Ems Ops Chapt. 46 Test 1A

Front 1

The _____________ is responsible for determining ambulance standards.

Back 1

US General Services Administration

Front 2

Ambulance design and manufacturing guidelines, outlined by the _________, are reviewed and updated every___ years.

Back 2

DOT KKK 1822

5

Front 3

Original DOT KKK 1822 guidelines required all ambulances be painted what 2 colors:

Back 3

Omaha orange and white

Front 4

The KKK Standards established three main_______, including Type I, Type II, and Type III

Back 4

ambulance designs

Front 5

Describe a Type I ambulance.

Back 5

Conventional, truck-cab chassis with a modular ambulance body that can be transferred to a new chassis as needed.

Front 6

Describe a Type II ambulance.

Back 6

Type II: Standard van, forward-control integral cab-body ambulance.

Front 7

Describe a Type III ambulance.

Back 7

Specialty van, forward-control integral cab-body ambulance. Both Type I and Type III have a square patient compartment that is mounted onto the chassis. The only difference between Type I and III is in the chassis. Type III is mounted on a cut-a-way van chassis.

Front 8

The __________ developed the first standardized list of ambulance equipment in 1970.

Back 8

American College of Surgeons (ACS)

Front 9

What are the "4 S's" that every ambulance should be capable of, and must be put out of commission immediately for if it cannot do?

Back 9

Start
Steer
Stop
Stay running

If the ambulance cannot do any of these 4 things, it must be put out of commission immediately.

Front 10

Describe "Belt noise"

Back 10

Chirping or squealing sound, synchronous with engine speed (not road speed); usually related to a load on one of the appliances operated by a drive belt - the power steering pump, water pump, vacuum pump (in diesel), alternator.
Always significant as it will eventually stop the ambulance from working. This does NOT necessarily warrant putting the ambulance out of service immediately.

Front 11

Describe "Brake Fade"

Back 11

Sensation of losing power brakes.Common causes include:
i. Overheating of brake surfaces
ii. Loss of vacuum
iii. Loss of brake fluid
iv. Wet or greasy brake drums
v. Failed master cylinder
b. Vehicle should be taken out of service immediately.

You should not ever hear, smell, or feel brakes with few exceptions such as cold brakes in wet weather, or when "telltale tabs" squeal, warning the operator of the end of the brake pads usefulness.

Front 12

Describe: "Brake pull"

Back 12

Feels like someone is trying to pull your steering wheel left or right whenever you depress the brake.
Causes:
i. Brake fluid or grease on a brake pad.
ii. Serious mechanical malfunction

Vehicle should be taken out of service immediately.

Front 13

Describe "Drift"

Back 13

Vehicle wanders to left or right when you let go of steering wheel.

Slight pull to the right is okay (because roads are built with a peak in the center), but vehicle should not consistently pull to the left.

Front 14

Describe "Steering Pull"

Back 14

Persistent tug on the steering wheel as the unit drifts to one side or another
.
Causes may include:
i. Uneven tire pressure
ii. Misaligned wheels
iii. Mechanical problem
b. Can cause loss of control during a sudden stop

Front 15

Describe a "pulsating brake pedal"

Back 15

Up-and-down motion of brake pedal while decelerating.

Causes may include:
i. Warped brake rotors or drums
ii. Bent wheel

Vehicle should be taken out of service immediately.

Front 16

Describe "Steering Play"

Back 16

Looseness or sloppiness while steering

a. Causes may include:
i. Wear
ii. Underinflated tires

Vehicle should be taken out of service immediately.

Front 17

Describe "Tire Squeel"

Back 17

Singing sound when you turn the vehicle at parking speeds
a. Normal on smooth concrete; abnormal on asphalt
b. Causes may include:
i. Underinflated tires
ii. Misaligned wheels
c. Warrant’s a mechanic’s attention

Front 18

Describe "Wheel bounce"

Back 18

Vibration synchronous with road speed that can be felt in the steering wheel (front wheel) or driver’s seat (back wheel). Usually detectable at speeds of >45mph

Causes may include:
i. Defective shock absorber
ii. Bubble in tire
iii. Unbalanced wheel

Front 19

Describe "Wheel wobble"

Back 19

Found at low speeds with a bent wheel. most commonly caused by potholes.

Front 20

"high-performance EMS systems" represent the effort to:

Back 20

maximize productivity and minimize response times

Front 21

"high-performance EMS systems" analyze these 4 factors:

Back 21

response times (<8 min)

productivity (#pt transports/hr): aka "unit-hour utilization)

unit costs

taxpayer subsidies

Front 22

Ambulance response time standards are based on recommendations by the _____________.

Back 22

Commission on the Accreditation of Ambulances (CAAS

Front 23

In the United States, most first-response EMS and ambulance service is delivered by ________.

Back 23

the fire department whose personnel are cross-trained in EMS.

Front 24

Describe the system known as the "third service delivery model"

Back 24

a public agency not part of the fire department delivers ambulance service

Front 25

Describe: Systems Status Management (SSM)

Back 25

SSM was developed by Jack Stout in 1983. Goals are to maximize efficiency and reduce response time.

Data is compiled and used to determine ambulance service demands, taking into consideration:
Peak loads: Increased demand during certain hours
Strategic deployment is used to minimize response times when demand is higher.
Deployment to a posting (location) can take advantage of satellite vehicle location and GPS.

SSM helps organize peak demand staffing.
Shift schedules provide a sufficient number of ambulances during peak load hours.
SSM can take a toll on personnel who have less downtime in between calls.

Front 26

Define: Peak loads

Back 26

Increased demand during certain hours or other frame of time

Front 27

Define: Strategic deployment

Back 27

staging of ambulances to strategic locations within a service area to allow for coverage of emergency calls.

used to minimize response times when demand is higher.

Front 28

Define: Posting

Back 28

the strategic placement of an ambulance at a specific geographic location in order to cover larger areas of territory and reduce response times

Front 29

3 factors affecting the locations of ambulance stationing include:

Back 29

distance vs. call volume
special facilities that increase ambulance demand

Front 30

4 factors affecting the design of ambulance stations include:

Back 30

need for vehicle maintenance
storage
classrooms for training/meetings
sleeping quarters

Front 31

When should you be concerned with restoring the flow of traffic at an accident?

Back 31

Only after your safety is assured, all the patients have been treated, and the emergency situation is under control.

Front 32

The main objectives in directing traffic are to:

Back 32

warn other drivers, prevent additional crashes, and to keep vehicles moving in an orderly fashion so that care of patients is uninterrupted.

Front 33

You should secure a patient with at least ____ straps across the body when transporting by ambulance.

Back 33

3

Front 34

___________ over the shoulders prevent forward movement of the patient if the ambulance suddenly slows or stops.

Back 34

Deceleration or stopping straps

Front 35

Define: Cleaning

Back 35

Remove dirt, dust, blood, or other visible contaminants.

Front 36

Define: Disinfection

Back 36

Kill pathogenic agents by directly applying chemicals made for this purpose

Front 37

Define: High-level disinfection

Back 37

Kill pathogenic agents by use of a potent disinfectant.

Front 38

Define: Sterilization

Back 38

Remove all microbial contamination with the use of heat or other appropriate process.

Front 39

________ must be done first in order for disinfection to be effective.

Back 39

Cleaning

Front 40

Cleaning the ambulance can be done with a _____% bleach and water solution.

Back 40

10%

Front 41

The stretcher should be cleaned with:

Back 41

EPA-registered germicidal/virucidal solution or bleach and water at 1:100 dilution.

Front 42

T/F
It is sufficient to have a GPS system in the ambulance as opposed to keeping map books.

Back 42

False. you should still have access to traditional maps in the event that the navigational system becomes disabled.

Front 43

Which is often more beneficial: Driving faster or choosing an alternative route?

Back 43

Often, switching to an alternative route will save more time than driving faster

Front 44

Which personnel in the ambulance is responsible for talking on the radio and operating audible devices?

Back 44

the passenger.

Front 45

Which medic makes the decision as to whether to drive with the lights/sirens in emergency mode?

Back 45

Paramedic riding in rear of ambulance with patient should make decision as to whether to transport in emergency mode.

Front 46

Maintaining a cushion of safety consists of:

Back 46

i. Maintaining a safe following distance from vehicles
ii. Avoiding being tailgated.
iii. Make sure you’re aware of blind spots.

Front 47

Maintaining a safe following distance from vehicles means:

Back 47

Drive 4 or 5 seconds behind a vehicle driving at an average speed.

Front 48

What are appropriate and inappropriate responses to a tailgater following you in emergency mode?

Back 48

Appropriate: call dispatch to alert police that someone is following recklessly behind you.

Inappropriate: do not speed up. do not slam on brakes. do not get out of ambulance to confront tailgaters

Front 49

Where are the 3 blind spots of the ambulance?

Back 49

(a) Mirror obstructs view
(b) Rear of vehicle cannot be seen fully through mirror.
(c) Side of vehicle cannot be seen through driver and passenger mirrors at a certain angle. May need to lean forward/backward to see.

Front 50

What is the most common source of vehicle damage for ambulances?

Back 50

backing p a vehicle.

Front 51

Define: Spotter

Back 51

a person who assists a driver in backing up an ambulance to compensate for a blind spot at the back of the vehicle.

Front 52

Where should you park your ambulance at an emergency scene?

Back 52

about 100 ft past the scene on the same side of the road, uphill or upwind. preferably downstream from the crash site.

Front 53

Should you leave headlights and emergency lights on when parked at an emergency scene or turn them off?

Back 53

Turn off headlights to avoid blinding oncoming traffic at night.

Leave emergency warning lights on if blocking part of a roadway.
i. Use only flashing yellow lights if possible.

Front 54

The 2 ways to control a vehicle include:

Back 54

changing direction and changing speed

Front 55

The ambulance tires' grip on the road depends on:

Back 55

(a) Condition of surface
(b) Age of road
(c) Weather
(d) Tire’s tread design and wear

Front 56

Describe: Road Position

Back 56

Position of the vehicle on the road relative to the inside or outside edge of a paved surface

Front 57

To corner efficiently in an ambulance, you must know:

Back 57

the vehicle's present position and projected path

Front 58

Describe: "the Apex of turn through a curve"

What happens if you reach it early/late?

Back 58

Point at which vehicle is closest to inside edge of curve

(a) If reached early, vehicle will be forced outside of roadway.
(b) If reached late, vehicle will stay on inside of roadway.

Front 59

Which should you aim for? Reaching the apex of a turn early or late?

Back 59

late. the vehicle will ten dot stay on the inside of the roadway; this helps you to keep the vehicle in the proper lane and allows room for error if you enter the turn too fast.

Front 60

Braking while ______ is safest and most efficient.

Back 60

traveling in a straight line

Front 61

Hydroplaning occurs at speeds of greater than ______ on wet roads.

Back 61

30 mph

Front 62

To make the ambulance stop hydroplaning, you should ______.

Back 62

Gradually slow down without slamming on the brakes if this occurs

Front 63

After driving through pool of standing water on the roadway, you should ______.

Back 63

lightly tap the brakes several times after driving out the water to dry them.
If you have anti-lock brakes, apply steady, light pressure to dry brakes.

Front 64

In the event of a crash, the ambulance driver is presumed ______ if crash occurs while vehicle is operating with warning lights and sirens.

Back 64

Guilty

Front 65

The largest source of lawsuits against EMS personnel and services is ______.

Back 65

ambulance crashes

Front 66

The use of warning lights and sirens allows EMS driver to do the following 5 things:

Back 66

a. Park or stand in otherwise illegal location.
b. Proceed through red light or stop sign after stopping.
c. Drive faster than posted speed limit.
d. Drive against the flow of traffic on a one-way street or make an illegal turn.
e. Travel left of center to make an illegal pass.

Front 67

In order to use warning lights and sirens EMS drivers must adhere to the following 3 stipulations:

Back 67

i. Unit must be on a true emergency call.
ii. Both audible and visual warning devices must be used simultaneously.
iii. Unit must be operated with due regard for the safety of others on and off the roadway.

Front 68

The most overused piece of equipment on the ambulance is the _______.

Back 68

Siren

Front 69

If family members disregard your warning to not follow close behind the ambulance, you should _________.

Back 69

consider turning off your lights and sirens and slow down to normal speed.

Front 70

These types of crashes are the most common and most serious type of crash for an ambulance.

Back 70

Intersection crashes

Front 71

You're driving in emergency mode and come upon a school bus that has stopped to load or unload children or that has its stop arm extended, what should you do?

Back 71

Never pass a school bus that has stopped to load or unload children or that has its stop arm extended.

Stop before reaching a bus with its lights flashing.

Wait for the driver to ensure children’s safety, close the door, and turn off the lights before proceeding.

Front 72

What privileges do ambulances have in school zones?

Back 72

Typically none. In many states it is illegal for an emergency vehicle to exceed the speed limit in school zones.

Front 73

How should you navigate your ambulance with regard to funeral processions?

Back 73

Most states offer no exemption when approaching a funeral procession.
Out of respect, most drivers turn off audible devices and slowly pass on the left if possible.

Front 74

Rotor-wing aircraft (helicopters) are standard of care for transportation of ________ patients.

Back 74

critically injured

Front 75

Fixed-wing aircraft are used mainly for patients requiring ___________.

Back 75

long-distance transportation

Front 76

Cardiac arrest patients need to be transported by _____ due to _______.

Back 76

ground

space limitations in the aircraft

Front 77

When calling for medevac, you should tell your dispatcher these 2 things:

Back 77

chief complaint
weight of patient

Front 78

6 Factors to consider before requesting medevac include:

Back 78

Weather
Environment/terrain
Altitude
Airspeed limitations
cabin size
cost

Front 79

Most medevac helicopters are limited to ________ft above sea level.

Back 79

10,000

Front 80

Most medevac helicopters usually fly between ____ and ____ mph

Back 80

130-150 mph

Front 81

cost of medevac usually ranges from $____ to $______, while an ambulance usually costs $____ to $____.

Back 81

medevac: $8,000-$10,000
ambulance: $400 - $1,000

Front 82

A helicopter landing zone should be no less than ______ by _____, but _____ x ______ is recommended

Back 82

not less than 60 ft x 60 ft; 100x1000ft is recommended

Front 83

The safest flight pattern to land and take off for a helicopter is _______.

Back 83

the same as for a fixed wing plane. That is, not straight up and down, but landing and taking off at a slight angle.

Front 84

Establishing a landing zone is the responsibility of the ________.

Back 84

ground EMS crew.

Front 85

List 3 things to never use to mark a medevac landing site.

Back 85

flares, people, accident tape

Front 86

When a helicopter is "hot" it means:

Back 86

the tail rotor is spinning

Front 87

The proper approach sites for a helicopter are between ______ and ____ o'clock.

Back 87

9 and 3 o'clock.

Front 88

In many helicopters the main blade is flexible and may dip as low as ____ feet off the ground.

Back 88

4 feet

Front 89

Smoking, open lights or flames, and flares are prohibited within ________ of the aircraft.

Back 89

50 ft

Front 90

When requesting a medevac response, always include these 2 things:

Back 90

a. Ground contact radio channel
b. Call sign of the unit that the medevac should make contact with

Front 91

If the aircraft lands on uneven ground, approach the aircraft from the _____ side.

Back 91

downhill side.