Chapter 38- Vehicle Extrication and Special Rescue

A 19-year-old female has just been extricated from her severely damaged car. She is on a long backboard and has been moved to a place of safety. As your partner maintains manual stabilization of her head, you perform a rapid assessment. The patient is unresponsive, has slow and shallow respirations, and has bilaterally closed femur deformities. You should:

direct your partner to begin ventilatory assistance.

A 33-year-old restrained driver of a motor vehicle crash is awake and alert, complaining only of neck pain and left leg pain. The vehicle is stable and no hazards are present. When removing this patient from his vehicle, you should:

immobilize him with a vest-style device.

At a scene with downed electrical lines, the EMT should _________.

remain outside the danger (hot) zone

Extrication is defined as:

B. removal from a dangerous situation or position.

If a technical rescue team is required at the scene, but is not present when you arrive, you should:

B. check with the incident commander to ensure that the team is en route.

Once entrance and access to the patient have been provided, you should:

B. perform a primary assessment.

Returning the emergency unit to service is part of the _________.

C. termination phase

The EMT’s responsibility during search-and-rescue operations is to _________.

A. wait at the staging area until the patient is located

The rescue team is in the process of extricating a 40-year-old male from his truck. The patient’s wife, who was uninjured in the crash, is calmly observing the extrication and asks you if her husband will be all right. You should:

A. ensure that she is in a safe area, away from the scene.

The use of special tools to remove an entrapped patient from a vehicle is known as _________.

A. complex access

Trench collapses usually involve large areas of falling dirt that weigh approximately _______ per cubic foot.

100 lb

Upon arrival at a search-and-rescue incident, the EMS crew should _________.

B. prepare the equipment to carry to the patient

Upon arrival at a trench rescue operation, you should _________.

C. park at least 500 feet from the incident

Upon arriving at the scene of a motor vehicle crash, you can see three patients, one who is entrapped in his car and two who have been ejected from their vehicle. You should:

B. immediately request additional resources.

When functioning at the scene of a motor vehicle crash in which a patient will require complex extrication, you should enter the vehicle and provide care to the patient:

C. after receiving approval from the incident commander.

When removing a critically injured patient from his or her vehicle, you should:

C. protect the cervical spine during the entire process.

While staged at the scene of a structure fire, the EMT should _________.

D. remain with the ambulance

You are attempting to gain access to a patient who was injured when his truck struck another vehicle from behind. The patient is conscious and alert, but is screaming in pain. You try to open the door, but it is locked. You should:

D. ask the patient if he can unlock the door.

You are standing by at the scene of a hostage situation when the incident commander advises you that one of his personnel has been shot. The patient is lying supine in an open area and is not moving. As the SWAT team escorts you to the patient, you should:

B. grab him by the clothes and immediately move him to safety.

You arrive at an accident scene to find an alternative-fuel vehicle leaking an unknown substance. You should immediately _________.

B. call for additional resources and keep bystanders away from the vehicle

You and your partner are standing by at the scene of a residential fire when you hear the incident commander state, "We have located a victim" over the radio. You should:

remain with the ambulance and wait for fire personnel to bring the victim to you.

The EMT’s primary responsibility during a rescue or extrication situation is _________.

patient care

Your unit has been dispatched to stand by at the scene of a structure fire. There are no injuries of which you are aware. Upon arriving at the scene, you should:

ask the incident commander where the ambulance should be staged.

Which of the following is the most important in protecting EMS providers during an extrication operation?

The scene size-up

A hiker was injured when he fell approximately 20 feet from a cliff. When you arrive at the scene, a member of the technical rescue group escorts you to the patient, who is positioned on a steep incline. The MOST appropriate method of immobilizing and moving the patient to the ambulance is to:

immobilize his spine with a long backboard and place him in a basket stretcher.

To evaluate the scene for hazards and identify the number of patients, the EMT should first _________.

do a 360-degree walk-around

As you and your team are removing an unresponsive patient from her wrecked car, you note that she has closed deformities to both of her legs and a deformity to her left humerus. You should:

support the injured extremities and continue removal.

What should be done for any type of alternative-fuel vehicle that is involved in an accident?

Disconnect the battery.

Disentanglement involves:

removing a patient from a dangerous position.

Who has overall command of an emergency incident?

Incident commander

A 50-year-old female is entrapped in her passenger car after it struck a tree. As the rescue team is preparing to extricate her, you quickly assess her and determine that she is breathing shallowly and that her radial pulse is absent. You should:

maintain spinal stabilization as she is extricated.

Tactical EMS providers are specially trained to function during _________.

dangerous law enforcement operations

In contrast to simple access, complex access:

involves forcible entry into a vehicle.

Rescuers have brought you a patient rescued from a structural collapse. You should immediately _________.

begin a rapid assessment

Which of the following is the BEST example of gaining simple access to a patient?

Entering a vehicle through an open window

Upon arrival at an active law enforcement incident, the EMT should _________.

notify the incident commander

A unique consideration when dealing with a hybrid vehicle is that:

the battery has higher voltage than a traditional vehicle battery.

_____________ is defined as the ability to reach the patient.

Access

Common duties and responsibilities of EMS personnel at the scene of a motor vehicle crash include all of the following, EXCEPT:

keeping bystanders at a safe distance.

The reasons for rescue failure can be referred to by the mnemonic FAILURE. In this mnemonic the "U" stands for:

underestimating the logistics of the incident.

When working around undeployed air bags after a vehicle crash, you should maintain at least a ________ clearance between yourself and the passenger-side airbag.

20 inch

Where should you park the ambulance when responding to a vehicle crash involving a hazardous material spill?

uphill and upwind

As an EMT, what is your main role at the scene of an accident involving extrication of the patient?

asses and provide immediate care

which of the following is an example of simple access

opening a rear door

In an instance of multiple casualties, how should patient care be initiated?

only after all have been triaged

During which phase of extrication should you don proper protective gear (PPE)?

upon arrival

You are assessing a female patient as the extrication team gets ready to roll up the dashboard to remove her. The patient has multiple fractures in her left arm. What should you do?

secure the injury against her body

You have tried to gain simple access to a crashed vehicle but the doors are all jammed. What is your next step?

break the window farthest away from the patient

At what point should you begin your primary assessment of a patient who has been entrapped?

before extrication begins

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