FFICM Emergency Response Procedures 2 — Questions and Answers
Question 1: During a mass casualty incident in the ICU, the START triage system categorizes a patient who is breathing at 22 breaths/min, has a radial pulse, and can follow commands. What color tag should be assigned?
- Red (immediate) (Correct answer)
- Green (minor/delayed)
- Yellow (delayed)
- Black (expectant/deceased)
Correct answer: Red (immediate)
A patient breathing spontaneously, with a radial pulse, and able to follow commands is tagged Red (immediate) under START triage, indicating life-threatening but salvageable injuries.
Question 2: When activating a hospital Code Blue for an adult ICU patient, which immediate action takes highest priority before the crash team arrives?
- Defibrillate if AED is available
- Begin high-quality chest compressions (Correct answer)
- Secure IV access and draw blood cultures
- Notify the attending physician by phone
Correct answer: Begin high-quality chest compressions
High-quality chest compressions are the single most important intervention in cardiac arrest, as they maintain coronary and cerebral perfusion until advanced care arrives.
Question 3: A fire is reported in the ICU medication room. Using the RACE acronym, what is the FIRST action staff should take?
- Activate the fire alarm
- Confine the fire by closing doors
- Evacuate patients from the area
- Rescue persons in immediate danger (Correct answer)
Correct answer: Rescue persons in immediate danger
RACE stands for Rescue, Alarm, Contain, Extinguish/Evacuate — Rescue of persons in immediate danger is always the first priority.
Question 4: During rapid sequence intubation (RSI) in a hemodynamically unstable trauma patient, which induction agent best preserves cardiovascular stability?
- Propofol 2 mg/kg
- Thiopental 3–5 mg/kg
- Ketamine 1–2 mg/kg (Correct answer)
- Midazolam 0.3 mg/kg
Correct answer: Ketamine 1–2 mg/kg
Ketamine maintains sympathetic tone, making it the preferred induction agent in hemodynamically unstable patients requiring emergency RSI.
Question 5: A patient on mechanical ventilation develops sudden hypotension, decreased SpO2, and absent breath sounds on the right. After ETT displacement is excluded, what is the most urgent next step?
- Obtain an urgent chest X-ray
- Perform needle thoracostomy on the right at the 2nd intercostal space midclavicular line (Correct answer)
- Increase PEEP to 10 cmH2O
- Administer 500 mL IV fluid bolus
Correct answer: Perform needle thoracostomy on the right at the 2nd intercostal space midclavicular line
These findings indicate tension pneumothorax, which is a clinical diagnosis requiring immediate needle thoracostomy without waiting for imaging.
Question 6: In the event of a hospital power failure affecting ICU ventilators, what is the minimum backup power duration that US Joint Commission standards require for life-safety systems?
- 30 minutes
- 90 minutes (Correct answer)
- 4 hours
- 72 hours
Correct answer: 90 minutes
The Joint Commission requires emergency generator systems to activate within 10 seconds and provide at least 90 minutes of backup power for life-safety branch circuits.
Question 7: During a hazardous material (HAZMAT) exposure incident, ICU staff receive a potentially contaminated patient from the ED. Which PPE level is appropriate for initial patient decontamination?
- Level D — standard surgical gown and gloves
- Level C — powered air-purifying respirator (PAPR) and chemical-resistant suit (Correct answer)
- Level A — fully encapsulated vapor-protective suit
- Level B — SCBA with chemical-resistant splash suit
Correct answer: Level C — powered air-purifying respirator (PAPR) and chemical-resistant suit
Level C PPE with PAPR or air-purifying respirator and chemical-resistant clothing is appropriate for patient decontamination when the hazardous substance is identified but not immediately life-threatening to rescuers.
FFICM Emergency Response Procedures 2
During a mass casualty incident in the ICU, the START triage system categorizes a patient who is breathing at 22 breaths/min, has a radial pulse, and can follow commands.
What color tag should be assigned?