Paramedics Exam Rescue Operations 5 — Questions and Answers
Question 1: The 'two-in/two-out' rule in rescue operations refers to:
- Two rescue teams entering alternately to prevent fatigue
- Requiring two rescuers to enter any IDLH environment with two standby rescuers outside (Correct answer)
- Two paramedics per patient during extrication
- Two exit routes established before any confined-space entry
Correct answer: Requiring two rescuers to enter any IDLH environment with two standby rescuers outside
OSHA's two-in/two-out rule mandates that at least two fully equipped rescuers stand by outside an IDLH atmosphere for every two who enter.
Question 2: During a vehicle rescue, the paramedic notes fuel leaking from a damaged tank. The FIRST action is:
- Immediately cut the battery cable to eliminate ignition sources
- Apply absorbent material and continue patient care
- Request a fire suppression team and establish a safety perimeter (Correct answer)
- Cover the fuel with a salvage tarp and proceed with extrication
Correct answer: Request a fire suppression team and establish a safety perimeter
Fuel leaks create fire and explosion hazards requiring immediate fire suppression standby and a safety perimeter before extrication continues.
Question 3: Helicopter landing zone (LZ) selection requires a minimum clear area of:
- 50 × 50 feet on flat, debris-free ground
- 100 × 100 feet on flat, debris-free ground (Correct answer)
- 200 × 200 feet near power lines is acceptable
- 30 × 30 feet if wind is calm
Correct answer: 100 × 100 feet on flat, debris-free ground
A minimum 100×100-foot clear, level LZ free of debris is the standard for most EMS helicopter operations.
Question 4: In a mass casualty incident (MCI), the START triage system classifies a victim with respirations of 24/min, radial pulse present, and inability to follow commands as:
- Green (minor)
- Yellow (delayed)
- Red (immediate) (Correct answer)
- Black (expectant/deceased)
Correct answer: Red (immediate)
Respirations >30/min or altered mental status (cannot follow commands) with a pulse categorizes the patient as Red (immediate) in START triage.
Question 5: When stabilizing a patient vehicle on its side for extrication, cribbing should be placed:
- Only under the roof to prevent further rolling
- At multiple low-points to create a three-point contact with the ground (Correct answer)
- Under the engine block only as it is the heaviest point
- Cribbing is not needed if the vehicle is against a barrier
Correct answer: At multiple low-points to create a three-point contact with the ground
Multi-point cribbing establishes a stable platform that prevents rolling or shifting during patient extrication.
Question 6: A patient in cardiac arrest is rescued from a building fire. CPR is initiated but the patient remains pulseless after two rounds. The paramedic suspects tension pneumothorax secondary to blast injury. Which intervention is indicated?
- Immediate defibrillation regardless of rhythm
- Needle decompression of the affected chest (Correct answer)
- Sodium bicarbonate 1 mEq/kg IV push
- Increase CPR rate to 120 compressions per minute
Correct answer: Needle decompression of the affected chest
Tension pneumothorax is a reversible cause of cardiac arrest; needle decompression at the second intercostal space midclavicular line can restore circulation.
Question 7: Which communication principle is MOST critical when transferring command at a complex rescue scene?
- Verbal briefing only to save time
- A face-to-face briefing covering situation status, resources, hazards, and priorities (Correct answer)
- Radio handoff of the incident number to the incoming commander
- Written ICS 201 form faxed to the new commander
Correct answer: A face-to-face briefing covering situation status, resources, hazards, and priorities
A face-to-face briefing ensures the incoming commander has accurate situational awareness of all critical factors before assuming command.
Paramedics Exam Rescue Operations 5
The 'two-in/two-out' rule in rescue operations refers to: