10 free Paramedic practice questions: Multiple Casualty Incidents, Triage, and Incident Command

Load the immediate patient into the ambulance: Loading the immediate patient before the other three are even triaged means the crew has no idea whether one of the untriaged occupants is even sicker.

Transport the immediate patient to the hospital: Transporting this one patient abandons the other three occupants who haven't been assessed at all, on a scene where the first crew is the only one who knows how many patients there are.

Begin treating the immediate patient's breathing: Beginning treatment on the difficulty-breathing patient stops the sort entirely: treatment is assigned after initial triage is complete, not interspersed with it.

Begin treating the two patients with severe respiratory distress while waiting for rescue crews: Treating the two patients with respiratory distress while waiting for rescue crews leaves the resource request undone, delaying additional ambulances and mutual aid that every patient on this scene needs.

Focus all efforts on extricating the two trapped patients from the building: Focusing all efforts on extrication without first requesting resources means the crew works alone on a scene that clearly exceeds what one unit can handle.

Triage all eight patients before any treatment or rescue efforts begin: Triaging all eight patients before requesting resources delays getting rescue teams, additional ambulances, and mutual aid moving: the request should go out based on the scene size-up, not wait for triage to finish.

Green (minor injuries): Incorrect. Green is only for ambulatory patients with minor injuries; this patient has major injuries and altered mental status.

Yellow (delayed): Incorrect. Yellow is appropriate for patients with normal vital signs AND normal mental status who cannot walk (like ssu-029); altered mental status makes this patient Red.

Black (expectant): Incorrect. Black triage is for patients with no signs of life or injuries incompatible with survival after resources are exhausted.

Red: all burn injuries require immediate assessment and transport: Incorrect. Not all burn injuries are Red; the triage category is determined by the START assessment sequence, beginning with the ambulation test.

Yellow: all burn patients must be triaged as Yellow until vitals confirm stability: Incorrect. Yellow is assigned to patients who cannot walk but have compensated vital signs; a walking patient is Green by definition.

Black: any patient with a burn injury is classified as nonviable: Incorrect. Black is for deceased or nonsalvageable patients; a walking, talking patient with a burn is not immediately nonviable.

Begin treatment of the most critically injured patient while waiting for additional units: Treating one patient first in a multi-patient scene means delaying care for the other three and does not address the unsafe scene.

Wait for fire department to arrive before treating any patients: Waiting for fire department may be appropriate for vehicle extrication, but initial resource request and triage can begin while waiting; do not delay all action.

Transport the first patient immediately to reduce the number of patients at the scene: Transporting one patient prematurely abandons the other three and prevents overall triage coordination.

Enter the tank with a rope and harness to retrieve the patient quickly: A rope and harness is the right equipment for a trained rescuer on a confined-space team, working with an atmospheric monitor, supplied air, a retrieval system, and an attendant stationed outside who never enters. Access is the visible problem, so rope feels like the answer, but the atmosphere is the part that kills and rope does not test air. A tank atmosphere can drop a healthy rescuer in seconds, which is why the key trades a fast improvised entry for a slower entry by people carrying equipment that addresses the actual hazard.

Have a site supervisor enter the tank first to assess the environment before you proceed: The site supervisor is genuinely the person to find, just not the person to send in. They know what the tank held, whether it was purged or inerted, where the permits and monitoring equipment are, and how to isolate whatever feeds it. Use them for information and for shutting the process down. Sending an untrained person inside creates the classic confined-space fatality pattern, where the would-be rescuer becomes the second and often the more critical patient, and now the specialized team is coming for two people instead of one.

Lower a ladder into the tank and direct the patient to climb out while monitoring from above: A ladder plus verbal coaching is reasonable for a shallow opening with a known-safe atmosphere and an uninjured patient who can self-extricate, since letting a capable patient walk out is often the least harmful path. Two details close it off here: the patient is unable to climb out, and if the atmosphere is what is disabling them, urging exertion accelerates the exposure. A ladder addresses height and nothing else, and leaning over the opening to coach puts you at the lip of the hazard with no monitoring and no retrieval line.

Enter the house to assess the full scene and determine if other patients require assistance: Incorrect. Entering a house with active violence endangers the paramedic and may escalate the situation or trap the responder inside.

Quickly assess and transport the patient to the hospital before the situation inside escalates further: Incorrect. Transporting the patient while violence continues inside abandons any other potential victims and exposes both patient and paramedic to ongoing danger during transport.

Provide full assessment and treatment from inside the ambulance while monitoring the house until police arrive: Incorrect. Remaining on scene while active violence continues inside the house is not safe for the paramedic or the patient. Police must secure the scene and confirm safety before patient care begins.

To the ambulance, where a running count can be kept: A student picks this thinking the ambulance is the natural rally point and that gathering patients there makes counting easier. Bringing a large group toward the ambulance is the specific error the landmark step is written to prevent, because it obstructs the crew and delays triage of the nonambulatory patients.

To the treatment area once it has been established: This assumes a treatment area already exists. No other EMS personnel are on scene, so no treatment area has been set up, and the ambulatory group still has to be moved clear before the nonambulatory patients can be assessed.

To the nearest exit from the collapsed floor section: A student picks this because an exit is the fastest way out of an unstable structure. An exit is a passage rather than a designated gathering point, and holding a group of patients in it blocks the route the crews and the remaining patients need; the collection point is a landmark clear of both the unstable structure and the ambulance.

Triage the patients where they stand and tag them for later: A student picks this because triage feels like the first thing that happens to any patient found at a mass-casualty incident. Triaging patients who are still wet with the chemical exposes the paramedic, contaminates the tag, and defeats the zone control the hazmat team has already set up.

Triage the patients as minimal and send them for transport: Walking out of the plant makes these patients look like the walking wounded, so the minimal category seems automatic. Ambulatory status does not clear a patient for the transportation area, and moving contaminated patients toward the ambulances spreads the contamination into a clean area.

Walk the patients into the treatment area and triage them: This gets patients to care quickly, which is the right instinct on an ordinary call. It carries the chemical into the treatment area, and patients are decontaminated before they are taken to a treatment area, not after.

Tag the patient immediate and move to the next patient: A student picks this because a pulse is present, so the patient is alive and obviously critical, and immediate looks like the safe tag. In JumpSTART the immediate tag belongs to the child who starts breathing after the rescue breaths; the child who does not is expectant.

Give five more rescue breaths and reassess for breathing: Repeating the trial follows the reasoning behind the rescue-breath step and feels safer than stopping. The algorithm allows one trial of five breaths, and repeating it holds primary triage on a single patient while the rest of the scene goes unsorted.

Begin chest compressions and ventilations: Compressions treat cardiac arrest, and a distal pulse is palpable in this patient. Starting a full resuscitation during primary triage also commits the paramedic to one patient while every other patient waits to be assessed.