Chapter 1 Emergency Care Systems, Research, and Public Health
• What is a primary purpose of the modern-day EMS system?
• Provide a means of transport to and from the hospital
• Ensure that all members of society have equal access to hospitals
• Decrease the incidence of death and disability related to injury and illness
• Provide emergency health care services to medically underserved areas Answer: C
Diff: 2 Page Ref: 7
Objective: 1-2
• Most authorities agree that the modern-day EMS system evolved after the release of which document?
• The Emergency Medical Services Act of 1973
• The white paper "Accidental Death and Disability: The Neglected Disease of Modern Society" in
1966
• The American Heart Association's Guidelines for Cardiac Resuscitation
• Emergency Medical Services: Agenda for the Future, in 1996 Answer:
B
Diff: 1 Page Ref: 3
Objective: 1-2
• An Emergency Medical Responder comes to you and states that he would like to work for your emergency
ambulance service on a full-time basis. Knowing the National EMS Scope of Practice Model, you inform him of
which element?
• He will be able to take care of only patients with non-life-threatening complaints
• He will first need approval from your ambulance service's medical director
• He will be able to work only with an Advanced EMT or paramedic
• He will first have to become an Emergency Medical Technician Answer: D
Diff: 1 Page Ref: 6-7
Objective: 1-1
• As defined by the National EMS Scope of Practice Model, the four levels of EMS practitioners
include:
• Ambulance drivers
• EMS medical director
• Paramedics
• Emergency medical dispatchers
Answer: C
Diff: 1 Page Ref: 6-7
Objective: 1-3
• An Emergency Medical Responder (EMR) approaches you and states that he is interested in becoming an
EMT. Specifically, he asks what he will be able to do as an EMT that he cannot presently do as an EMR. You
respond by saying he will be able to:
• Administer some medications
• Assist in emergency childbirth
• Use an automated external defibrillator
• Obtain vital signs
Answer: A
Diff: 1 Page Ref: 6-7
Objective: 1-5
• You have been dispatched for a 61-year-old female in cardiac arrest. Emergency Medical Responders
(EMRs) are on scene. In your community, all EMS practitioners are trained according to the National EMS
Scope of Practice Model. Given this, which type of care do you expect the EMRs to be providing?
• Emergency medication administration
• Automated external defibrillation
• Intravenous therapy
• Reading an electrocardiogram
Answer: B
,Diff: 2 Page Ref: 6
Objective: 1-5
• An EMT with your service states that she desires to become a paramedic because she wants to provide
advanced care. Under the National EMS Scope of Practice Model, which one of these types of care will she be
able to provide as a paramedic that she cannot provide as an EMT?
• Automated blood pressure monitoring
• Assistance with emergency childbirth
• Interfacility transports
• IV
therapy
Answer: D
Diff: 1 Page Ref: 7
Objective: 1-5
• Which statement made by an EMT requires immediate intervention by a superior or the service
supervisor?
• "I always wear my seat belt whenever I am in the patient compartment of the ambulance, unless I
have to remove it to care for a patient."
• "I drive as fast as I can to get to the scene of an emergency, especially if a child is sick or injured
according to dispatch information."
• "When I am driving with lights and sirens, I instruct my partner that he will need to handle all radio
communications."
• "I put exam gloves on for every patient I contact, even if he or she does not have a known or suspected
infectious disease."
Answer: B
Diff: 1 Page Ref: 9
Objective: 1-7
• Which statement shows that the EMT has a good understanding of her role and
responsibilities related to being an EMT?
• "The patient's needs come before anyone else's needs."
• "At the scene of an emergency, my responsibility is to get to the patient no matter what."
• "My safety comes first, and then the patient's safety."
• "As an EMT, I recognize that the public's safety comes before the safety of me or my partner."
Answer: C
Diff: 2 Page Ref: 8-9
Objective: 1-7
• An ambulance with two EMTs arrives in front of a house for an unknown medical emergency. On scene,
bystanders report that a female patient was beaten by her husband in the driveway and then dragged back into
the house. They state that the patient appeared unconscious and was bleeding from the head. Which action
would the EMTs perform next?
• Do not enter the scene until it has been controlled by law enforcement
• Quietly enter the home and quickly move the patient to the ambulance
• Remove the husband from the house, then provide emergency care to the wife
• Enter the home to protect the patient while waiting for the police to arrive Answer: A
Diff: 2 Page Ref: 9
Objective: 1-7
• Why is EMS in a unique position to contribute significantly to mobile integrated health care?
• EMS providers are familiar with and capable of functioning in the out-of-hospital environment
• Ambulances are easily identified
• The community trusts uniformed health care providers
• EMS providers are familiar with the many routes of medication administration Answer: A
Diff: 1 Page Ref: 17
Objective: 1-15
,• You have arrived on the scene of a motor vehicle collision. A car has gone off the road and into a utility
pole. The pole is broken and wires are hanging just above the car. You do not see any sparking or arcing of the
wires. The driver of the car is slumped over the steering wheel and not moving. Several bystanders around the
car are yelling for you to help. Which steps represent the correct order of your response?
• Clear the bystanders, allow the fire department to secure the wires, access the patient, extricate
the patient, transport
• Access the patient, clear the bystanders, allow the fire department to secure the wires, extricate the
patient, transport
• Clear the bystanders, access the patient, extricate the patient, transport, allow the fire department
to secure the wires
• Access the patient, allow the fire department to secure the wires, clear the bystanders, extricate the
patient, transport
Answer: A
Diff: 2 Page Ref: 8-9
Objective: 1-7
• Once a scene is free of safety hazards, the EMT must recognize and focus on the needs of the:
• Rescuers
• Patient
• Family
• Bystande
rs Answer: B
Diff: 1 Page Ref: 9
Objective: 1-7
• You have been asked to sit on your service's quality improvement (QI) committee. As a knowledgeable
EMT, you recognize that in this role you will be involved in projects that are primarily designed to:
• Communicate with insurance companies for increased reimbursement
• Recruit and educate EMTs about the Emergency Medical Services profession
• Develop ways in which the delivery of emergency care can be improved
• Identify and reeducate EMTs who routinely do not provide proper care Answer: C
Diff: 2 Page Ref: 13
Objective: 1-10
• What would be a logical project to be undertaken and developed by a quality improvement (QI)
committee?
• Termination of EMTs who are chronically late to work
• A program by which pay raises are based on performance and attitude
• Community fundraiser to raise money for new EMS equipment
• Monthly continuing education programs in which seldom-used skills are practiced Answer: D
Diff: 2 Page Ref: 14
Objective: 1-10
• You are interviewing for the position of EMT with a busy urban service. This morning you are to meet with
the service's medical director. You have been told that she likes it when applicants ask questions about her role
as the medical director. Related to her responsibilities as medical director, which question is most appropriate?
• "How do you determine the wages that the EMTs are paid?"
• "How do you determine the number and location of ambulances within the system?"
• "How often are the emergency care protocols updated?"
• "Do you assign the daily chores that must be completed around the stations?" Answer: C
Diff: 2 Page Ref: 12
Objective: 1-9
• To be a medical director of an ambulance service, which requirement must the interested individual
satisfy?
• Licensed physician
• Emergency physician with surgical experience
• Physician who was a paramedic
, • Physician with a college degree in EMS
Answer: A
Diff: 1 Page Ref: 12
Objective: 1-9
• As an EMT, which requirement must be met so that you can provide routine and emergency medical care
to the sick and injured, as an extension of the medical director's authority?
• Prior medical experience
• A service medical director
• A knowledgeable partner
• A safe driving record
Answer: B
Diff: 1 Page Ref: 12
Objective: 1-9
• It has been some time since you were involved in the care of a pediatric patient. You decide to review the
assessment and treatment basics that your medical director requires. To review this information, which resource
should you consult first?
• Emergency Medical Responders
• Reputable websites
• Emergency department nurses
• Service protocols
Answer: D
Diff: 1 Page Ref: 13
Objective: 1-9
• Before the EMT contacts medical direction for authorization to assist a patient with shortness of breath in
using her metered-dose inhaler, protocols state that the EMT must first attempt to provide relief by administering
oxygen if the pulse oximeter reading is less than 94%. You recognize that the administration of oxygen is best
described as a(n):
• Standing order
• On-line medical direction
• Direct permission
• Quality improvement
Answer: A
Diff: 2 Page Ref: 13
Objective: 1-9
• If a patient with chest pain takes a daily aspirin, your medical director wants the EMT to contact an
emergency department physician first before administering additional aspirin. The act of contacting the
emergency department physician by phone or radio for permission to administer additional aspirin is an example
of:
• Quality improvement
• On-line medical direction
• Off-line medical direction
• Indirect medical control
Answer: B
Diff: 2 Page Ref: 13
Objective: 1-1
• At the scene of a minor motor vehicle collision, you are attending to a female patient who complains of
head and neck pain. A crowd has gathered to watch the action. What will the observing public most likely
remember about the role EMS portrayed?
• The number of emergency vehicles that showed up
• The color of the ambulances
• If the EMTs were all wearing the same color uniforms
• EMTs who were yelling and cursing loudly at the fire department to hurry up and get the patient out of
the car
Answer: D
