route to the hospital you should ..................with a patient report
Notify the hospital by radio. (Limmer & O'keefe pg 992)
Unless you transfer care of your patient directly to a member of the hospital staff, you may be open to a charge of
Abandonment. (Limmer & O'keefe pg 993)
During your verbal report you should include...
Any changes in the patient's condition. (Limmer & O'keefe pg 993)
As soon as you are free from patient care you should....
Prepare a patient care report. (Limmer & O'keefe pg 993)
You or your partner should begin making the ambulance ready for another call while you are still at
The hospital. (Limmer & O'keefe pg 995)
Place disposable towels used to clean up blood or body fluids in ---
Red bag. (Limmer & O'keefe pg 995)
Nondisposable equipment should be
Cleaned and disinfected. (Limmer & O'keefe pg 995)
Blood on the ambulance cot should be cleaned using a
1:100 bleach/water solution. (Limmer & O'keefe pg 996)
Place contaminated linens in a ...............
Biohazard container. (Limmer & O'keefe pg 998)
To clean and kill germs on ambulance floors and walls use
A low-level disinfectant approved by the U.S. Environmental Protection Agency. (Limmer & O'keefe pg )
To clean and kill germs on equipment surfaces you may use a....
Intermediate level disinfectant, such as mixture 1:100 bleach-to-water. (Limmer & O'keefe pg 1000)
To destroy all forms of microbial life except high number of bacterial spores use
A high-level disinfectant, such as Cidex Plus. (Limmer & O'keefe pg 1000)
To destroy all possible sources of infection on equipment that will be used in an invasive way, you should use
Sterilization method. (Limmer & O'keefe pg 1000)
Air rescue may be required for any of the following operational reasons:
To speed transport to a distant trauma center 2)when extrication of a high priority patient is prolonged 3)from a remote location that can only be reached by helicopter. (Limmer & O'keefe pg 1001)
Air rescue may be required for any of the following medical reasons
High priority for rapid transport. (Limmer & O'keefe pg 1002)
Patients with certain medical conditions may also be flown by helicopter, some examples include...
Cardiac requiring catheterization or surgery, stroke pt, pt requiring hyperbaric oxygen treatment. (Limmer & O'keefe pg 1002)
Cardiac arrest patients are usually ---------------unless they are hypothermic
Not transported by air rescue. (Limmer & O'keefe pg 1002)
A helicopter requires a landing zone, of LZ approximately ------------feet on ground that has a slope of less than 8 degrees.
100 by 100 feet (30 large steps on each side1002)
The landing zone should be marked with -------------in an upwind position.
One flare. (Limmer & O'keefe pg 1002)
When loading a helicopter do not approach unless escorted by ----------.
Flight personnel. (Limmer & O'keefe pg 1003)
You should stay clear of the ----------------at all times.
Tail rotor. (Limmer & O'keefe pg 1003)
Keep all traffic and vehicles -----------distance from the helicopter
100 feet or more. (Limmer & O'keefe pg 1003)
Do not smoke within -----feet of the aircraft
200 feet. (Limmer & O'keefe pg 1003)
Always approach a helicopter in ------------when the rotor is moving
A crouch. (Limmer & O'keefe pg 1003)
Approach the aircraft form the ----------side when a helicopter is parked on a hillside
Downhill side. (Limmer & O'keefe pg 1003)
Any substance or material in a form which poses an unreasonable risk to health, safety, and property when transported in commerce
Hazardous Material. (Limmer & O'keefe pg 1007)
Two federal agencies that developed regulations to deal with the increasing frequency of hazmat emergencies.
(OSHA) Occupational Safety and Health Administration and (EPA) the Environmental Protection Agency. . (Limmer & O'keefe pg 1008)
-----------are responsible for determining, providing and documenting the appropriate level of training for each employee.
The employer. (Limmer & O'keefe pg 1009)
This level of rescuer is expected to have advanced knowledge and skill sand to command and support activities at the incident site. A minimum of 24 hours of additional training is required.
Hazardous Materials Specialist. (Limmer & O'keefe pg 1009)
This level of training is for those who initially respond to releases or potential releases of hazardous materials in order to protect people, property, and the environment. Minimum of 8 hours of training is required
First responder operations. (Limmer & O'keefe pg 1009)
Rescuers at this level are likely to witness or discover a hazardous substance release. They are trained only to recognize the problem and initiated a response from the proper organizations.
First Responder Awareness. (Limmer & O'keefe pg 1009)
This level is for rescuers who actually plug, patch, or stop the release of a hazardous material. A minimum of 24 hours of training is required.
Hazardous materials technician. (Limmer & O'keefe pg 1009)
EMS should be trained to the.............level
Awareness level. (Limmer & O'keefe pg 1009)
Your responsibility as an EMT at a hazardous materials incident include
Recognizing that a hazardous materials incident exists, controlling the scene, and identifying the substance. (Limmer & O'keefe pg 1009)
Identification of a possible hazardous materials incident starts with...
Awareness of what exists in the community. (Limmer & O'keefe pg 1009)
After the initial patients, -------are the most likely to become injured or killed
EMTs. (Limmer & O'keefe pg 1009)
When you arrive at a hazardous materials incident you should...
Take a command position and stay a safe distance. (Limmer & O'keefe pg 1009)
Once a hazmat is recognized, who should enter the immediate site
Only personnel trained to the technician level. (Limmer & O'keefe pg 1009)
All patients leaving the site should be considered
Contaminated. (Limmer & O'keefe pg 1009)
Your primary concerned at the scene of a hazardous materials incident are ........................
Your safety and the safety of your crew, the patient and the public. (Limmer & O'keefe pg 1009)
If you arrive first at the scene of a hazardous materials incident, you should
Establish a "danger zone" and a "safe zone." (Limmer & O'keefe pg 1009)
The area surrounding a hazmat incident; extends far enough to prevent adverse effects outside the zone
Hot zone. (Limmer & O'keefe pg 1010)
Area where personnel and equipment decontamination and hot zone support take place; it includes control points for the access corridor and thus assists in reducing the spread of contamination
Warm zone. (Limmer & O'keefe pg 1010)
Area where the Incident Command post and support functions are located
Cold zone. (Limmer & O'keefe pg 1010)
The safe zone should be on the-----------level and --------from the hazardous materials incident
Same level and upwind. (Limmer & O'keefe pg 1010)
If you are the first responder at the scene, you should
Call for help and implement your agency's incident management system. (Limmer & O'keefe pg 1010)
You should establish and remain in command until.....
You are relieved. (Limmer & O'keefe pg 1010)
EMTs should not risk personal safety by.........
Initiating rescue attempts. (Limmer & O'keefe pg 1010)
You should station yourself in the ----------zone from the incident
Cold. (Limmer & O'keefe pg 1010)
When there are multiple medical patients, think....
Hazmat. (Limmer & O'keefe pg 1010)
As a responding EMT, you may be the first to recognize that a hazardous materials situation exists. You must make an attempt to
Identify the hazardous materials. (Limmer & O'keefe pg 1010)
Contamination that occurs when a contaminated person makes contact with someone who previously was "clean
Secondary contamination. (Limmer & O'keefe pg 1010)
To obtain information safely you should use...to look for identifying signs, labels, or placards from a safe distance
Binoculars. (Limmer & O'keefe pg 1010)
System of placards that uses numerical and color coding to show the type and degree of health hazard, fire hazard, reactivity, and specific hazard contained within a fixed facility
National fire Protection Association 9NFPA) 704 system. (Limmer & O'keefe pg 1011)
Other ways to gather information about the substance includes looking for.....
Labels , check invoices, bills of lading, and shipping manifests. (Limmer & O'keefe pg 1011)
Sheets with information about a chemical product that are maintained at the work site
(MSDS) material safety data sheet. (Limmer & O'keefe pg 1011)
To gather information you may also interview
Workers or others leaving the hot zone. (Limmer & O'keefe pg 1012)
This essential booklet, published by the U.S. Department of Transportation, transport Canada, and the Secretariat of Communications and Transportation of Mexico, provides the names of chemicals and concise descriptions of the actions.
Emergency Response Guidebook (ERG 2008). (Limmer & O'keefe pg 1012)
Group established in Washington, DC, as a service of the Chemical Manufacturers Association. They can provide you with information about the hazardous material through a 24-hour toll-free telephone number for the United States and Canada.
Chemical Transportation Emergency Center (CHMETREC). (Limmer & O'keefe pg 1012)
This emergency response communication service can be reached 24 hours a day
CHEM-TEL, Inc. (Limmer & O'keefe pg 1013)
This source is often overlooked during a hazardous materials situation. They can provide essential guidance in the decontamination and treatment of patients affected by hazardous materials.
Regional poison control centers. (Limmer & O'keefe pg 1013)
EMS personnel have two responsibilities at a hazmat incident: to -------------- and ----------- the hazmat team members and to take ----------
Monitor and rehabilitate hazmat team members and care for the injured. (Limmer & O'keefe pg 1014)
To address the needs of the rescuers who are wearing chemical-protective clothing during rescue operations, you should....
Establish an area of operations called rehabilitation (rehab). (Limmer & O'keefe pg 1014)
The rehab area should be located in the cold zone, protected from weather, large for multiple personnel, free form exhaust fumes, and should allow for ---------------------------into the emergency operation
Rapid re-entry. (Limmer & O'keefe pg 1014)
When the hazmat team members show signs of fatigue or when they have had 45 minutes of work time, they are sent to ---------
Rehab area. (Limmer & O'keefe pg 1014)
If a team member heart rate exceeds 110 beats per minute, you should...
Take an oral temperature. (Limmer & O'keefe pg 1014)
If a member's temperature exceeds ---------the rescuer must stay in rehab until his pulse slows and temperature returns to normal.
100.6 F�. (Limmer & O'keefe pg 1014)
In addition to medical monitoring, rehab should be set up for ----------rest, and in some cases nourishment of hazmat team members.
pre-hydration and hydration. (Limmer & O'keefe pg 1015)
During physical exertion members should consume at least -------of water per hour.
One quart. (Limmer & O'keefe pg 1015)
If electrolyte drinks are used they should be ----------to ---------------
Diluted to half strength. (Limmer & O'keefe pg 1015)
A chemical and/or physical process that reduces or prevents the spread of contamination from persons or equipment; the removal of hazardous substances from employees and their equipment to the extent necessary to preclude foreseeable health effects
Decontamination. (Limmer & O'keefe pg 1015)
The decontamination of patients and of hazmat team members is done on the -----
Decontamination corridor of the warm zone. (Limmer & O'keefe pg 1015)
EMS is responsible for setting up the..............area in the ----zone to receive ---------------------patients.
Treatment area in the cold zone to receive decontaminated patients. (Limmer & O'keefe pg 1015)
EMTs most remain in the cold zone unless......
They are trained to the hazmat technician level. (Limmer & O'keefe pg 1015)
Even if patients are decontaminated before EMTs receive them , there is a chance of ...
Secondary contamination. (Limmer & O'keefe pg 1015)
To prevent secondary contamination, EMS personnel need to wear ---------------
PPE such as Tyvek coveralls and booties, and a double layer of gloves. (Limmer & O'keefe pg 1015)
Solid or particulate contaminants should be lightly-------------prior to washing (wet decontamination)
Brushed off (dry decontamination). (Limmer & O'keefe pg 1015)
Viscous liquid contaminants including (vesicants, which are blistering agents) should be....
Blotted off prior to washing. (Limmer & O'keefe pg 1015)
When transporting a decontaminated patient, you should be aware of possible water runoff from the patient, you should ----
Protect the ambulance from contamination. (Limmer & O'keefe pg 1015)
Open wounds should be irrigated starting from the area ---the body core and working -----------
Near the body core and working outward. (Limmer & O'keefe pg 1016)
Once the wound has been cleaned you may use --------------to isolate the wound
Plastic wrap. (Limmer & O'keefe pg 1016)
If you are confronted with contaminated patients prior to the arrival of the hazmat team
Use PPE, follow the first aid measures listed in the ERG, and manage patients' critical needs. (Limmer & O'keefe pg 1017)
If treatment calls for irrigation with water, - cut the patient's clothing off and irrigate the patient's body with large amounts of water. Try to contain the runoff. After treating the patient
Decontaminate yourself; your clothing may need disposal. (Limmer & O'keefe pg 1017)
The severity of any poisoning depends on the substance,
Route of entry, dosage, and duration of contact. (Limmer & O'keefe pg 1017)
If scene decontamination is not performed, patients must be decontaminated at an --------------------before they enter the emergency department
at an appropriate hospital decon site. (Limmer & O'keefe pg 1017)
The two major phases of decontamination are
Gross decontamination and secondary decontamination. (Limmer & O'keefe pg 1017)
The removal or chemical alteration of the majority of the contaminant.
Gross decontamination. (Limmer & O'keefe pg 1017)
The alteration or removal of most of the residual product contamination
Secondary decontamination. (Limmer & O'keefe pg 1017)
A process for decontamination that neutralizes, degrades, or otherwise chemically alters the contaminant. Not recommended for use on living tissue.
Chemical reaction. (Limmer & O'keefe pg 1017)
A process of decontamination that produces a suspension of ordinarily immiscible (unmixable) insoluble materials using an ---------agent such as a surfactant, soap, or detergent
Emulsification. (Limmer & O'keefe pg 1017)
Process that removes the biological contamination hazards as the it destroys microorganisms and their toxins
Disinfection. (Limmer & O'keefe pg 1017)
A process for decontamination that reduces the concentration of the contaminants. Huge quantities of solvent may be required for even small volumes of contaminants
Dilution. (Limmer & O'keefe pg 1017)
The process for decontamination that requires the penetration of a liquid or gas into another substance. An example is water soaking into a sponge
Absorption and adsorption. (Limmer & O'keefe pg 1017)
The physical process of removing contaminants by pressure or vacuum.
Removal. (Limmer & O'keefe pg 1017)
The aseptic removal of a contaminated object form a host, after which the object is disposed of
Disposal. (Limmer & O'keefe pg 1018)
Patients wearing PPE should be decontaminated y rinsing from head to toe, scrub the suit with a brush, rinse again, then
Assist the responder (patient) in removing PPE, contain the runoff. (Limmer & O'keefe pg 1018)
When decontaminating patients who are not wearing PPE , the most concern is for ....
Responder safety. (Limmer & O'keefe pg 1018)
Use the public address system to direct ambulatory patients to a
Decontamination line. (Limmer & O'keefe pg 1018)
Alert patients should be instructed to begin decontamination by ..
Removing their clothing. (Limmer & O'keefe pg 1018)
Next the patients should receive a ----------minute water rinse
2 to 5 minute. (Limmer & O'keefe pg 1018)
MULTIPLE-CASUALTY INCIDENTS
CHAPTER 39
An event that places great demand on EMS equipment and personnel resources
Multiple-casualty incident (MCI). (Limmer & O'keefe pg 1019)
The most common MCI is an
Automobile collision with three or more patients. (Limmer & O'keefe pg 1019)
For any MCI plan to be effective, it must be............ and .........enough to be used from small three patient incidents to large scale incidents of 15 or more patients.
Flexible and expandable. (Limmer & O'keefe pg 1020)
One way to minimize the operating difficulties of a large-scale MCI is for every EMT to be familiar with the local
Disaster plan. (Limmer & O'keefe pg 1020)
Features common to every good disaster plan are: written to address the events that are conceivable for a particular location, well publicized, realistic and ..........................
Rehearsed. (Limmer & O'keefe pg 1020)
The management system used by federal, state, and local governments to manage emergencies in the United States.
National Incident Management System (NIMS). (Limmer & O'keefe pg 1020)
A subset of the NIMS designed specifically for management of multiple-casualty incidents
Incident Command System (ICS). (Limmer & O'keefe pg 1020)
The first on the scene to establish order and initiate the Incident Command System, is the person in ----------
Command. (Limmer & O'keefe pg 1020)
The ICS system's components include; Command, Operations, Logistics, Planning, and Finance. The most commonly used are
Command and Operations. (Limmer & O'keefe pg 1020)
The person who assumes responsibility for incident management.
Command. (Limmer & O'keefe pg 1020)
ICS recognize that the manageable span of control is ----people
Six. (Limmer & O'keefe pg 1020)
Unless the incident is very complex, the most common function designated is
Operations. (Limmer & O'keefe pg 1021)
Two methods of command defined under NIMS are...
Single and unified. (Limmer & O'keefe pg 1021)
An agency controls all resources and operations
Single incident command. (Limmer & O'keefe pg 1021)
Command organization in which several agencies work independently but cooperatively
Unified command. (Limmer & O'keefe pg 1022)
Is assumed by the most senior member of the first service on the scene
Incident command. (Limmer & O'keefe pg 1022)
Once command is established two modes or phases of action must then be undertaken: --------
Scene size-up;/triage and organization/delegation. (Limmer & O'keefe pg 1022)
First, command and the crew do an initial scene size up, start the triage process, and.
Call for backup. (Limmer & O'keefe pg 1022)
While waiting for help, --------------- is completed and Command gets ready for arriving resources
Initial triage. (Limmer & O'keefe pg 1022)
In a single incident command mode, one person acts as Command, and EMS would typically be group under the -------------
Operations section. (Limmer & O'keefe pg 1022)
After performing a scene size up of the incident, you should
Radio in an initial scene report and call for additional resources. (Limmer & O'keefe pg 1023)
To distinguish yourself and your incident location form other personnel and incidents that may be using the same radio system you should
Give yourself a unique Command name. (Limmer & O'keefe pg 1023)
Accordingly, the only unit talking to the communications center and requesting resources is
Command. (Limmer & O'keefe pg 1023)
Uncoordinated or undirected activity at the scene.
Freelancing. (Limmer & O'keefe pg 1025)
On larger incidents, Command may have an aide to assist with communications as well as a ---------officer and a ------officer
Public information officer and a safety officer. (Limmer & O'keefe pg 1025)
Under NIMS, in a very large and complex multiple-casualty incident, EMS will function as a branch under the --------------------section
Operations. (Limmer & O'keefe pg 1025)
EMS operations generally include the following: command center, extrication, staging area, triage area....area, ....area ........area
Mobile command center, extrication, staging area, triage area, treatment area, transportation area, rehabilitation area. (Limmer & O'keefe pg 1025)
EMT arriving at the scene would be expected to report to an area supervisor for assignment of specific duties. Once assigned a specific task, the EMT should complete the task then ...................
Report back to the area supervisor. (Limmer & O'keefe pg 1025)
The process of quickly assessing patients at a multiple-casualty incident and assigning each a priority for receiving treatment
Triage. (Limmer & O'keefe pg 1026)
The triage supervisor is ----------------------EMS provider
The most knowledgeable. (Limmer & O'keefe pg 1026)
You should quickly classify each patient into one of four groups: Priority 1 includes patients with.....
Priority 1: treatable life-threatening illness or injuries. (Limmer & O'keefe pg 1026)
You should quickly classify each patient into one of four groups: Priority 2 patients are those who.............
Priority 2: serious but not life-threatening illness or injuries
You should quickly classify each patient into one of four groups: priority 3 patients are..........
Priority 3: "walking wounded." Patients with minor musculoskeletal injuries or minor soft-tissue injuries (Limmer & O'keefe pg 1026)
You should quickly classify each patient into one of four groups: priority 4 or 0 includes patients who.........
Priority 4: (or priority 0): dead or fatally injured. (Limmer & O'keefe pg 1026)
Patients with airway and breathing difficulties, uncontrolled or severe bleeding, decreased mental status, severe medical problems, shock, and or severe burns are considered priority
One. (Limmer & O'keefe pg 1027)
Patients who have burns without airway problems, major or multiple bone or joint injuries, and/or back injuries with or without spinal cord damage are considered priority
Two. (Limmer & O'keefe pg 1027)
Patients with minor musculoskeletal injuries or minor soft-tissue injuries
Three. (Limmer & O'keefe pg 1027)
Examples of these patients include exposed brain matter, cardiac arrest (no pulse for over 20 minutes except with cold-water drowning or severe hypothermia), decapitation, severed trunk, an incineration are considered priority...
Four (sometimes zero). (Limmer & O'keefe pg1027)
Once ample resources are available, patients in arrest become priority
One. (Limmer & O'keefe pg 1027)
The first triage cut can be done rapidly by using a bullhorn, PA system, or loud voice to direct all patients capable of walking to move to a particular area. This patients most likely are priority
Three. (Limmer & O'keefe pg 1027)
If priority 3 patients are nearby and well enough to help, they may be employed to assist you by
Maintaining an airway or direct pressure on bleeding wounds of other patients. (Limmer & O'keefe pg 1027)
Priority four patients -----------------treatment unless no other patients are believed to be at risk of dying or suffering long-term disability
Do not receive treatment. (Limmer & O'keefe pg 1027)
Extensive treatment does not occur at the --------------------since it is in a hazard zone
Hazard zone. (Limmer & O'keefe pg 1027)
The most common method of prioritizing patients in the United States is the
START method of triage. (Limmer & O'keefe pg 1027)
START stands for
Simple Triage and Rapid Treatment. (Limmer & O'keefe pg 1027)
The parameters to remember when using the mnemonic RPM for the use of the START triage method,
Respiration - pulse - mental status. (Limmer & O'keefe pg 1027)
START triage is intended to be completed in ----------seconds
30. (Limmer & O'keefe pg 1027)
START triage patients who are able to walk - should be considered
Green or priority 3. (Limmer & O'keefe pg 1028)
On START triage patients who cannot walk, and who are not breathing you should,,,,
Position airway. (Limmer & O'keefe pg 1028)
After positioning the airway on the non-breathing patient, patient begins to breath, you should prioritize ...........
Red or priority 1. (Limmer & O'keefe pg 1028)
If after positioning the airway on the non-breathing patient, patient does not breathe on his own, patient is a priority
Black 4 or 0. (Limmer & O'keefe pg 1028)
Using START triage your patient is breathing faster than 30 per minute, should be considered priority
Red or one. (Limmer & O'keefe pg 1028)
Using START triage your patient is breathing at a normal rate but has no good pulses and not good skin signs and capillary refill greater than 2 seconds should be considered a .....
Red or one. (Limmer & O'keefe pg 1028)
Using START triage your patient is breathing at a normal rate with good pulses and good skin signs and capillary refill less than 2 seconds plus good mental status and follows simple commands....should be considered a .....
Yellow or priority 2. (Limmer & O'keefe pg 1028)
Patient who does not follow simple commands should be considered
Red - Priority one. (Limmer & O'keefe pg 1028)
Start making your triage sweep methodically by avoiding patients who are ----------
Obviously conscious. (Limmer & O'keefe pg 1028)
The only three treatments provided during STRT triage are to:
Open an airway and insert an oropharyngeal airway, apply pressure to bleeding and elevate an extremity. (Limmer & O'keefe pg 1028)
When you complete the triaging of non-walking patients you should...
Re-triage the priority 3 patients. (Limmer & O'keefe pg 1028)
Patients with altered mental status, or absent radial pulse or respirations of greater than 30/minute
Priority 1 red. (Limmer & O'keefe pg 1029)
Patients who are alert, and have radial pulses present, have respirations less than 30/minute are tagged
Priority 2 yellow. (Limmer & O'keefe pg 1029)
Patients who are not breathing (after an attempt to open the airway), or have no pulse and are not breathing
Priority 0 or 4 (black). (Limmer & O'keefe pg 1029)
As you move among patients to conduct initial triage, you should
Affix a triage tag. (Limmer & O'keefe pg 1029)
The area in which patients are treated at a multiple-casualty incident
Treatment area. (Limmer & O'keefe pg 1030)
Person responsible for overseeing treatment of patients who have been triaged at a multiple-casualty incident
Treatment supervisor. (Limmer & O'keefe pg 1030)
Is generally performed at a patient collection point or triage area from which patients are assigned to a treatment group
Secondary triage. (Limmer & O'keefe pg 1030)
The treatment supervisor should re-triage the patients in the area to
Determine the order in which they will receive treatment. (Limmer & O'keefe pg 1030)
Secondary triage is important to ensure that the
Patients are treated and transported according to their priority. (Limmer & O'keefe pg 1030)
Transportation to the hospital is done according to
Triage priority. (Limmer & O'keefe pg 1030)
The person responsible to maintain a list of patients and the hospitals to which they are transported
Transportation supervisor. (Limmer & O'keefe pg 1031)
Because radio communication channels will be heavily used, the ------------------------not individual EMTs, should communicate with the hospitals
Transportation officer. (Limmer & O'keefe pg 1033)
Adequately managing a patient during an MCI may require you to administer -----------. This may be talking with a terrified parent, child, or witness.
Psychological first aid." (Limmer & O'keefe pg 1033)
If an EMT becomes emotionally incapacitated, the EMT should be treated as a patient and
Removed to an area where they can rest without viewing the scene. (Limmer & O'keefe pg 1033).
HIGHWAY SAFETY AND VEHICLE EXTRICATION
CHAPTER 40
The first-arriving unit should institute "blocking" to protect the work area. Because of its size and weight, ------------preferred for this.
Fire trucks. (Limmer & O'keefe pg 1038)
The most common type of rescue across the United States is
A vehicle collision where extrication of patient is required. (Limmer & O'keefe pg 1039)
Who establishes command and confirm the exact location of the incident with the dispatch center
The first arriving units. (Limmer & O'keefe pg 1039)
Upstream blocking of the scene can be performed by...
First arriving unit, fire apparatus can be used after arriving. (Limmer & O'keefe pg 1039)
Police or EMS arriving should be positioned -----------of the initial blocking vehicle
Downstream. (Limmer & O'keefe pg 1039)
To minimize congestion, units should park in --------------direction and remain in ----------if possible
Same direction and remain in single file if possible. (Limmer & O'keefe pg 1039).
Command and EMS units are position ---------in the safe zone.
Downstream. (Limmer & O'keefe pg 1039)
Unless a roadway is completely shut down, EMS crews should------------crossing over lanes of traffic on foot
Avoid. (Limmer & O'keefe pg 1039)
The apparatus that is used to block should be positioned to create ----------to ------lanes of blockage
One and a half to two. (Limmer & O'keefe pg 1039)
Responders should always exit into the ------------zone of the vehicle
Safe Zone. (Limmer & O'keefe pg 1040)
All responders should be in full protective clothing or, at a minimum,
ANSI Class 2 traffic safety vests and helmets. (Limmer & O'keefe pg 1040)
To help slow oncoming traffic, ---------------or other devices should be placed to channel traffic away from the incident
Flares, traffic cones. (Limmer & O'keefe pg 1040)
Cones and or flares should be placed on an angle across the road and.....
Around the site. (Limmer & O'keefe pg 1040)
At night, headlights or flashing lights can temporarily blind drivers that are approaching an emergency scene, preventing them from....
Seeing emergency workers. (Limmer & O'keefe pg 1040)
Emergency vehicles parked at highway incidents should turn off vehicle headlights. In addition, they should shut off any white response lighting that could --------------
blind oncoming drivers. (Limmer & O'keefe pg 1041)
The best combination of lights to provide maximum visibility is:
Red/amber warning lights - on, Headlights - off, Fog lights - off, Traffic directional boards operating. (Limmer & O'keefe pg 1041)
The process by which entrapped patients are res cued form vehicles, buildings, tunnels, or other places.
Extrication. (Limmer & O'keefe pg 1041)
As an EMT, you are responsible for the..............component of the rescue process
Medical. (Limmer & O'keefe pg 1043)
If you arrive first at a highway incident you should park----------------and establish ---------------
Park to protect the work area and establish command. (Limmer & O'keefe pg 1043)
When you arrive on the scene of a vehicle crash, it is important to conduct a good------
Size up to evaluate hazards and assess the need for additional resources. (Limmer & O'keefe pg 1043)
During extrication operations the best practice for EMS safety...
Wear EMS or firefighter turnout clothing. (Limmer & O'keefe pg 1045)
One of the easiest ways to determine the correct PPE is to look at what other workers are doing and match....
Their level of PPE. (Limmer & O'keefe pg 1046)
Good hand protection for the EMT includes wearing......................underneath firefighter's gloves or leather gloves
Disposable vinyl gloves. (Limmer & O'keefe pg 1046)
An aluminized rescue blanket, a lightweight vinyl-coat paper tarpaulin, short and long spine boards can be used during extrication to
Shield and protect the patient form heat and cold. (Limmer & O'keefe pg 1047)
When positioning flares you should...
Take a handful of flares and walk (carefully) toward oncoming traffic. (Limmer & O'keefe pg 1047)
Flares should be positioned
Every 10 feet, if possible, to channel vehicles into an unblocked lane. (Limmer & O'keefe pg 1047)
Where should you position the flares if the collision occurred on a two-lane road
Position flares in both directions. (Limmer & O'keefe pg 1047)
An airbag that did not deploy should be disabled by
Disconnecting the battery then wait 2 to 3 minutes depending on the system(Limmer & O'keefe pg 1047)
To prevent injury from a 5-mile-per-hour bumpers that is "loaded" the EMT you should
Never stand in front of a loaded bumper. (Limmer & O'keefe pg 1047).
When there is an electrical hazard, establish a danger zone and a safe zone. The safe zone should be sufficiently far away to ensure
That an arcing or moving wire could not possibly injure personnel. (Limmer & O'keefe pg 1048)
In a collision with wires down you should park the ambulance...
Park the ambulance outside the danger zone. (Limmer & O'keefe pg 1049)
In a collision with wires down you should discourage the occupants of the collision vehicle from
Leaving the wreckage. (Limmer & O'keefe pg 1049)
In a collision with wires down you should not attempt to
Move downed wires. (Limmer & O'keefe pg 1049)
When walking towards a collision you feel tingling sensation in your legs and lower torso, you should
Stop, turn 180 degrees and take one of two escape measures. Hop to a safe place on one foot or hop away with both feet together. (Limmer & O'keefe pg 1049).
When an above ground pad-mounted electrical transformer is struck and damaged, you should do all these...
Request power company response, Do not touch the transformer, Stand in a safe place, Keep spectators out of danger area. (Limmer & O'keefe pg 1050)
Vehicle fires, when small, may be extinguished with a 15 or 20 pound class A: B: C dry chemical fire extinguisher. These fire extinguishers may be used for almost anything, Except for
Burning magnesium and other flammable metals. (Limmer & O'keefe pg 1050)
When there is fire in the engine compartment and the hood is fully open,
Use a fire extinguisher and sweep it back and forth(Limmer & O'keefe pg 1050)
When there is fire in the engine compartment and the hood is closed tight, you should....
Let the fire burn under the closed hood and let firefighters extinguish it. (Limmer & O'keefe pg 1050)
Check to see if a door can be opened or if an occupant of the vehicle can roll down a window or unlock a door. This is known as
Simple access. (Limmer & O'keefe pg 1056)
When tools or equipment are used to dismantle a vehicle this process is called
Complex access. (Limmer & O'keefe pg 1056)
Once you gain an entry point to a vehicle at least one EMT, who is properly dressed, should crawl inside the vehicle and immediately begin the
Primary assessment and rapid trauma assessment. (Limmer & O'keefe pg 1057).
The first steps of disentanglement is
Gain access by disposing of doors and the roof. (Limmer & O'keefe pg 1057)
The main job in disentanglement for the EMT is
To act as patient's advocate and be the EMT inside the vehicle. (Limmer & O'keefe pg 1057).
FBI defines it as "the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population or any segment thereof, in furtherance of political or social objectives.
Terrorism. (Limmer & O'keefe pg 1064)
2 types of terrorism as defined by FBI
Domestic and international. (Limmer & O'keefe pg 1064)
Chemical attacks stand for chemical, biological, radiological, nuclear and explosive agents
CBRNE. (Limmer & O'keefe pg 1066)
CBRNE agents are also known as
WMD weapons of mass destruction. (Limmer & O'keefe pg 1066)
When analyzing a possible incident you may thing OTTO which means
Occupancy and location, Type of event,Timing of the event, On-scene warning signs. (Limmer & O'keefe pg 1067)
The acronym TRACEM-P (Thermal, Radiological, Asphyxiation, Chemical, Etiological, Mechanical, and Psychological) can be utilized to
Implement self-protection measures. (Limmer & O'keefe pg 1069)
The radiological penetrating power of gamma rays, can penetrate as deep as ----while alpha particles penetrate ---and beta particles penetrate ----
Gamma rays - Lead Alpha particles - paper beta particles - skin. (Limmer & O'keefe pg 1069)
Normal breathing requires an oxygen concentration of
19.5. (Limmer & O'keefe pg 1069)
This refers to harm caused by either extreme heat, such as that generated by burning liquids or metals, or extreme cold form cryogenic materials such as liquid oxygen. Radiant heat can melt protective clothing and other equipment if an individual is too n
Thermal harm. (Limmer & O'keefe pg 1069)
Refers to danger form alpha particles, beta particles, or gamma rays, which are generally produced by sources such as nuclear fuels, byproducts of nuclear power production, or nuclear bombs.
Radiological harm. (Limmer & O'keefe pg 1069)
This is caused by a lack of oxygen in the atmosphere. One common cause of this is heavier-than-air gases such as argon, carbon dioxide, or chemical vapors in a confined space.
asphyxiation. (Limmer & O'keefe pg 1069)
This harm is posed by toxic or corrosive materials. These can include acids such as sulfuric acid, caustics such as lye, and chemical toxins ranging from cyanides to nerve agents.
Chemical harm. (Limmer & O'keefe pg 1070)
This is any sort of physical trauma such as gunshot wounds, slip-trip-and-fall injuries, and injury form bomb fragments or shrapnel.
Mechanical harm. (Limmer & O'keefe pg 1070)
Concerns the causes of disease. These can include acids such as sulfuric acid, caustics such as lye, and chemical toxins ranging from cyanides to nerve agents
Etiological harm . (Limmer & O'keefe pg 1070)
Protection of the Emergency Medical Responder is based on avoiding or minimizing exposure through the principles of
Time, distance, and shielding. (Limmer & O'keefe pg 1070)
This can, of course, result from any violent or traumatic event. Terrorist events are designed to create fear, invoke panic, reduce faith in government, and (as the name indicates) cause terror.
Psychological harm. (Limmer & O'keefe pg 1070)
Protection of the emergency medical response is based on avoiding or minimizing exposure through the principles of
Time, distance, and shielding. (Limmer & O'keefe pg 1070)
Obtain a weather report from the dispatch enter when responding to suspected chemical incidents and approach the incident
Upwind form any potential airborne chemicals. (Limmer & O'keefe pg 1071)
Secondary harm since many chemical reactions create heat.
Thermal harm. (Limmer & O'keefe pg 1071)
Secondary harm form chemical incidents because some chemical reactions may deplete oxygen or create gases that displace oxygen
Asphyxiation. (Limmer & O'keefe pg 1071)
The primary harm from chemical incidents and include a wide variety of effects such as corrosivity and reactivity
Chemical harms. (Limmer & O'keefe pg 1071)
This is the secondary harm that must be taken into account because corrosive chemicals like strong acids can weaken structural elements
Mechanical harm. (Limmer & O'keefe pg 1071)
This is a secondary harm because many individuals will react emotionally to a possible chemical exposure
Psychological harm. (Limmer & O'keefe pg 1071)
Single cell organisms can grow in a variety of environments.
Bacteria. (Limmer & O'keefe pg 1072)
Smallest known entities capable of reproduction. They only grow inside of living cells and cause those cells to produce more
Viruses. (Limmer & O'keefe pg 1072)
Poisons produced by living organisms.
Toxins. (Limmer & O'keefe pg 1072)
The dose or concentration of an agent multiplied by the time, or duration
Exposure. (Limmer & O'keefe pg 1072)
Biological agents can enter the body through four rout3es
Absorption, ingestion, injection and inhalation. (Limmer & O'keefe pg 1072)
Pathways into the body, generally by absorption, ingestion, injection, or inhalation
Routes of entry. (Limmer & O'keefe pg 1072)
Contact with or presence of a material that is present where it does not belong and that is somehow harmful to persons, animals, or the environment.
Contamination. (Limmer & O'keefe pg 1073)
The movement of a substance through a surface or, on a molecular level, through intact materials; penetration, or spreading.
Permeation. (Limmer & O'keefe pg 1073)
Spreading
Dissemination. (Limmer & O'keefe pg 1075)
The most effective and most common means of dissemination is to enable the material to enter through the
Respiratory tract. (Limmer & O'keefe pg 1075)
These chemical agents predominately respiratory irritants can be found not only as weaponized materials but also as commonly encountered industrial chemicals.
Choking agents. (Limmer & O'keefe pg 1078)
These agents cause chemical changes in the cells of exposed tissues almost immediately on contact. However, in many cases, the effects are not felt or realized until hours after the exposure
Vesicanting agents (blister agents). (Limmer & O'keefe pg 1078)
Formerly referred to as "blood agents," these actually have no impact on the blood. They work by preventing the use of oxygen within the body's cells and therefore are cellular asphyxiants
Cyanides. (Limmer & O'keefe pg 1078)
These agents inhibit an enzyme that is critical to proper nerve transmission, allowing the parasympathetic nervous system to run out of control.
Nerve agents. (Limmer & O'keefe pg 1078)
Stronger versions of common pesticides form the organophosphate family and are easily absorbed through the skin
Nerve agents. (Limmer & O'keefe pg 1078)
They produce the signs and symptoms that make up the mnemonic SLUDGEM
Nerve agents. (Limmer & O'keefe pg 1078)
These agents include irritating materials and lacrimators (tear-flow increasers).
Riot control agents. (Limmer & O'keefe pg 1078)
The primary concern for all biological agents is -----if the agent is transmitted from human to human.
Personal protection. (Limmer & O'keefe pg 1079)
The role of EMS in patient care and treatment for patients suffering from biological agent exposure will be primarily
Supportive in nature. (Limmer & O'keefe pg 1079)
Features that influence biological agents potential for use as weapons are
Infectivity, virulence, toxicity, incubation period, transmissibility, lethality, stability. (Limmer & O'keefe pg 1079)
This quality of an agent reflects the relative ease with which the microorganisms involved establish Themselves in a host species.
The infectivity of an agent (Limmer & O'keefe pg 1079)
An agent's ----- reflects the relative severity of the disease produced by a microorganism.
Virulence. (Limmer & O'keefe pg 1080)
An agent' s---reflects the relative severity of the illness or incapacitation produced by a toxin
Toxicity. (Limmer & O'keefe pg 1080)
The time between exposure and the appearance of symptoms is known as
Incubation period. (Limmer & O'keefe pg 1080)
The relative ease with which an agent is passed from person to person constitutes the principal concern
Transmissibility. (Limmer & O'keefe pg 1081)
Reflects the relative ease with which an agent causes death in a susceptible population
Lethality. (Limmer & O'keefe pg 1081)
The viability of a biological agent is affected by various environmental factors, including temperature, relative humidity, atmospheric pollution, ultraviolet light, and sunlight.
Stability. (Limmer & O'keefe pg 1081)