Deck 45: Multiple-Casualty Incidents and Incident Management

Question 1

Which of the following patient triage tags indicates the lowest priority for care and transport on the scene of a multiple-casualty incident?

A) Yellow
B) Red
C) Black
D) Green

Answer 1

C

Question 2

You have been assigned to the triage unit at a multiple-casualty incident. A patient with a yellow triage tag arrives. Your immediate action should be to:

A) change the tag to green.
B) obtain vital signs.
C) arrange for immediate transport.
D) retriage the patient.

Answer 2

D

Question 3

The National Incident Management System (NIMS) is beneficial in an emergency response to a disaster or terror attack because it provides for:

A) specific codes and terms to enhance communications between EMS, fire, and law enforcement personnel.
B) increased funding and reimbursement for any EMS agency involved in a disaster response.
C) a consistent approach to managing a disaster by many different responders and agencies.
D) federal government control of any disaster scene regardless of location.

Answer 3

C

Question 4

Your EMS system uses the Simple Triage and Rapid Transport (START) system for triaging patients at a multiple-casualty incident. Which item should you include in your triage assessment to determine the order in which patients will receive emergency care?

A) Chief complaint and vital signs
B) Respiratory and perfusion status
C) Level of consciousness and past medical history
D) Chief complaint, vital signs, and past medical history

Question 5

Approximately 15 trucks and cars have been involved in a "chain-reaction" collision. You are the first ambulance on the scene and begin going from vehicle to vehicle to determine the type and severity of each injury. This would be an example of what kind of triage?

A) Secondary
B) Emergency
C) Primary
D) Tertiary

Question 6

The EMT identifies the primary benefit of triage when she states:

A) "Triage is a process by which the number of patients is quickly estimated so the appropriate resources can be summoned."
B) "Triage is a system that can be used by the EMT to determine the number of patients who will most likely die."
C) "Triage is a system used by the EMT to assign the order of care when an incident contains more than five patients."
D) "Triage is used to determine the order in which patients will receive medical care and transport."

Question 7

While responding to an MCI drill involving an explosion, you pass a dozen ambulances sitting in a parking lot three blocks away from the incident. You should recognize this area as the:

A) transport unit.
B) staging unit.
C) treatment unit.
D) triage area.

Question 8

A natural gas explosion has destroyed an apartment building. At least five occupants have been killed and another 12 injured. You are in charge of triage and are presented with a young woman who is breathing at a rate of 40 breaths per minute. Using the Simple Triage and Rapid Transport (START) system for triaging, you should immediately:

A) place a red tag on the patient and move on to the next patient.
B) start positive pressure ventilation.
C) apply oxygen with a nonrebreather face mask.
D) check for a radial pulse and capillary refill.

Question 9

A problem with the Simple Triage and Rapid Transport (START) system of triage is it:

A) is difficult to apply to young children.
B) requires at least 10 rescuers.
C) is only used for traumatic injuries.
D) can be complex and difficult to use.

Question 10

You have responded to a bar for a fight involving approximately 20 patrons. Weapons were used and all the patrons have varying degrees and types of injuries. You are in charge of triage and must use the Simple Triage and Rapid Transport (START) system. You find a young person lying on the floor with blood covering his shirt. Quick assessment reveals him to be breathing at 24 times per minute. Which one of the following should you do next?

A) Start positive pressure ventilation.
B) Check for a radial pulse.
C) Determine the mental status.
D) Place a yellow tag on his wrist.

Question 11

The EMT correctly defines a multiple-casualty incident (MCI) when he states:

A) "It is any event that places an excessive demand on rescue personnel and equipment."
B) "It occurs when the number of patients requiring care is greater than 10."
C) "It occurs any time the incident requires the medical director to leave the hospital and direct activities on scene."
D) "It occurs any time that five or more people are injured and require transport to different hospitals."

Question 12

A bleacher at a college has collapsed, and you are the first EMS unit to arrive on the scene. As you enter the gym, several patients are walking around with various injuries. What instruction is most appropriate for these ambulatory patients?

A) "Go outside and wait by the red fire truck in the parking lot and stay there."
B) "Sit down here so that I can do a quick assessment on you."
C) "Put this yellow tag on your wrist and go outside to the red fire truck in the parking lot."
D) "Leave this gym and wait outside. I will be out in a few minutes after I check others who cannot walk."

Question 13

As the EMT responsible for triage at a motor vehicle collision, you find a patient who is breathing 18 times per minute and has a radial pulse. Which one of the following should you do next?

A) Check the mental status.
B) Check the blood pressure.
C) Move the patient to the treatment area.
D) Place a yellow tag on the patient.

Question 14

You are using the Simple Triage and Rapid Transport (START) system of triage. Which one of the following patients should have a yellow tag applied prior to being moved to the treatment area?

A) Male with a respiratory rate of 8, no radial pulse, and unresponsive mental status
B) Female with a respiratory rate of 22, palpable radial pulse, and squeezes your fingers when instructed
C) Female with agonal respirations, no radial pulse, and unresponsive mental status
D) Male with a respiratory rate of 40, palpable radial pulse, and squeezes your fingers when instructed

Question 15

A young child involved in a multiple-casualty incident is found lying on the ground with obvious deformity to the left thigh. Using the Jump START system for triage, you note that he is not breathing. Which one of the following should you do next?

A) Tag the patient as black, and then move to the next one.
B) Provide 30 seconds of positive pressure ventilation.
C) Open the airway, and then check for a radial pulse.
D) Tag the patient as red, and then move him to the treatment area.

Question 16

You are teaching some Emergency Medical Responders (EMRs) to use the Jump START system of triage. Which one of the following comments made by an EMR requires you to intervene and provide corrective instruction?

A) "I like the Jump START system since it uses the same categories of assessment as the START system of triage."
B) "If we have a young child injured in a multiple-casualty incident, I will use the Jump START system to triage him."
C) "The Jump START system allows me to classify the patient according to his ability to ambulate, his breathing, perfusion, and mental status."
D) "The Jump START system is very effective since it allows me to take 2 minutes to assess the patient."

Question 17

At a multiple-casualty incident, a crew brings you a patient with a red tag tied to his wrist. You should recognize which one of the following?

A) Immediate care and transport are necessary.
B) Delayed care and transport are permissible.
C) The patient has a minor injury to his wrist.
D) The patient is deceased.

Question 18

At a drill involving the rollover of a tourist bus, you have been assigned to the transport area. Which one of the following activities will you perform within this section?

A) Transport patients to the hospital or other appropriate facilities.
B) Transfer patients to ambulances for transport to the hospital.
C) Triage and assign priorities of EMS care and transport to the hospital.
D) Triage and provide patient care prior to transport to the hospital.

Question 19

At the scene of a multiple-casualty incident, you are triaging a patient using the Simple Triage and Rapid Transport (START) system. You are presented with a patient who is not breathing. Which one of the following should you do next?

A) Place a red tag on the patient.
B) Start positive pressure ventilation.
C) Open the airway.
D) Place a black tag on the patient.

Question 20

You are teaching a group of EMTs about multiple-casualty incidents and the Incident Command System (ICS). Which one of the following statements about ICS is true?

A) Each EMS agency can use its own codes and terms.
B) There is a separate commander for EMS, fire, and law enforcement.
C) Each individual responder is accountable to two supervisors.
D) Plain English is used for all communications.

Question 21

You are in charge of triage at a scene involving 30 patients exposed to carbon monoxide. You find a 6-year-old boy who is not breathing. You open his airway and find that breathing does not return. Furthermore, you cannot locate a radial pulse. You should:

A) provide 15 seconds of positive pressure ventilation.
B) place a black tag on the patient and move to the next.
C) provide 15 seconds of CPR and recheck for a radial pulse.
D) apply oxygen and check the patient's mental status.

Question 22

Which of the following statements made by an EMT shows a proper understanding of the EMT's role at the scene of a multiple-casualty incident?

A) "The EMT will be in charge of providing direct medical care."
B) "The role of the EMT will always be to transport patients."
C) "The EMT will always be in charge of triage and transport of patients."
D) "The role of the EMT will vary depending on the exact situation."

Question 23

At the scene of a multiple-casualty drill, you have been assigned to the role of Transport Unit leader. As such, your responsibility is:

A) ensuring proper care for each patient.
B) distributing patients to each medical facility.
C) immobilizing all patients prior to transport.
D) ensuring that patients in cardiac arrest leave for the hospital first.

Question 24

A large bus with 52 passengers overturned on a busy highway. On scene 12 people were dead and 23 others were taken to various hospitals, many with life-threatening injuries. As commander of the incident, which one of the following is most appropriate after the last patient has left the scene?

A) Encourage rescuers to talk amongst themselves about their feelings.
B) Bring all rescuers to a central point and hold a discussion to critique the rescue effort.
C) Set a date and time for a mandatory stress debriefing.
D) Promote lighthearted talk about the incident to decrease rescuer tension and stress.

Question 25

You are on the scene of a multiple-casualty incident where a church van carrying 15 parishioners has overturned. You and your partner are in charge of the treatment unit and are presented with the following four patients. Who will you treat first?

A) A confused 69-year-old male with a respiratory rate of 40 and a rapid and weak radial pulse
B) An elderly female patient with a femur fracture and a yellow tag on her wrist
C) A 21-year-old male in cardiopulmonary arrest
D) A 13-year-old boy who walked to the treatment area complaining of a severe headache

Question 26

On the scene of a multiple-casualty incident, you note that another EMT has become overwhelmed and emotionally incapacitated after unsuccessfully trying to save a child's life. You should:

A) monitor the EMT for improper care.
B) remove the EMT from the scene.
C) instruct the EMT to go home.
D) assess the EMT for a head injury.

Question 27

In most EMS systems, a multiple-casualty incident occurs when the number of patients is:

A) 3 or more.
B) 10 or more.
C) 20 or more.
D) 50 or more.

Question 28

A second-story deck has collapsed. Several patients have fallen and are lying on the ground below. As the first emergency personnel to arrive on the scene, your initial priority is to determine:

A) the number of patients.
B) the number of ambulances required.
C) if the scene is safe to enter.
D) type and severity of injuries.

Question 29

You have been selected to represent EMS on a disaster planning committee involving many different agencies. Regarding preparation for a possible disaster, which item is most beneficial to stress in the meeting?

A) Specific terminology and codes will need to be established to make communication effective.
B) It will be important to ensure that all rescuers are flexible and can perform any task asked of them at a disaster.
C) The lay community will need to become involved by learning basic first aid and CPR.
D) Separate plans using the NIMS system need to be developed for natural and man-made disasters.