Santa Clara County EMS Exam
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1. Policy 108 - Sys- incidents that result in a threat to public safety, patient,
tem Variance Re- by-stander, or responder harm
porting
2. What types of in- any incident that results in a threat to public safety, patient,
cidents are con- by-stander or responder harm
sidered Level A
variances? 1. gross negligence
2. fraud of certifications
3. repeated negligence
4. incompetence
A. any deviation from an EMS Agency policy or treatment
protocol with patient harm
B. medication or procedural errors with patient harm
C. failure or refusal to respond to request for aid, whether
from the public or another system provider
D. equipment failure or malfunction with patient harm
E. any significant EMS-related event that would be report-
ed to another regulatory agency
3. What is the max- within 24 hours
imum time you
must report a
Level A vari-
ance?
4. Who must be no- EMS On-Duty Chief via County Communications
tified ASAP of
a Level A vari-
ance?
5. What type of inci- any incident that does NOT result in patient harm, but is
dents are consid- a deviation from EMS agency policies, procedures, and
protocols
, Santa Clara County EMS Exam
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ered Level B vari-
ances? A. potential clinical care variance
B. potential policy variance
C. poor interagency coordination
D. general complaint (public)
E. communications system variance
F. equipment failure or malfunction
6. What is the max- within five (5) business days
imum time you
must report a
Level B vari-
ance?
7. What type of inci- incidents where the responders provided outstanding
dents are consid- care and went above and beyond the normal expectations
ered Level C vari- of responders; compliments
ances?
A. good patient outcome
B. outstanding customer service
C. positive provider agency/hospital cooperation
D. field supervisor went above and beyond normal expec-
tations
8. What form would EMS Form #903
you use to file a (System Performance Variance Report)
variance report?
9. Policy 109 - Pol- standards for creation, revision, and implementation of
icy Development SCC Pre-Hospital Care Policy (including plans, protocols,
and Implementa- procedures, etc.)
tion
10. How will poli- EMS Program Manager
cy implementa-
tion be dissemi-
nated to you?
11. What other re- -county EMS website
sources do you -county EMS app
, Santa Clara County EMS Exam
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have to find new -electronic/social media
policies and up- -hardcopy
dates?
12. Which policy ad- Policy #109
dressed alloca-
tion and imple-
mentation of re-
sources?
13. Policy 500 - minimum standard criteria for the completion and submis-
Electronic Pa- sion of electronic patient care record (ePCR)
tient Care
14. When an MCI No; the EMS Agency may temporarily suspend the re-
alert occurs with quirement to complete an ePCR in certain times of mass
five (5) or more causality incidents, large scale disasters, or EMS Data
patients, is a System failure.
PCR required?
15. What would you triage tags
use in lieu of an
ePCR when an
MCI alert occurs
with five (5) or
more patients?
16. Policy 501 - Hos- standard hospital radio report format for prehospital care
pital Radio Re- providers to inform a hospital of pending arrival and when
ports communicating with the Base Hospital
17. What alerts (hos- -Major Trauma Victim (MTV)
pital report/ring- -STEMI
down) require -Stroke
use of the county -critical patient transports, transporting with red lights and
radio? sirens (RLS/code 3)
-when cell phone/landline contact is NOT possible
18. What channel do EMS Command 92
you use for ma-
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