Scene Size-Up and Safety — All Questions

What is the FIRST action an EMT should take upon arriving at any emergency scene?

You are dispatched to a domestic disturbance where a patient reportedly has a stab wound. Upon arrival, you hear yelling from inside the residence and see broken glass on the front porch. What should you do?

You respond to a call at a warehouse where a worker has collapsed. As you approach, a coworker runs toward you shouting that there is a strong chemical odor inside. What is your most appropriate action?

You are treating a patient with a fractured femur at a construction site when you notice a crane overhead begins to swing a heavy load toward your location. A coworker shouts a warning. The patient is on a backboard and partially immobilized. What is your priority?

Which of the following best describes a significant mechanism of injury?

You arrive at a single-vehicle crash where a sedan has struck a utility pole at approximately 40 mph. The windshield has a starred pattern on the driver’s side. The driver is alert and denies neck pain. Based on the mechanism of injury, what should you suspect?

A motorcyclist was traveling at highway speed when the bike struck the side of a turning car. The rider was thrown approximately 30 feet from the motorcycle and was wearing a helmet. Which injury pattern should the EMT most suspect?

You respond to a report of a person who fell. On arrival, you find an 82-year-old female who tripped on a rug and fell to the floor from a standing height. She is complaining of hip pain. Should this be considered a significant mechanism of injury?

You respond to a two-car intersection collision. The driver of Vehicle 1, a compact car, was T-boned on the driver’s side by Vehicle 2, a large SUV traveling at approximately 45 mph. The driver’s side door is pushed inward about 14 inches. The driver is complaining only of left shoulder pain. Based on the mechanism of injury, what injuries should you have the highest index of suspicion for?

During scene size-up for a medical patient, which of the following is the EMT attempting to determine?

You are dispatched to a residence for an “unknown medical emergency.” On arrival, you find a 55-year-old male sitting in a chair, pale and diaphoretic, clutching his chest. A bottle of nitroglycerin is on the table beside him. What is the most likely nature of illness?

You respond to a call for a 30-year-old female who fainted at a restaurant. Bystanders tell you she had been complaining of abdominal pain and dizziness before she collapsed. She is now conscious but confused. What clue from the scene size-up helps you determine the nature of illness?

You arrive at the home of a 68-year-old male. His wife states he has been vomiting blood for the past hour. You observe blood in the toilet and on towels. He appears weak and his skin is pale, cool, and clammy. Based on your scene size-up, which assessment approach should guide your care?

During scene size-up, determining the need for additional resources refers to which of the following?

You arrive at a two-vehicle head-on collision on a rural highway. One vehicle has heavy front-end damage with a patient trapped inside. The other vehicle has two ambulatory patients. Your ambulance carries two EMTs. What additional resource should you request first?

You respond to a report of a child in respiratory distress at a daycare. On arrival, you find a 4-year-old with audible wheezing and increased work of breathing. The child’s condition appears to be worsening. Your service area has a 25-minute transport time to the nearest hospital. What resource determination is most appropriate?

You arrive at a multi-story apartment building for a cardiac arrest. The patient is on the fourth floor and there is no elevator. Your crew consists of two EMTs. You have initiated CPR. Which resource consideration is most critical to ensure effective patient care?

Standard precautions in EMS are based on the principle that:

Which of the following is an example of standard precautions in the prehospital setting?

You are called to treat a patient who is coughing up blood-tinged sputum and has a fever. The patient states he was recently diagnosed with tuberculosis. In addition to gloves, what standard precaution is most important?

While suctioning a patient who is vomiting, a splash of vomitus strikes your face near your eyes. You are wearing gloves but no eye protection. What is the most appropriate immediate action?

Which of the following is a potential scene hazard that an EMT should identify during scene size-up?

You respond to a nighttime call on a busy interstate for a multi-vehicle crash. As you approach, you see fluid leaking from one of the vehicles and smell gasoline. What is your most appropriate initial action regarding this hazard?

You are dispatched to a residential call for difficulty breathing. Upon entering the home, you notice several family members also appear drowsy and complain of headaches. The home has a gas fireplace operating. What hazard should you suspect?

You arrive at a rural farm for a report of a worker who collapsed inside a grain silo. A coworker at the entrance tells you the worker went inside 10 minutes ago and has not responded to calls. What is the most appropriate action?

During scene size-up, why is it important to determine the number of patients as early as possible?

You arrive at a school bus accident with approximately 20 children on board. Several children are crying, a few appear to have minor injuries, and one child is unresponsive. As the first arriving EMT, what is your initial priority?

You are the first unit on scene at a three-vehicle collision. You count five patients. Two are walking around, two are sitting in their vehicles complaining of neck pain, and one is slumped over the steering wheel and unresponsive. Using the START triage system, what category should the walking patients be assigned?

During START triage at a building collapse, you assess a patient who is not breathing. You open the airway with a head-tilt chin-lift, and the patient begins breathing at a rate of 22 breaths per minute. What triage category should this patient receive?

What does BSI stand for in the context of EMS scene size-up?

Which level of PPE is the minimum an EMT should wear for every patient contact?

You are called to assist a patient who has been involved in an assault and is bleeding heavily from a large scalp laceration. Blood is actively spurting from the wound. What PPE should you wear before making patient contact?

You are called to a patient with projectile vomiting and profuse, watery diarrhea. The patient’s family members report similar symptoms. What is the most appropriate level of PPE for this situation?

Your partner begins patient care on a bleeding patient without putting on gloves. You notice this as your partner applies direct pressure to the wound with bare hands. What is the most appropriate action?

When approaching a vehicle crash at night, the EMT should be alert for which environmental hazard?

You and your partner arrive at a house fire where a neighbor reports that two people are still inside. The fire department has not yet arrived. Flames are visible in the front windows and thick smoke is pouring from the roof. A bystander is urging you to go in and rescue the occupants. What is the most appropriate course of action?

Which of the following environmental clues at a residential call should prompt an EMT to suspect a potential carbon monoxide hazard?

When approaching a motor vehicle crash at night on a highway, where should the EMT position the ambulance?

You arrive at a scene where a construction worker has fallen from a scaffold. Coworkers are gathered around the patient on a construction site with active overhead crane operations. What is your first action?

You respond to a report of an unresponsive person in a parking garage. Upon arrival, you notice a running vehicle parked next to the patient with the garage door closed. What should you do?

While treating a patient at a roadside emergency, a bystander alerts you that a downed power line has shifted and is now within 10 feet of your position. What is your immediate action?

You are treating a patient who collapsed at a pool party. As you begin assessment, you smell a strong chemical odor near the pool equipment area and notice a yellow-green haze at ground level. Two other partygoers are coughing nearby. What should you suspect and how should you respond?

You respond to a residential call for a patient with difficulty breathing. Upon arrival, you find a middle-aged male on the front lawn. Neighbors tell you the patient ran out of the house saying he “mixed cleaning products.” He is coughing and has watery eyes. What is your priority?

What is the recommended minimum safe distance for an EMT to stage from a scene involving a confirmed weapon or active violence?

You are on scene at a residential fire assisting with patient care in the cold zone. A firefighter exits the structure and collapses near the front door. The fire is still active. What should you do?

Which of the following is an example of a scene that may appear safe initially but could become dangerous?

You arrive at an apartment complex for a reported overdose. The caller stated needles are present. As you approach the unit, you hear a dog barking aggressively behind the door, the hallway lighting is out, and a neighbor warns you that the patient’s boyfriend “doesn’t like paramedics.” Which combination of factors most strongly supports requesting law enforcement before entry?

During a response to a rural farm, you find a worker unresponsive inside a grain silo. Bystanders urge you to climb in and help. What is the correct response?

What does the term “situational awareness” mean in the context of EMS scene safety?

You respond to a call at a methamphetamine lab. Law enforcement has secured the scene but informs you that the lab was recently active. Chemical containers and makeshift equipment are visible. Your patient is a law enforcement officer with respiratory irritation from initial entry. Where should you treat this patient?

You are treating a patient on the sidewalk of a busy urban street. A crowd has gathered and one individual is becoming verbally aggressive, shouting that you are “not doing enough.” What is the most appropriate action?

Which of the following is considered a significant mechanism of injury for an adult patient?

In a motor vehicle crash, what does “intrusion into the passenger compartment” refer to?

You arrive at a two-vehicle head-on collision where speeds were estimated at 40 mph per vehicle. The unrestrained driver of one vehicle has a starring (spider web) pattern on the windshield. Based on the mechanism of injury, which injury pattern should you anticipate?

A motorcyclist was traveling at approximately 35 mph when the motorcycle struck a car broadside. The rider was ejected over the handlebars and landed on the pavement. Based on this mechanism, what injury pattern is most likely?

You respond to a shooting where a patient was struck by a single handgun round to the right upper quadrant of the abdomen. What should you consider about the potential injury pattern?

Which type of motor vehicle collision typically produces injuries to the lateral chest, pelvis, and femur on the impact side?

You arrive at a single-vehicle crash where a car left the roadway and struck a tree at approximately 50 mph. The driver, who was wearing a seat belt, is alert and denies pain. The vehicle shows significant frontal deformation with 14 inches of intrusion into the passenger compartment. The steering wheel is bent. How should the mechanism of injury influence your assessment?

A pedestrian struck by a vehicle at moderate speed typically sustains a predictable three-part injury pattern. Which set of injuries describes this pattern?

A child darts into the street and is struck by a sedan traveling at 25 mph. Compared to an adult pedestrian struck by the same vehicle, what difference in injury pattern should the EMT expect?

You respond to a 25-year-old male who fell approximately 12 feet from a roof and landed on his feet on concrete. He is standing, ambulatory, and reports only heel pain bilaterally. Based on the mechanism, which additional injury should you suspect despite the patient’s limited complaints?

What is the significance of a “down-and-under” pathway in a frontal motor vehicle collision?

You respond to a construction site where a worker was struck in the chest by a piece of rebar propelled from a pneumatic nail gun. The rebar is protruding from the left anterior chest. Based on this mechanism of penetrating trauma, what should the EMT anticipate?

You respond to a 70-year-old female who tripped on a rug and fell forward, striking her forehead on a coffee table. She is alert and oriented with a small laceration on her forehead. She denies neck pain and moves all extremities freely. Should you consider this a significant mechanism of injury?

Which of the following motor vehicle crash characteristics is an indicator for trauma center transport according to CDC field triage guidelines?

What is the primary purpose of determining the nature of illness (NOI) during scene size-up?

Which of the following sources of information is most useful for determining the nature of illness before reaching the patient?

You respond to a call for a “sick person.” On arrival, you find a 58-year-old male seated at a kitchen table clutching his chest. You notice a nitroglycerin bottle on the table and a home blood pressure monitor nearby. What does the scene suggest about the nature of illness?

You arrive at a college dormitory for an unresponsive 19-year-old. The room contains multiple empty alcohol bottles, a rolled-up dollar bill on a mirror, and white powder residue on the desk. What nature of illness should you suspect?

Dispatch sends you to a residence for a “fall.” On arrival, a family member states the 74-year-old patient “just dropped to the floor for no reason while standing in the kitchen.” The patient is now alert but confused. How should this information influence your NOI determination?

You respond to a daycare facility where three children in the same room developed vomiting and diarrhea within the same hour. Staff reports no unusual foods were served and the rest of the children are asymptomatic. What NOI consideration is most important?

How does identifying the nature of illness differ from identifying the mechanism of injury?

You arrive at a home for a “difficulty breathing” call. The patient is a 62-year-old female sitting in a tripod position. You observe home oxygen equipment, an inhaler on the counter, and a nebulizer. The home smells of cigarette smoke. What initial nature of illness impression is most supported by these clues?

You are dispatched for an “unknown medical.” On arrival, you find a 35-year-old male sitting on the floor with a medical alert bracelet indicating “Type 1 Diabetes.” He is diaphoretic, tremulous, and unable to answer questions coherently. Based on these findings, what is the most likely nature of illness?

Which of the following scene observations would help an EMT determine the nature of illness for an unresponsive patient found alone at home?

You respond to an office building for a 40-year-old female with sudden onset of severe headache, nausea, and stiff neck. She was previously healthy with no medical history. Coworkers state she suddenly grabbed her head and said it was the “worst headache of her life.” What nature of illness should this presentation suggest?

You respond to a call for a 28-year-old female with abdominal pain. She is lying on the bathroom floor in the fetal position. You notice a positive home pregnancy test on the sink. She reports sharp lower abdominal pain and light vaginal bleeding. What NOI should you consider?

During scene size-up, what is the primary purpose of resource determination?

An EMT crew arrives at a scene and determines that the patient requires ALS (Advanced Life Support) interventions. What is the most appropriate action?

You arrive at a two-story residential fire with reports of two people trapped on the second floor. Fire department units are not yet on scene. What resources should you request?

You respond to a single-vehicle rollover on a rural highway. The driver is entrapped with the roof partially collapsed on the driver’s compartment. Your BLS ambulance is the first unit on scene. What is your immediate priority regarding resource determination?

You arrive at a multi-vehicle pileup on a foggy interstate. You can see at least six vehicles involved, with people walking around and others still inside vehicles. Visibility is poor and traffic is still approaching the scene at highway speed. Which resource request strategy is most appropriate?

Which of the following situations would require an EMT to request a helicopter (air medical) transport?

You respond to a patient who attempted suicide by cutting their wrists. The patient is now cooperative and the bleeding is controlled. Law enforcement is not on scene. Should you request law enforcement?

Your BLS unit arrives at a cardiac arrest in a third-floor apartment with no elevator. The patient weighs approximately 350 pounds. Your crew consists of two EMTs. Beyond ALS, what additional resource is most critical to request?

When should additional resources ideally be requested during an emergency response?

You respond to a report of a child who has fallen through ice on a frozen pond. Bystanders state the child is clinging to the ice edge approximately 30 feet from shore. What is the most critical resource to request?

You are dispatched to a report of a natural gas odor in a residential neighborhood. Multiple callers report the smell and one caller reports a person down in their yard. As you approach, you can smell the gas from two blocks away. What resource determination is most appropriate?

Which route of disease transmission involves inhaling airborne droplets or particles containing pathogens?

You are called to a homeless shelter for a patient with a persistent productive cough, night sweats, and unintentional weight loss. Which level of respiratory protection should you use?

While removing your gloves after patient care, you notice a small tear in the right glove. Your hand has blood on it. What is the most appropriate action?

What is the single most effective measure an EMT can take to prevent the spread of infection between patients?

You are assisting a patient who is actively vomiting. What personal protective equipment is most appropriate for this situation?

You respond to a patient with a rash and fever. The patient’s family states a visiting relative was recently diagnosed with chickenpox. The patient has never had chickenpox and has not been vaccinated. You were vaccinated against varicella as a child. What precautions should you take?

Which of the following body fluids requires standard precautions by the EMT?

After transporting a patient with confirmed meningococcal meningitis, what is the appropriate ambulance decontamination procedure?

You are called to a multi-patient incident involving a bus crash. You have limited PPE supplies remaining on the ambulance. You have four pairs of gloves, two masks, and one gown. How should you prioritize PPE use?

What should an EMT do with a needle after administering an injection or encountering a used needle?

You sustain a needlestick from a used syringe found at a scene while treating an unresponsive patient. What is the correct sequence of actions?

What does the OSHA Bloodborne Pathogen Standard require of all EMS agencies?

You are treating a patient with active, spurting arterial bleeding from a forearm laceration. While applying direct pressure, blood soaks through your gloves and you feel moisture on your skin. You have an intact skin surface with no cuts or abrasions on your hands. What is your risk level and appropriate action?

A patient with a known latex allergy needs emergency care. What type of gloves should the EMT use?

During scene size-up, which of the following is a primary environmental hazard that EMTs should assess for?

What type of placard on a commercial vehicle indicates that the cargo is flammable?

You respond to a call at a residential swimming pool where a teenager is unresponsive in the water. Upon arrival, you notice a strong, unusual chemical smell and the pool water appears cloudy with a greenish tint. What should you do?

You arrive at a residential structure fire to stage for potential patients. You notice the building has solar panels covering most of the roof. Why is this observation important for hazard identification?

The NFPA 704 diamond (fire diamond) uses four colored sections to communicate hazards. What does the yellow section indicate?

You respond to a warehouse where a forklift struck a large metal storage tank. A liquid is pooling on the floor and you notice dead insects and a small dead bird near the loading dock. Workers report a faint, sweet smell. No placards are visible. What should these clues tell you?

You respond to a motor vehicle crash on a two-lane rural road at dusk. The crash is just past a blind curve. What specific traffic hazard should you address immediately?

What is the recommended minimum safe distance for EMS staging from a hazardous materials incident when the substance is unknown?

You arrive at a nighttime highway crash where a tractor-trailer has overturned. The trailer is damaged and you can see containers scattered on the roadway. Using binoculars from a distance, you read a four-digit UN number on the containers but cannot identify the specific substance. What resource should you consult?

While assessing a patient at a construction site, you notice a hissing sound coming from a damaged pipe behind you and smell a rotten egg odor. What hazard does this represent?

What visual clue on a vehicle involved in a crash may indicate the presence of a hybrid or electric vehicle battery system?

You respond to a building collapse at a strip mall after an explosion. Upon arrival, you observe a partially collapsed structure with exposed rebar, broken glass, a strong smell of natural gas, and a water main break flooding the debris field. Which combination of hazards is most critical to address before any rescue attempt?

What is the primary purpose of determining the number of patients during scene size-up?

In the START triage system, what triage category is assigned to a patient who is not breathing even after repositioning the airway?

You are the first EMT at a school bus accident with approximately 20 children. Using START triage, you call out “If you can walk, come over to me.” Twelve children walk to you. What triage category should you assign to these ambulatory patients?

During START triage at a building collapse, you assess a patient who is breathing at 32 breaths per minute. What triage category should this patient receive?

During START triage at a multi-vehicle crash, you assess a patient who is not ambulatory. The patient is breathing at 22 breaths per minute, has a radial pulse present, and follows your commands when you ask them to squeeze your hand. What triage category should you assign?

In the START triage system, what is the maximum time that should be spent assessing each patient during initial triage?

You arrive at a nightclub fire with approximately 40 patients. You have one ambulance. What is your first triage-related action?

During START triage, you encounter a patient who is not breathing. You open the airway with a head-tilt/chin-lift maneuver and the patient begins breathing at 24 breaths per minute. What triage category should you assign?

What does the START triage acronym stand for?

During START triage, you assess a non-ambulatory patient who is breathing at 18 breaths per minute but has no radial pulse. The patient’s skin is cool and pale. What is the appropriate triage category and immediate action?