Chapter 39 - Vehicle Extrication & Special Rescue

Question 1

A 19-year-old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unresponsive, has slow and shallow respirations, and has bilateral closed femur deformities. You should:

Select one:

A. apply oxygen via a nonrebreathing mask.

B. obtain baseline vital signs and transport at once.

C. stabilize her legs with long board splints.

D. direct your partner to begin ventilatory assistance.

Answer 1

D. direct your partner to begin ventilatory assistance.

Question 2

A 33-year-old restrained driver of a motor vehicle crash is awake and alert, complaining only of neck pain and left leg pain. The vehicle is stable and no hazards are present. When removing this patient from his vehicle, you should:

Select one:

A. maintain slight traction to his neck area.

B. use the rapid extrication technique.

C. apply a full leg splint prior to extrication.

D. immobilize him with a vest-style device.

Answer 2

D. immobilize him with a vest-style device.

Question 3

At a scene with downed electrical lines, the EMT should _________.

Select one:

A. relocate the danger (hot) zone away from the patient

B. enter the danger (hot) zone for patient removal only

C. remain outside the danger (hot) zone

D. stabilize the patient in the danger (hot) zone

Answer 3

C. remain outside the danger (hot) zone

Question 4

Extrication is defined as:

Select one:

A. dismantling an automobile to remove a victim.

B. immobilizing a patient before moving him or her.

C. using heavy equipment to access a patient.

D. removal from a dangerous situation or position.

Answer 4

D. removal from a dangerous situation or position.

Question 5

If a technical rescue team is required at the scene, but is not present when you arrive, you should:

Select one:

A. check with the incident commander to ensure that the team is en route.

B. remain with your ambulance until the rescue team arrives at the scene.

C. don personal protective equipment and begin the rescue process.

D. have fire personnel initiate the rescue process if they are at the scene.

Answer 5

A. check with the incident commander to ensure that the team is en route.

Question 6

Once entrance and access to the patient have been provided, you should:

Select one:

A. perform a primary assessment.

B. allow extrication to commence.

C. begin treating his or her injuries.

D. administer high-flow oxygen.

Answer 6

A. perform a primary assessment.

Question 7

Returning the emergency unit to service is part of the _________.

Select one:

A. hazard-control phase

B. termination phase

C. support phase

D. transfer phase

Answer 7

B. termination phase

Question 8

The EMT’s responsibility during search-and-rescue operations is to _________.

Select one:

A. assist in the search on foot

B. wait at the staging area until the patient is located

C. direct other incoming EMS units

D. assume medical command

Answer 8

B. wait at the staging area until the patient is located

Question 9

The rescue team is in the process of extricating a 40-year-old male from his truck. The patient’s wife, who was uninjured in the crash, is calmly observing the extrication and asks you if her husband will be all right. You should:

Select one:

A. ask her follow-up questions about the details of the crash.

B. ensure that she is in a safe area, away from the scene.

C. allow her to talk to her husband during the extrication.

D. allow her to observe the extrication and keep her calm.

Answer 9

B. ensure that she is in a safe area, away from the scene.

Question 10

The use of special tools to remove an entrapped patient from a vehicle is known as _________.

Select one:

A. vehicle stabilization

B. incident management

C. simple access

D. complex access

Answer 10

D. complex access

Question 11

Trench collapses usually involve large areas of falling dirt that weigh approximately _______ per cubic foot.

Select one:

A. 100 lb

B. 200 lb

C. 50 lb

D. 150 lb

Answer 11

A. 100 lb

Question 12

Upon arrival at a search-and-rescue incident, the EMS crew should _________.

Select one:

A. prepare the equipment to carry to the patient

B. split up and request a search grid

C. begin searching for the patient

D. provide the incident commander with the crew’s names and certification level(s)

Answer 12

A. prepare the equipment to carry to the patient

Question 13

Upon arrival at a trench rescue operation, you should _________.

Select one:

A. assist with the rescue operation

B. determine if rescuers are operating safely

C. park at least 500 feet from the incident

D. park as close to the incident as possible

Answer 13

C. park at least 500 feet from the incident

Question 14

Upon arriving at the scene of a motor vehicle crash, you can see three patients, one who is entrapped in his car and two who have been ejected from their vehicle. You should:

Select one:

A. call medical control for further direction.

B. request law enforcement for traffic control.

C. begin triage to determine injury severity.

D. immediately request additional resources.

Answer 14

D. immediately request additional resources.

Question 15

When functioning at the scene of a motor vehicle crash in which a patient will require complex extrication, you should enter the vehicle and provide care to the patient:

Select one:

A. after rescue personnel have cut the battery cables.

B. only if the patient has experienced a major injury.

C. only after you believe the vehicle has been stabilized.

D. after receiving approval from the incident commander.

Answer 15

D. after receiving approval from the incident commander.

Question 16

When removing a critically injured patient from his or her vehicle, you should:

Select one:

A. move him or her in one fast, continuous step.

B. release c-spine control to facilitate rapid removal.

C. protect the cervical spine during the entire process.

D. remove him or her using a short backboard.

Answer 16

C. protect the cervical spine during the entire process.

Question 17

While staged at the scene of a structure fire, the EMT should _________.

Select one:

A. remain with the ambulance

B. locate the safety officer

C. assess firefighters for signs of fatigue

D. stay with the incident commander

Answer 17

A. remain with the ambulance

Question 18

You are attempting to gain access to a patient who was injured when his truck struck another vehicle from behind. The patient is conscious and alert, but is screaming in pain. You try to open the door, but it is locked. You should:

Select one:

A. break the window and unlock the door.

B. request the rescue team to extricate him.

C. ask the patient if he can unlock the door.

D. use a pry bar to attempt to open the door.

Answer 18

C. ask the patient if he can unlock the door.

Question 19

You are standing by at the scene of a hostage situation when the incident commander advises you that one of his personnel has been shot. The patient is lying supine in an open area and is not moving. As the SWAT team escorts you to the patient, you should:

Select one:

A. limit your primary assessment to airway and breathing only.

B. grab him by the clothes and immediately move him to safety.

C. perform a rapid assessment and move him to a place of safety.

D. treat only critical injuries before moving him to a safe place.

Answer 19

B. grab him by the clothes and immediately move him to safety.

Question 20

You arrive at an accident scene to find an alternative-fuel vehicle leaking an unknown substance. You should immediately _________.

Select one:

A. search the vehicle for occupants

B. disconnect the car battery

C. apply retardant to the leaking fuel

D. call for additional resources and keep bystanders away from the vehicle

Answer 20

D. call for additional resources and keep bystanders away from the vehicle

Question 21

As you and your team are removing an unresponsive patient from her wrecked car, you note that she has closed deformities to both of her legs and a deformity to her left humerus. You should:

A.realign the deformed extremities before continuing.

B. splint the deformities before moving her any further.

C. support the injured extremities and continue removal.

D. assess distal neurovascular functions in her extremities.

Answer 21

C. support the injured extremities and continue removal.

Question 22

What should be done for any type of alternative-fuel vehicle that is involved in an accident?

A. Drain the fuel.

B. Apply fire retardant to the engine compartment.

C. Leave the engine in neutral during rescue operations.

D. Disconnect the battery.

Answer 22

D. Disconnect the battery.

Question 23

Which of the following is the most important in protecting EMS providers during an extrication operation?

A. The dispatch information

B. The scene size-up

C. The number of patients

D. The availability of special operations personnel

Answer 23

B. The scene size-up

Question 24

A hiker was injured when he fell approximately 20 feet from a cliff. When you arrive at the scene, a member of the technical rescue group escorts you to the patient, who is positioned on a steep incline. The MOST appropriate method of immobilizing and moving the patient to the ambulance is to:

A. immobilize his spine with a long backboard and place him in a basket stretcher.

B. immobilize him to a long backboard and use the four-person carry to move him.

C.apply a vest-style immobilization device and move him using a stair chair device.

D. immobilize him with a short backboard and place him on the ambulance stretcher.

Answer 24

A. immobilize his spine with a long backboard and place him in a basket stretcher.

Question 25

Tactical EMS providers are specially trained to function during _________.

A. High-angle rescue operations

B. dangerous law enforcement operations

C. aircraft rescue and recovery operations

D. swift-water rescue operations

Answer 25

B. dangerous law enforcement operations

Question 26

Common duties and responsibilities of EMS personnel at the scene of a motor vehicle crash include all of the following, EXCEPT:

A. keeping bystanders at a safe distance.

B. assigning all patients a triage category.

C. preparing all patients for transportation.

D. continual assessment of critical patients.

Answer 26

A. keeping bystanders at a safe distance.

Question 27

Who has overall command of an emergency incident?

A. Incident commander

B. Safety officer

C. Senior paramedic

D. Medical director

Answer 27

A. Incident commander

Question 28

In contrast to simple access, complex access:

A. involves forcible entry into a vehicle.

B. is a skill commonly taught to EMTs.

C. does not involve the breaking of glass.

D. often involves simply unlocking a door.

Answer 28

A. involves forcible entry into a vehicle.

Question 29

_____________ is defined as the ability to reach the patient.

A. Access

B. Rescue

C. Extrication

D. Disentanglement

Answer 29

A. Access

Question 30

Upon arrival at an active law enforcement incident, the EMT should _________.

A. look for the suspect(s)

B. enter the hot zone

C. set up a treatment area

D. notify the incident commander

Answer 30

D. notify the incident commander

Question 31

Your unit has been dispatched to stand by at the scene of a structure fire. There are no injuries of which you are aware. Upon arriving at the scene, you should:

A. contact medical control and apprise him or her of the situation.

B. park your ambulance behind the incident commander’s vehicle.

C. set up a staging area where firefighters can be treated if necessary.

D. ask the incident commander where the ambulance should be staged.

Answer 31

D. ask the incident commander where the ambulance should be staged.

Question 32

Disentanglement involves:

A. removing a patient from a dangerous position.

B. the use of simple access tools such as a pry bar.

C. extrication techniques that EMTs are trained in.

D. gaining access to a patient in a crashed vehicle.

Answer 32

A. removing a patient from a dangerous position.

Question 33

You and your partner are standing by at the scene of a residential fire when you hear the incident commander state, “We have located a victim” over the radio. You should:

A. notify the hospital that you will be transporting a burn patient to their facility.

B. remain with the ambulance and wait for fire personnel to bring the victim to you.

C. immediately locate the incident commander and ask where the victim is located.

D. locate the victim and provide initial care while your partner stays with the ambulance.

Answer 33

B. remain with the ambulance and wait for fire personnel to bring the victim to you.

Question 34

The reasons for rescue failure can be referred to by the mnemonic FAILURE. In this mnemonic the “U” stands for:

A. underutilizing personnel at the scene.

B. unprepared to effectively manage the scene.

C. underestimating the logistics of the incident.

D. undertrained to correctly utilize equipment.

Answer 34

C. underestimating the logistics of the incident.

Question 35

Which of the following is the BEST example of gaining simple access to a patient?

A. Using a pry bar to open a damaged door

B. Entering a vehicle through an open window

C. Breaking glass to gain access to the patient

D. Removing the roof to access a critical patient

Answer 35

B. Entering a vehicle through an open window

Question 36

To evaluate the scene for hazards and identify the number of patients, the EMT should first _________.

A. do a 360-degree walk-around

B. interview witnesses

C. ask law enforcement to search the scene

D. photograph the accident scene

Answer 36

A. do a 360-degree walk-around

Question 37

Rescuers have brought you a patient rescued from a structural collapse. You should immediately _________.

A. notify the incident commander

B. contact medical direction

C. begin a rapid assessment

D. transport the patient

Answer 37

C. begin a rapid assessment

Question 38

The EMT’s primary responsibility during a rescue or extrication situation is _________.

A. incident command

B. documentation

C. crowd control

D. patient care

Answer 38

D. patient care

Question 39

A unique consideration when dealing with a hybrid vehicle is that:

A. you must locate the ignition switch and cut it to prevent a fire.

B. cutting the battery cables often results in an explosion or fire.

C. rescue teams should disconnect the positive battery cable first.

D. the battery has higher voltage than a traditional vehicle battery.

Answer 39

D. the battery has higher voltage than a traditional vehicle battery.

Question 40

A 50-year-old female is entrapped in her passenger car after it struck a tree. As the rescue team is preparing to extricate her, you quickly assess her and determine that she is breathing shallowly and that her radial pulse is absent. You should:

A. maintain spinal stabilization as she is extricated.

B. secure her with a short backboard or vest device.

C. stabilize her condition before extrication begins.

D. begin CPR as the rescue team begins extrication.

Answer 40

A. maintain spinal stabilization as she is extricated.

Question 41

When removing a critically injured patient from his or her vehicle, you should:

A. Release C-spine control to facilitate rapid removal

B. Remove him or her using a short backboard

C. Move him or her in one fast, continuous step

D. Protect the cervical spine during the entire process

Answer 41

D. Protect the cervical spine during the entire process

Question 42

Once entrance and access to the patient have been provided, you should:

A. Perform a primary assessment

B. Administer high flow oxygen

C. Allow extrication to commence

D. Begin treating his or her injuries

Answer 42

A. Perform a primary assessment

Question 43

A 19-year-old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unresponsive, has slow and shallow respirations, and has bilaterally closed femur deformities. You should:

A. Supply oxygen via a nonrebreathing mask

B. Director partner to begin ventilatory assistance

C. Obtain baseline vital signs and transport at once

D. Stabilize her legs with longboard splints

Answer 43

B. Director partner to begin ventilatory assistance

Question 44

_____ is responsible for properly securing and stabilizing the vehicle and providing a safe entrance and access to the patient.

Select one:

A. Law enforcement
B. The rescue team
C. The EMS service
D. The hazardous materials unit

Answer 44

B. The rescue team

Question 45

A lack of identifiable _____ at the scene hinders the rescue effort and patient care.

Answer 45

Leadership

Question 46

When arriving at the scene of a cave-in or trench collapse, response vehicles should be parked at least _____ away from the scene.

Select one:

A. 50 feet (15 m)
B. 150 feet (46 m)
C. 250 feet (76 m)
D. 500 feet (152 m)

Answer 46

D. 500 feet (152 m)

Question 47

Extinguishing fires, preventing additional ignition, and removing any spilled fuel is primarily the responsibility of _______ _______.

Answer 47

fire fighters

Question 48

If there are downed power lines near a vehicle involved in a crash, you should:

A. attempt to move the power lines yourself
B. touch the power lines with an object to see if there is active electricity
C. have the patient slowly exit the vehicle
D. have the patient remain in the vehicle

Answer 48

D. have the patient remain in the vehicle

Question 49

The EMT’s role at the scene of a search and rescue attempt is to:

A. Report to a location where the patient will be carried

B. Stand at the command post until the person is located

C. Accompanies search team members and provide care

D. Direct the search effort from a centralized location

Answer 49

B. Stand at the command post until the person is located

Question 50

Upon arrival at a motor vehicle crash, the EMT should:

A. Turn off the emergency flashing lights and headlights

B. Leave only the essential warning lights activated

C. Turn off the ambulance and set the emergency brake

D. Park at least 300 feet away from the accident scene

Answer 50

B. Leave only the essential warning lights activated

Question 51

Upon arriving at the scene of a law enforcement tactical situation, you should ensure your own safety and then:

A. Locate all injured personnel and begin treatment

B. Apprise medical control of the tactical situation

C. Report the incident commander for instructions

D. Begin immediate triage of any injured personnel

Answer 51

C. Report the incident commander for instructions

Question 52

In order to evaluate hazards present at the scene and determine the number of patients, you should:

A. Performing 360 walk around of the scene.

B. Use the information provided by dispatch

C. Request the fire department at all scenes

D. Interviewed by standards present at the scene

Answer 52

A. Performing 360 walk around of the scene.

Question 53

Your primary concern when arriving at the scene of a motor vehicle crash is:

A. Immediately begin triage

B. Surveying the area for hazards

C. Any access to patient(s)

D. Requesting additional resources

Answer 53

B. Surveying the area for hazards

Question 54

Access requiring no special tools and training

Answer 54

Simple access

Question 55

Lighting at a scene, establishing a tool and equipment area, and marking for a helicopter landing all fall under:

Select one:

A. logistics operations.
B. EMS operations.
C. support operations.
D. law enforcement.

Answer 55

C. support operations.

Question 56

When you arrive at the scene where there is a potential for hazardous materials exposure:

Select one:

A. turn off your warning light.
B. do not waste time waiting for the scene to be marked and protected.
C. park your unit downhill of the scene.
D. park your unit uphill of the scene.

Answer 56

D. park your unit uphill of the scene.

Question 57

Situational awareness is MOST accurately defined as:

A. an ongoing process of information gathering and scene evaluation to determine appropriate strategies and tactics.
B. the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact.
C. predicting the presence of certain hazards at the scene after receiving initial information from the dispatcher.
D. performing an initial scan of the scene in order to identify hazards that will pose an immediate threat to you and your crew.

Answer 57

B. the ability to recognize any possible issues once you arrive at the scene and act proactively to avoid a negative impact.

Question 58

________ is the ongoing process of information gathering and scene evaluation to determine measures for managing an emergency

Answer 58

Size-up

Question 59

No matter what the fuel source of a crashed vehicle is, one common practice remains the same—the need to disconnect the _____.

Answer 59

battery

Question 60

Which of the following statements regarding trench rescue is correct?

A. Rescue vehicle should park at least 250 feet from the scene

B. Most deaths involving cave-ins are caused by head injury

C. Trench deeper than 10 feet should be stored prior to entry

D. Ground vibration is a primary cause of secondary collapse

Answer 60

D. Ground vibration is a primary cause of secondary collapse

Question 61

Which of the following statements regarding the rapid extrication technique is correct?

A. The only indication for performing a rapid extraction is if the patient is not entrapped and is in cardiac arrest

B. It involves rapidly removing a patient from his or her vehicle after immobilizing him or her with a short backboard

C. Rapid extraction involves the use of heavy equipment to disentangle a patient from his or her crashed vehicle

D. The rapid extrication technique is indicated if the scene is unsafe and the patient is not entrapped in his or her vehicle.

Answer 61

D. The rapid extrication technique is indicated if the scene is unsafe and the patient is not entrapped in his or her vehicle.

Question 62

When determining the exact location and position of the patient(s) in a wrecked vehicle, you and your team should routinely consider all of the following, EXCEPT:

A. The position of the crashed vehicle

B. The hazards that pose a risk to rescuers

C. The make and model of the vehicle

D. The possibility of vehicle instability

Answer 62

C. The make and model of the vehicle

Question 63

The scene size-up at a motor vehicle crash or other incident:

A. Is an ongoing process until the incident is terminated.

B. Determines who is allowed to safely enter the hot zone

C. Should be performed by the most experienced EMT

D. Is a quick visual assessment of the scene prior to entry

Answer 63

A. Is an ongoing process until the incident is terminated.