Santa Clara Local systems orientation
exam with Complete Solutions
Private EMS response to hazardous materials general procedure: secondary actions: Correct
Ans-a. Establish Command: ( i.e. incident commander)
b. Identify hazardous Materials
- ask bystanders what the saw smell tasted, or heard.
-refer to DOT guide book
Private EMS response to hazardous materials general procedure: supportive actions: Correct
Ans-a. only trained public safety HAZMAT or authorized specialized personnel are allowed to
enter the "Hot Zone" of a HAZMAT incident
b. EMS providers shall coordinate with on scene HAZMAT specialists to provide recieving
hospital's with information (i.e. chemical names, Decon methods, DOT reference #, etc)
Procedures
A. Spinal Motion Restriction (SMR) Correct Ans-a. SMR will be applied to all patients that
have, or may have sustained a
significant mechanism of injury and have an abnormal spinal injury
assessment
b. Begins with manual stabilization and immobilization of the cervical spine,
followed by proper application of the following devices:
,1. Properly sized cervical collar
2. Long plastic spine board
3. Web belt or strapping device
4. Lateral head support device
Procedures
C. Spinal Injury Assessment Correct Ans-a. If potential for spinal injury exists, apply manual
stabilization and assess
patient for following:
1. Determine if there is a language barrier
2. Assess for any distracting injuries and alcohol or drug use
3. Determine if patient is cooperative, alert and oriented
4. Palpate and visualize the entire vertebral column for injury
b. If the above is abnormal at any step, apply SMR
c. If unremarkable, continue with exam:
1. Assess for adequate circulation, motor, and sensation in all
extremities
2. Assess flexion and extension in both elbows and wrist
3. Assess finger adduction and abduction in both hands
4. Assess flexion and extension in both knees
5. Assess plantar flexion and dorsiflexion in both feet
d. If above assessment is abnormal at any step, apply SMR
e. If above is unremarkable consider Modified SMR, or omit SMR
, Procedures
B. Modified Spinal Motion Restriction Correct Ans-a. Begins with the manual stabilization
and immobilization of the cervical
spine, followed by the application of, at minimum, a rigid cervical collar
and is utilized for a less acute patient with a simple mechanism of injury.
b. Modified SMR is utilized for patients that exhibit para-vertebral pain or soft
tissue tenderness and has an unremarkable spinal injury assessment
Risk refusal "turn down" Correct Ans-A "turn down" is a situation where an EMS responder
has determined that due
to safety concerns, they cannot undertake or negotiate a safe alternate solution
(based on assessments of risk and the ability of the individual to control the risk.
Including, but not limited to:
Routine Medical Care (Adult) Correct Ans-a. Baseline Vital Signs (assessed every 10 minutes
for stable, every 5
minutes for unstable patients)
1. Glasgow Coma Scale
2. Blood Pressure (first should be obtained via manual cuff)
3. Respiratory Rate
4. Pulse Rate (obtained via palpation)
5. Pulse Oximetry (if unit is equipped)
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