PHTLS Scene Assessment and Safety 3 — Questions and Answers
Question 1: At a mass casualty incident with 15 patients from a bus crash, which resource request should be made first?
- Request a medical helicopter for every critical patient
- Establish command, declare an MCI, and request additional resources early (Correct answer)
- Begin transporting patients before establishing command
- Wait for a full patient count before calling for help
Correct answer: Establish command, declare an MCI, and request additional resources early
Early declaration of an MCI and immediate resource requests prevent delays that worsen outcomes in mass casualty events.
Question 2: A provider notes a strong smell of natural gas upon entering a residential structure. What is the immediate action?
- Ventilate the structure by opening windows before continuing assessment
- Evacuate all occupants and call the gas utility from outside (Correct answer)
- Use a radio inside to call dispatch for guidance
- Check the patient first, then address the gas leak
Correct answer: Evacuate all occupants and call the gas utility from outside
Natural gas creates an explosive atmosphere; immediate evacuation and external notification are required before any other action.
Question 3: Which factor most commonly causes EMS providers to overlook scene hazards?
- Inadequate PPE supply
- Tunnel vision focused on the patient rather than the environment (Correct answer)
- Insufficient training on hazardous materials
- Poor lighting at night scenes
Correct answer: Tunnel vision focused on the patient rather than the environment
Tunnel vision — focusing entirely on the patient — is the most common cause of missed scene hazards in EMS.
Question 4: During a farm accident, a patient is trapped under agricultural equipment with a running diesel engine nearby. What hazard requires immediate attention?
- Risk of hydraulic fluid skin irritation
- Carbon monoxide accumulation in a low-lying area (Correct answer)
- Sunburn risk for rescuers
- Potential for agricultural dust inhalation
Correct answer: Carbon monoxide accumulation in a low-lying area
Diesel engines in enclosed or low-lying areas produce carbon monoxide that accumulates rapidly and can incapacitate rescuers and patients.
Question 5: A provider receives a dispatch for a 'man down' in an alley. Which approach is safest?
- Drive directly to the alley entrance and exit the vehicle immediately
- Approach on foot from a parallel street for initial scene observation (Correct answer)
- Call the patient's cell phone to assess safety before arrival
- Park at the alley entrance with emergency lights off
Correct answer: Approach on foot from a parallel street for initial scene observation
Approaching from an observation angle before committing allows providers to assess scene safety without placing themselves in a potentially dangerous position.
Question 6: Which situation requires the EMS provider to wear a high-visibility vest in addition to standard PPE?
- Any indoor patient contact in a private residence
- Working on or near active roadways (Correct answer)
- Treating patients at a sports venue
- Transporting patients in the ambulance
Correct answer: Working on or near active roadways
High-visibility vests are required when working on or near active roadways to reduce the risk of being struck by passing vehicles.
Question 7: When evaluating mechanism of injury (MOI) at a scene, what is the primary reason for doing so?
- To determine billing codes for the transport
- To anticipate potential injuries even before they are clinically apparent (Correct answer)
- To identify the responsible party for legal documentation
- To decide which hospital has the appropriate specialty care
Correct answer: To anticipate potential injuries even before they are clinically apparent
Understanding MOI allows providers to anticipate occult injuries and maintain a high index of suspicion during assessment.
PHTLS Scene Assessment and Safety 3
At a mass casualty incident with 15 patients from a bus crash, which resource request should be made first?