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Test Bank For Prehospital Emergency Care, 9th Edition

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    H a n d o u t 1 - 1 Student’s Name C HAPTER 1 Q UIZ Write the letter of the best answer in the space provided. __________ 1. The first priority of the EMT on the emergency scene is to A. manage a hostile crowd. B. secure the patient. C. ensure personal safety. D. provide a situation update to dispatch. __________ 2. An EMT is operating as a designated agent of the A. EMT-Intermediate. C. medical director. B. ED nurse. D. shift commander. __________ 3. The _____ is legally responsible for the clinical and patient-care aspects of an EMS system. A. paramedic C. Advanced EMT B. shift commander D. medical director __________ 4. The first concern of an EMT always must be _____ safety. A. patient C. vehicle B. bystander D. personal __________ 5. A policy set by an EMS medical director that allows EMTs to administer glucose to patients in certain circumstances without speaking to the physician is an example of a(n) A. direct order. C. standing order. B. on-line order. D. QI order. __________ 6. An order from an EMS system’s on-duty physician given by radio or phone is an example of A. off-line medical control. C. designated direction. B. on-line medical direction. D. standing orders. __________ 7. The level of EMS that involves medical training for those who are usually first on the scene of an emergency is A. Emergency Medical Responder. C. Advanced EMT. B. EMT. D. Paramedic. __________ 8. Most EMT courses today are based on models developed by the A. AHA. C. DOT. B. ARC. D. NST. __________ 9. The system of internal and external reviews and audits for all aspects of an emergency medical system is known as A. quality improvement. C. EMDs. B. protocols. D. standing ORs. __________ 10. The aspect of the EMT’s job that involves protecting the patient’s rights is A. assessment. C. advocacy. B. transfer. D. protocol. C H A P T E R 1 Emergency Medical Care Systems, Research, and Public Health Prehospital Emergency Care, 9th Ed.

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    I N THE F IELD Review the following real-life situation. Then answer the questions that follow. You and an EMT partner are assigned to EMS Unit 5 one morning in September. At 1035, the emergency dispatcher directs you to an accident on Mesa Drive. A woman driving her car along that road called 911 on her cell phone to report that the car ahead of her had swerved to avoid a dog, gone off the road, plunged into a ditch, and hit a tree. Your unit pulls up at the scene 6 minutes later. As you don your personal protective equipment, you note that a county sheriff’s car is already on-scene. A deputy is kneeling beside a male in his early 20s who is lying on the ground. Even from the top of the ditch, you can see that the young man’s shirt and pants are blood soaked. The deputy is applying direct pressure to the patient’s right wrist. As you approach, the deputy tells you that after the crash, the patient, who had been wearing a seat belt, did not believe himself injured. However, before the deputy arrived, the patient attempted to get out of the car. In doing so, he sliced his wrist on jagged metal. Your partner takes over holding direct pressure to the wound. Meanwhile, you introduce yourself to the patient as you begin your assessment of his condition. The patient seems anxious and restless; as you assess him, you talk to him, explaining what you are doing, and try to calm him. Because of the circumstances of the accident, you are especially alert during the assessment to the possibility that the patient may have received internal and/or spinal injuries. In fact, you determine that the patient is showing signs and symptoms of internal bleeding and shock (hypoperfusion). Shock is a life-threatening condition, so you decide that he needs immediate transport to the hospital, some 20 minutes away. You have provided the patient with high concentration oxygen. Now, as you prepare him for transport, you ask the police officer to call in a request for a rendezvous with Paramedics of the advanced life support (ALS) unit. When he has done so, he joins you and your partner in moving the patient, now immobilized to a long spine board, to the ambulance. You remain with the patient, holding direct pressure on the wrist wound, while your partner drives. You also monitor the patient’s airway, breathing, and circulation and re- assess his vital signs. Seven minutes later, you meet the paramedics of the ALS unit at the parking lot of a farm produce stand. You provide the paramedics with a concise report of the patient’s condition and your interventions. The paramedics assume care of the patient. They contact medical direction and report on their findings and expected time of arrival at the hospital as transport continues. At 1105, the ambulance reaches County General Hospital. The emergency room staff is briefed on the patient’s status and vital signs and on the care he has received. The hospital crew takes over, and wheels the patient off to surgery. 1. Which components of the EMS system were involved in this scenario? 2. What roles and responsibilities of an EMT were demonstrated in this scenario? Prehospital Emergency Care, 9th Ed. H a n d o u t 1 - 2 Student’s Name C H A P T E R 1 Emergency Medical Care Systems, Research, and Public Health

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    C HAPTER 1 R EVIEW Write the word or words that best complete each sentence in the space provided. 1. The modern emergency medical services (EMS) system began in the ______________________________. 2. The National Highway Safety Act charged the United States ______________________________ ______________________________ ______________________________ with developing an EMS system. 3. The emergency medical treatment given by EMTs to patients before they are transported to a facility is called ______________________________ ______________________________. 4. The type of facility that provides specialized treatment for injuries that exceed normal hospital emergency department capabilities is a(n) ______________________________ ______________________________. 5. The system of answering emergency telephone calls that uses specially trained EMS personnel who obtain information about emergency situations from callers and also provide instructions for emer- gency care to callers is ______________________________ ______________________________ ______________________________. 6. The 911 telephone number used to access emergency services in many parts of the nation is often referred to as the ______________________________ ______________________________. 7. A(n) ______________________________ ______________________________ is a basic-level EMS provider who has passed specific additional training programs and is authorized to provide some level of ad- vanced life support such as intravenous therapy and advanced defibrillation. 8. The system of internal and external reviews and audits of all aspects of an emergency medical system is known as ______________________________ ______________________________. 9. Standing orders that allow EMTs to give certain medications or perform certain procedures without speaking directly to a physician are examples of ______________________________ ______________________________ medical direction. 10. An EMT has responsibility for a patient until the ______________________________ ______________________________ ______________________________ to hospital personnel has been properly completed. C H A P T E R 1 Emergency Medical Care Systems, Research, and Public Health Prehospital Emergency Care, 9th Ed. H a n d o u t 1 - 3 Student’s Name

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    EMT: L ISTING 1. List five of the categories in which the National Highway Traffic Safety Administration Technical Assistance Program sets standards for EMS systems. 2. List three types of specialty hospitals. 3. List three responsibilities of emergency medical dispatchers. Prehospital Emergency Care, 9th Ed. H a n d o u t 1 - 4 Student’s Name (continued) C H A P T E R 1 Emergency Medical Care Systems, Research, and Public Health

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    4. List the four general levels of EMS training and certification. 5. List at least four responsibilities of the EMT. C H A P T E R 1 Emergency Medical Care Systems, Research, and Public Health Prehospital Emergency Care, 9th Ed. H a n d o u t 1 - 4 (continued)

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    EMT: T RUE OR F ALSE Indicate if the following statements are true or false by writing T or F in the space provided. __________ 1. As an EMT, your authority to give medications and provide emergency care is an extension of the medical director’s license to practice medicine. __________ 2. As an EMT, you will be one of the many persons and professionals that come together to form an EMS system. __________ 3. Trauma centers are not yet considered “specialty” hospitals. __________ 4. Certification as an EMT requires only that a person successfully complete the DOT EMT-National Standard Training Program. __________ 5. Keeping yourself safe is your second priority after patient safety when providing medical care. __________ 6. The care an individual patient requires may range from simple emotional support to life-saving CPR. __________ 7. You must never abandon care of the patient at the hospital until transfer to hospital personnel has been properly completed. __________ 8. Good personality traits are really not very important to the EMT. __________ 9. Good quality continuing education can often take the place of an original EMT training course. __________ 10. Quality improvement is designed and performed to ensure that the public receives the highest quality prehospital care. __________ 11. The EMT has no direct role in the quality improvement process. __________ 12. Striving for quality in the care you personally give to patients and as a collective part of an ambulance squad is to uphold the highest standards of the EMS system. Prehospital Emergency Care, 9th Ed. H a n d o u t 1 - 5 Student’s Name C H A P T E R 1 Emergency Medical Care Systems, Research, and Public Health

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    C H A P T E R 1 Emergency Medical Care Systems, Research, and Public Health Prehospital Emergency Care, 9th Ed. CHAPTER 1 ANSWER KEY HANDOUT 1-1: Chapter 1 Quiz 1. C 4. D 7. A 9. A 2. C 5. C 8. C 10. C 3. D 6. B HANDOUT 1-2: In the Field 1. The emergency dispatcher; an emergency medical responder (the deputy); the EMT on Unit 5; the paramedics from the ALS unit; the emergency room personnel at the hospital 2. Personal safety; safety of patient; patient assessment; patient care; lifting and moving; transport; transfer of care HANDOUT 1-3: Chapter 1 Review 1. 1960s 2. Department of Transportation 3. prehospital care 4. trauma center 5. emergency medical dispatching 6. universal number 7. Advanced EMT 8. quality improvement 9. off-line 10. transfer of care HANDOUT 1-4: EMT: Listing 1. Any five: Regulation and Policy, Resource Management, Human Resources and Training, Transportation, Facilities, Communications, Public Information and Education, Medical Direction, Trauma Systems, Evaluation. 2. Any three: trauma centers, burn centers, pediatric centers, poison centers, stroke centers. 3. To obtain appropriate information from callers; to facilitate dispatch of emergency services; to provide medical instructions for emergency care. 4. Emergency medical responder, EMT, Advanced EMT, Paramedic. 5. Responsibilities include preparation for response, safe response, safe transportation, patient assessment, patient care, proper transfer of the patient to hospital personnel for continuity of care. HANDOUT 1-5: EMT: True or False 1. T 4. F 7. T 10. T 2. T 5. F 8. F 11. F 3. F 6. T 9. F 12. T

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. C HAPTER 2 Q UIZ Write the letter of the best answer in the space provided. __________ 1. The stage of the dying process that can be characterized by the words “Why me?” is A. denial. C. anger. B. acceptance. D. depression. __________ 2. A type of emergency call likely to produce extreme levels of stress is one involving A. a patient with a communicable disease. B. injury or death of a coworker. C. a geriatric patient. D. narcotics. __________ 3. The goal of the CISD is to A. assign blame for the incident. B. assist patients in their recovery. C. assist emergency care workers in dealing with stress. D. allocate funds for ambulance services. __________ 4. A less structured version of the CISD, which may be held from 1 to 4 hours after an incident and before the formal debriefing, is called a(n) A. resolution. C. escape mechanism. B. defusing. D. R&R process. __________ 5. The stage of grieving in which a patient seeks to postpone death, even for a short time, is A. anger. C. acceptance. B. bargaining. D. denial. __________ 6. Organisms that cause infection, such as viruses and bacteria, are A. toxins. C. venoms. B. pathogens. D. poisons. __________ 7. The standard that assumes all blood and body fluids are infectious and requires emergency personnel to follow strict procedures to protect themselves from them is referred to as A. infective body fluid measures. B. isolated infection controls. C. preventive control substance standards. D. body substance isolation. __________ 8. Gloves, masks, and gowns are examples of A. turnout gear. B. optional field equipment. C. personal protective equipment. D. “red bag” gear. __________ 9. If a patient is suspected of having tuberculosis, an EMT should wear a _____ respirator. A. PPD C. HEPA B. CISD D. BSI H a n d o u t 2 - 1 Student’s Name (continued)

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. __________ 10. Lifestyle changes that can help an EMT deal with stress include all of the following except A. cut down on sugar, fat, and caffeine. B. avoid exercise in your daily routine. C. avoid self-medication. D. keep balance in your life. __________ 11. Which of the following materials is not recommended for gloves to be used when there is the potential for contact with blood and other body fluids? A. latex C. cotton B. vinyl D. synthetics __________ 12. Equipment used as a BSI precaution includes all of the following except A. a HEPA respirator. C. cotton scrub pants. B. vinyl gloves. D. goggles. __________ 13. The process by which an object is subject to a chemical or physical substance that kills all microorganisms on the surface is A. sterilization. C. disinfection. B. OR cleaning. D. scouring. __________ 14. A situation that would usually call for the use of a gown as protection would be one involving a A. drug-overdose patient. C. suspected TB patient. B. childbirth. D. patient with a fractured leg. __________ 15. Dispose of all needles immediately after use in a(n) A. “green bag.” C. “OSHA jar.” B. “HAZMAT box.” D. “sharps container.” __________ 16. The single most important way an EMT can prevent the spread of infection is A. up-to-date immunizations. C. wearing a jumpsuit. B. hand washing. D. using a mask. __________ 17. In general, before entering a hazardous materials scene, EMTs should A. call for an ambulance. C. put on a mask. B. put on goggles. D. call for a specialized HAZMAT team. __________ 18. The test that can detect exposure to tuberculosis is the _____ test. A. PSA C. SAT B. Mantoux D. Rubella __________ 19. If you suspect the potential for violence at a scene, before entering it, you should A. call law enforcement. C. put on body armor. B. turn on all lights and sirens. D. approach on foot. __________ 20. Vehicles, structures, and storage containers holding hazardous materials should be identified by A. signs or placards. C. reflectors. B. strobe lights. D. warning flags. H a n d o u t 2 - 1 (continued)

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. I N THE F IELD Review the following real-life situation. Then answer the questions that follow. You and your partner are dispatched to the scene of a motor vehicle collision. As you approach the scene, you note that a large tanker truck has overturned in the middle of the road. The truck’s driver is trapped in the cab. You are also informed by dispatch that a bystander has reported that the truck has placards dis- played on its exterior. 1. What should you do at this point? 2. If you determine that the truck carries hazardous materials, what should you do next? H a n d o u t 2 - 2 Student’s Name

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. H a n d o u t 2 - 3 Student’s Name C HAPTER 2 R EVIEW Write the word or words that best complete each sentence in the space provided. 1. Dying patients experience five emotional stages—denial, anger, ______________________________, ______________________________, and ______________________________. 2. A(n) ______________________________-______________________________ ______________________________ is a single incident in which there are multiple patients. 3. Chronic ______________________________ brought about by work-related problems in an emotionally charged environment can lead to burnout. 4. ______________________________ ______________________________, which include deep-breathing exercises and meditation, are valuable stress reducers. 5. Held within 24 to 72 hours of a critical incident, a(n) ______________________________ ______________________________ ______________________________ ______________________________ is a process in which a team of trained peer counselors and mental health professionals meet with rescuers and health care providers who have been involved in the incident. 6. The state of emotional exhaustion and irritability that can markedly decrease an EMT’s effectiveness in delivering medical care is called ______________________________. 7. According to the U.S. Public Health Service, most contaminants can be removed from the skin with ______________________________ to ______________________________ seconds of vigorous ______________________________ ______________________________. 8. Airborne ______________________________ are spread by tiny droplets sprayed during breathing, coughing, or sneezing. 9. The strict form of infection control for emergency personnel is known as ______________________________ ______________________________ ______________________________. 10. In addition to eye protection, gloves, and a mask, another item of personal protective equipment that should be worn when there may be significant contact with blood or other body fluids is a(n) ______________________________. 11. As an advance safety precaution, an EMT should have a ______________________________ ______________________________ ______________________________ test for TB every year. (continued)

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. 12. The level of cleaning for items such as backboards and cervical collars, which come in contact with the intact skin of patients, is ______________________________. 13. EMS personnel treating a patient suspected of having TB should use a(n) ______________________________ respirator. 14. Before entering scenes involving domestic disputes, gang fights, or bar fights, an EMT should first ______________________________ ______________________________ ______________________________. 15. When approaching a wrecked vehicle that may be carrying hazardous materials, use binoculars to try to find ______________________________ or ______________________________ that can identify the material as hazardous. H a n d o u t 2 - 3 (continued)

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. H a n d o u t 2 - 4 Student’s Name W ELL -B EING B ASICS : L ISTING 1. List at least five signs and/or symptoms of stress. 2. List four types of calls that have a higher-than-normal potential for causing stress in EMS personnel. 3. List and define five emotional stages a dying patient may go through. 4. List the basic types of personal protective equipment that EMTs can be expected to use on a regular basis.

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. W ELL -B EING B ASICS : T RUE OR F ALSE Indicate if the following statements are true or false by writing T or F in the space provided. __________ 1. Emergencies are rarely stressful. __________ 2. All seriously ill patients pass through a five-stage grieving process. __________ 3. The main purpose of a CISD is to affix responsibility for the events that took place during an incident. __________ 4. If a CISD is thorough, follow-up is not essential. __________ 5. Keeping yourself safe is your first priority when providing medical care as an EMT. __________ 6. Diseases are caused by pathogens, which may be spread through the air or by contact with blood and/or body fluids. __________ 7. In the practice of prehospital emergency care, all body fluids must be considered infectious. __________ 8. It is imperative that the EMT changes gloves between every patient contact. __________ 9. Because EMTs wear protective gloves while with patients, hand washing is not essential immediately after each call. __________ 10. A HEPA or N-95 respirator should be worn after contact with an HIV-positive patient. __________ 11. In some jurisdictions, when a patient is suspected of having an infection spread by droplets, a surgical-type mask may be placed on the patient if he or she is alert and cooperative. __________ 12. An EMT called to a scene of suspected violence should treat any life-threatening emergencies before calling law enforcement. __________ 13. A copy of the Emergency Response Guidebook should be on board every emergency vehicle. __________ 14. An EMT exposed to bloodborne pathogens should seek medical attention within 4 weeks after the exposure. __________ 15. An EMT should make preservation of evidence at a crime scene the highest priority. H a n d o u t 2 - 5 Student’s Name

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    C H A P T E R 2 Workforce Safety and Wellness of the EMT Prehospital Emergency Care, 9th Ed. HANDOUT 2-1: Chapter 2 Quiz 1. C 6. B 11. C 16. B 2. B 7. D 12. C 17. D 3. C 8. C 13. A 18. B 4. B 9. C 14. B 19. A 5. B 10. B 15. D 20. A HANDOUT 2-2: In the Field 1. Before approaching the truck, you should, from a safe distance, use binoculars to try to identify the placards on the truck. Check in the DOT’s Emergency Response Guidebook to see what the placards indicate. 2. If the placards indicate the truck carries hazardous materials, call for assistance from appropriate specialized teams before attempting to assist the driver. Provide basic emergency care only after the scene is secured and patient contamination is limited. Follow your local protocols in regard to protective clothing. HANDOUT 2-3: Chapter 2 Review 1. bargaining, depression, acceptance 2. multiple-casualty incident 3. stress 4. Relaxation techniques 5. critical incident stress debriefing 6. burnout 7. 10, 15, hand washing 8. pathogens 9. body substance isolation 10. gown 11. Purified Protein Derivative (PPD) 12. disinfection 13. HEPA (or N-95) 14. call law enforcement 15. placards, signs CHAPTER 2 ANSWER KEY HANDOUT 2-4: Well-Being Basics: Listing 1. Any five: irritability with family, friends, or coworkers; inability to concentrate; difficulty in sleeping; nightmares; loss of appetite; loss of interest in sexual activity; anxiety; indecisiveness; guilt; isolation; loss of interest in work. 2. Any four: multiple-casualty incidents; calls involving infants or children; severe injuries; abuse and neglect; death of a coworker. 3. Denial (“Not me.”); anger (“Why me?”); bargaining (“OK, but first let me . . .”); depression (OK, but I haven’t . . .”); acceptance (“OK, I’m not afraid.”). 4. Protective eyewear (safety glasses, goggles, side shields); gloves; gown; mask (surgical type for blood or other body fluids, HEPA or N-95 respirator for patient with suspected TB). HANDOUT 2-5: Well-Being Basics: True or False 1. F 5. T 9. F 13. T 2. F 6. T 10. F 14. F 3. F 7. T 11. T 15. F 4. F 8. T 12. F

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