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132 Cards in this Set

  • Front
  • Back
Paramedics normally work under the _______ branch under an ICS.
EMS/medical
By using the principles of the incident command system (ICS), you will be able to do the ___________.
greatest good for the greatest number of people.
The _________ was created and implemented in 2004 to provide a consistent nationwide template for emergency response, and to promote effective, well-organized and efficient emergency response from the regional, state, and national levels of government and non-governement agencies.
National Incident Management System
Homeland Security Presidential Directive (HSPD-5) requires students to do these 2 things:
a. Complete entry-level certifications in FEMA IS-100 and IS-700 training
b. Have a complete understanding of NIMS
NIMS is used to prepare for, prevent, respond to, and recover from domestic incidents regardless of these 3 factors:
Cause, size, complexity
These are the 3 key principles of NIMS:
Flexibility, standardization, and interoperability
Describe "interoperability"
Interoperability allows agencies of different types or from different jurisdictions to communicate with each other.
Of ICS and NIMS, which is a component of the other?
ICS is a component of NIMS
The 6 major components of NIMS are:
Command and management
Preparedness
Resource management
Communications and information management
supporting technologies
ongoing management and maintenance
The NIMS standard incident command structures are based on these 3 key constructs:
ICS
multiagency coordination systems
public information systems
"systems that describe, inventory, track, and dispatch resources before, during, and after incident", in addition to "standard procedures regarding the recovery equipment that was used" are delineated under which component of NIMS?
Resource management
The NIMS component called "_____________" enables essential functions needed to provide interoperability.
Communications and information management
"National standards and interoperability among all technologies", in addition to "structure for the science and technology used in incident management" is provided by which component of NIMS?
Supporting technologies
A ___________ will be set up by "Ongoing management and Maintenance" to provide strategic direction and oversight of the NIMS, supporting routine maintenance and continuous improvement of the system in the long term.
multijurisdictional, multidisciplinary NIMS Integration Center
You should use _______ communications, as opposed to jargon such as 10-codes.
"clear text", plain english
Define: Incident Command System (ICS)
a system implemented to manage disasters and multiple-casualty incidents in which section chiefs, including finance, logistics, operations, and planning report to the incident commander.
Define: freelancing
when individual units or different organizations make independent and often inefficient decisions about the next appropriate action
The ICS is designed to control ______ and _____.
duplication of effort
freelancing
Define: Span of Control
In incident command, the subordinate positions under the commander's direction to which the workload is distributed; the supervisor/worker ratio.
The ICS limits the supervisor/worker ratio (span of control) at ________.
1 supervisor to 3-7 workers

(1:3 - 1:7)
In some regions, ______________ may exist which are usually operated by city, state or federal governments. They typically are only activated in a large catastrophic event that taxes the whole system or goes on for days.
Emergency operations centers
The goal of the ICS modular organizational structure is:
to make the best use of resources to manage the environment and treat patients.
ICS organizational divisions can include these 4:
a. Sections
b. Branches
c. Divisions and groups
d. Resources
The groups of staff defined in the ICS are in these 5 organizational divisions:
Command
Finance
Logistics
Operations
Planning Roles
Describe: (ICS) Command
In incident command, the position that oversees the incident, establishes the objectives and priorities, and from there develops a response plan.
These are the 3 officers who operate under ICS "Command".
public information officer
safety officer
liaison officer
The number of command duties the IC takes on often varies due to ________.
The size of the incident.

The larger or more complex the incident, the more responsibilities (public information officer, safety officer, liaison officer) she may delegate to others.
Define: Unified Command System
A command system used in larger incident in which there is a multiagency response or multiple jurisdictions are involved.
In a unified command system, the response plan should be planned ahead of time and it should designate _______.
the lead and support agencies in several kinds of MCIs. ( ex. the Hazmat team will take lead in a chemical outbreak).
Define: Single command system
a command system in which one person is in charge, generally used with small incidents that involve only one responding agency or jurisdiction.
This type of command system is ideally used for short-duration, limited incidents.
Single command system
Define: Transfer of Command
In incident command, when an incident commander turns over command to someone with more experience in a critical area.
Define: Termination of Command
the end of the incident command structure when an incident draws to a close.
Define: demobilization
the process of directing responders to return to their facilities when work at a disaster or multiple-casualty incident has finished, at east for the particular responders.
Define/Describe: (ICS) finance
In incident command, the position in an incident responsible for accounting of all expenditures and needs for reimbursment.
In 1973, this technical team was established by the US forestry and other major California fire departments. It is the origin of NIMS.
First FIRESCOPE (Firefighting RESources of California Organized for Potential Emergencies)
In 1982, modifications were made to the FIRESCOPE management style, and the ________ was developed.
NIIMS (National Interagency Incident Management System)
In 2003, _________ mandated the development of a national incident management system.
Homeland Security Presidential Directive 5 (HSPD-5)
In _______, Homeland Security released the first NIMS training material.
2004
Who in ICS will help your organization receive reimbursements if eligible?
The finance chief
The roles/units of the finance section under the finance chief are these 4:
1.) Time unit - keep daily record of personnel time and equipment use.

2.) Procurement unit - deals with vendor contracts

3.) Compensation/claims unit - Deals with claims regarding incident and injury compensation

4.) Cost unit - Collects, analyzes, and reports costs
-
What does the "Time unit" of the Finance section of ICS do?
Keeps a daily record of personnel time and equipment use
What does the "Procurement unit" of the Finance section of ICS do?
Deals with vendor contracts
What are the 2 functions of the "Compensation/claims unit" of the Finance section of ICS?
(a) Deals with claims regarding incident and injury compensation
What is the function of the "Cost unit" of the Finance section of ICS?
It Collects, analyzes, and reports costs related to an incident
The "section chief" is part of which of the 7 sections of ICS?
Logistics section
Define/Describe: (ICS) Logistics
In incident command, the position that helps procure and stockpile equipment and supplies during an incident.
List the 6 resources that the ICS Logistics group is responsible for acquiring.
i. Communications equipment
ii. Facilities
iii. Food and water
iv. Fuel
v. Lighting
vi. Medical equipment and supplies
In a large MCI where many people are working in the Logistics division, how many people will report to the IC?
only 1.
Define/Describe: (ICS) Operations
In incident command, the position that carries out the orders of the commander to help resolve the incident.
At a large incident, the Operations section is responsible for managing:
the tactical operations job usually handled by the IC on routine EMS calls. That is, they will supervise the people working at the scene of the incident.
Operations personnel often have experience in management within the ________ department.
Fire department.
Define/Describe: (ICS) Planning
In incident command, the position that ultimately produces a plan to resolve any incident.
Solve problems as they arise during the MCI.
Use data from the current incident to analyze the previous plan and predict next steps for the new plan.
Which ICS group will setup the plan for demobilization?
the ICS Planning section
When, and by who, is the incident action plan written?
Written at the beginning of a response by the Planning section chief with input from other departments, and continually revised throughout the incident.
Should the ICS Planning section use time to call on technical experts to help with the planning process?
Yes, they can and should call technical experts for their help with the planning process.
Are written Incident action plans always necessary?
No. In an initial response for an incident that is readily controlled, a written pan may not be necessary.

Typically, the need for an incident action plan, in addition to its level of detail is dictated by the size and complexity of the incident.
Define/Describe: (ICS) Safety Officer
In incident command, part of the "Command" staff. The SO is the person who gives the "go ahead" to a plan or who may stop an operation when rescuer safety is an issue.

i. Continually monitors the area for any hazards to responders and patients
ii. Possibly will interact with environmental health and HazMat teams
iii. Have the authority to stop an emergency operation when a rescuer is in danger
Define/Describe: (ICS) Public information officer (PIO)
In incident command, the person who keeps the public informed and relates any information to the press.

May work in conjunction with other organizations in a joint information center (JIC).
May be responsible for providing a message that will help a situation, prevent further panic, and provide evacuation directions
Define/Describe: Joint Information Center (JIC)
An area designated by the incident commander, or designee, in which public information officers (PIOs) from multiple agencies disseminate information about the incident.
Where will a wise Public information officer (PIO) position his or her headquarters in relation to the incident command post and the incident itself?
They will take post well away from incident, and from the incident command post, to keep media safe from the emergency and to keep distractions to a minimum
Define/Describe: (ICS) Liaison officer (LNO)
In incident command, the person who relays information, concerns, and requests among responding agencies
If an agency is not represented in the command structure, questions and input should be given through which officer in the ICS?
The Liaison officer (LNO)
Historically, the weak point in most major incidents has been:
communication
To minimize the effects of communications problems, it is recommended that communications be ______. This means all agencies can communicate easily and quickly by radio
Integrated
What happens after an incident has been declared, and the need for additional resources has been identified?

What happens after that?
a request is made for the resources.

Once the request is made , the resources are mobilized and deployed to a designated location/staging area.
On arrival to an incident, you should first check-in with the ______ section.
Finance section
What 3 purposes are served by first checking in with the finance section upon your arrival to an incident?
i. Allows you to be assigned to a supervisor for job tasking
ii, Allows for personnel tracking
iii. Allows for precise tracking of costs, pay, and reimbursement
The 5 steps of 'mobilization and deployment' are as follows:
1. Check-in with Finance section upon arrival at the incident
2. Check-in with your supervisor for initial briefing
3. keep records to document items which may necessitate reimbursement
4. keep your supervisor up-to-date with location, action, and completed tasks.
5. demobilization of resources at conclusion of IC
After check-in with the Finance section, you should check-in with ________, because _______.
your supervisor for an initial briefing.

it will allow you to get info regarding the incident, as well as specifics on job function and responsibilities.
"Preparedness" with regard to the ICS involves:
the decisions made and basic planning done before an incident occurs.
This includes decisions and planning about he most likely natural disasters for the area, among other disasters.
EMS facilities should have disaster supplies for at least a ____-hour period of self-sufficiency.
72
A copy of your EMS agency's disaster plan should be kept where?
In each EMS vehicle
Which should your EMS agency and it's mutual aid agreement partner do?
A) Practice with mock incidents involving 10-15 patients on a regular basis.

B) practicing a 100-patient incident every few years.
A
Your response to "What do I have?" with regard to Scene size up of an MCI should include these 5 assessments/actions:
- assessing for hazards
- confirming incident location
- Is the incident open or closed?
- How many casualties are there?
- Report findings to dispatch.
What 3 basic questions should you ask yourself when you arrive on the scene of an incident?
What do I have?
What do I need to do?
What do I need?
After your and your partner's safety, and the safety of bystanders, your next 2 priorities at an incident, in order are:
1) Incident stabilization
2) Preservation of property and the environment
Should you treat your patient or stabilize the scene first?
stabilize the scene first. An unstabilized scene is a threat to your safety.
Once you have performed a good scene size-up and answered the 3 basic questions, what should happen?
command should be established, notification to other responders should go out, and necessary resources requested.
Describe/Define: Medical Incident Command
a branch of operations in a unified command system, whose three designated sector positions are triage, treatment, and transport.

also known as the medical (or EMS) branch of the ICS.
The Medical Branch Director will oversee the primary roles of the medical group. These 3 subgroups under the EMS branch are:
Triage
Treatment
Transportation
Describe/Define: medical branch director
a. Oversees 3 primary roles of medical team
b. Makes sure that EMS units are working within the ICS
c. Assigns each medical unit with tasks prior to working at the scene
d. Depending on the size of the incident, EMS may be its own command or work under the logistics section.
Depending on the size of the incident, EMS may be its own command or work under the _______ section.
Logistics
Describe/Define: Triage Supervisor
the person in charge of counting and prioritizing patients, whose primary duty is to ensure that every patient receives initial triage.
Describe/Define: Treatment Supervisor
In incident command, the person responsible for locating, setting up, and supervising the treatment area.
Describe/Define: Transportation Supervisor
In incident command, the person who coordinates transportation and distribution of patients to appropriate receiving hospitals.
The duty of triage paramedics is to:
transfer patients to the correct treatment section.
The transportation supervisor position requires coordination with _________ to help ensure that enough personnel and ambulances are in staging or have been requested.
Incident Command
The (MIC) Transportation supervisor documents these 3 things:
numbers of vehicles transporting
patients transported
facility destination of each vehicle and patient
Define/Describe: Staging Supervisor
In incident command, the person who locates an area to stage equipment and personnel and tracks unit arrival and deployment from the staging area.

stages ambulances away from the scene, and is the only person allowed to grant ambulances access or egress from the scene.

Prevents traffic congestion among responding vehicles.

Should be assigned when MCIs require response by numerous emergency vehicles or agencies.
Define/describe: Rehabilitation supervisor
In incident command, the person who establishes an area that provides protection for responders from the elements and the situation.

The rehabilitation area is set up away from the incident, crowds, and media.
Monitors EMS personnel for stress signs.
a. Fatigue
b. Altered thinking
c. Collapse
Define/describe: Extrication supervisor/Rescue Supervisor
In incident command, the person appointed to determine the type of equipment and resources needed for a situation involving extrication or special rescue.
Define/Describe: Morgue Supervisor
In incident command, the person who works with area medical examiners, coroners, and law enforcement agencies to coordinate the disposition of dead victims.
Which ICS branch will the Extrication supervisor/Rescue Supervisor most likely work under?
the EMS branch
What should the Morgue supervisor do with dead victims until a removal and storage plan is determined?
Attempt to leave them in the location they were found, as it may help with victim identification or crime-scene requirements.
Define: Multiple Casualty Incident (MCI)
An emergency situation involving 3 or more patients, or any situation that can place great demand on the equipment or personnel of the EMS system or has the potential to overwhelm your available resources, requiring a mutual aid response.
Define: Mutual Aid agreement
an agreement between neighboring EMS systems to respond to multiple-casualty incidents or disasters in each other's region when local resources are insufficient to handle the response.
Define: Open (uncontained) incident
an ongoing or unconfined incident in which rescuers will have to search for patients and then triage or treat them. the situation may produce more patients.
Examples: school shootings, tornadoes, hazmat release, rising floodwaters.
Define: Closed (contained) Incident
a contained incident in which patients are found in one focal location and the situation is not expected to produce more patients than initially present.
Would loss of power to a hospital or nursing home with ventilator-dependant and non ambulatory victims be considered an MCI even though no one is injured?
Yes.
Define: Triage
To sort patients based on the severity of their conditions and prioritize them for care accordingly
Define: Primary triage
initial triage done in the field.
a type of patient sorting used to rapidly categorize patients; the focus is on speed in locating all patients and determining an initial priority as their condition warrants.
Define: Secondary triage
a type of patient sorting used in the treatment sector that involves retriage of patients
Define: START triage
a patient sorting process that stands for simple triage and rapid treatment, and uses a limited assessment of the patient's ability to walk, respiratory status, hemodynamic status, and neurologic status.
Define: JumpSTART triage
a sorting system for pediatric patients younger than 8 years or weighing less than 100 pounds. There is a minor adaptation for children because they cannot ambulate on their own.
Define: Hospital surge capacity
The capabilities of a receiving hospital to handle a large number of unexpected emergency patients, such as those seen in a multiple-casualty incident.
Define: Critical incident stress management (CISM)
a process that confront responses to critical incidents and defuses them.
Main information needed on the primary triage tag are these 2 things:
a unique number and a triage category
after primary triage, the team leader should communicate the following 4 pieces of information to the medical branch director:
1) total number of patients
2) number of patients in each triage category
3) recommendations for extrication and movement of patients
4) resource needed to complete triage and begin movement of patients.
What does the acronym IDME stand for?
The four common triage categories.

Immediate (Red)
Delayed (Yellow)
Minimal (Green; hold)
Expectant (Black; likely to die or dead)
The first step of the START triage system is:
calling out to the disaster site, "If you can hear my voice and are able to walk..." and then directing patients to an easily identifiable landmark.

These are "walking wounded", and are minimal/3rd priority patients.
A triage tag should have these 4 characteristics:
a. Weatherproof
b. Easy to read
c. Color-coded
d. Clearly identify triage category. (In case a responder may be color-blind use both symbols and colors.)
Second step of START evaluates the nonwalking patients. You should check the respiratory status.

If a patient is not breathing, you should:
open the airway using a simple manual maneuver.
Using the START triage system, after opening the airway of a non-ambulatory patient, the patient does not breath. What is this triage category?

If breathing >30/min or <10/min?
If breathing between 10-30/min?
No breathing = Black.

>30/min = Red
<30/min = proceed with assessment
When utilizing START, you should check the ______ to assess the hemodynamic status of a patient.
radial pulse
With START, an breathing between 10-30/min, with an absent radial pulse indicates what triage category?
Red
The final step of START is assessing the _________ status. This is done by:
neurologic.

Ask the patient to follow simple commands (eg, “Show me three fingers.”)
If you are testing the neurologic status of a patient in START, and they do not follow your simple command, they are categorized _____.

If the patient did follow your command, they would be categorized: _______.
did not comply: Red

did comply: yellow
What does the acronym SALT stand for? What is it used for?
Sort, Assess, Lifesaving interventions, and/or Transport.

It is another triage method.
The SALT method differs from others with its lifesaving intervention steps which include:
bleeding control, opening the airway, two rescue breaths for children, needle decompression for tension pneumothorax, and auto-injector antidotes.
As in START, JumpSTART begins by identifying walking wounded. But, for infants or children not developed enough to walk or follow commands (including those with special needs) you should do something different, which is to:
take them as soon as possible to the treatment sector for immediate secondary triage.
If a pediatric patient isn’t breathing after positioning the airway, IMMEDIATELY check for a pulse.
i. If there is no pulse the patient is labeled as ______.
ii. If there is a pulse, open airway with a manual maneuver, re-check the breathing.
iii. Give five rescue breaths if the patient still isn’t breathing.
iv. If the patient doesn’t respond they are labeled as ________.
v. If the patient begins to breath the are labeled as ____.
i. expectant

iv. expectant

v. Immediate
According to JumpSTART, how many rescue breaths should you give an apneic child with a palpable pulse?
5
According to JumpSTART a child who is breathing fewer than 15 breaths/min or more than 45 breaths/min is categorized as ______.

What should you do if respirations are between 15-45/minute?
<15 or >45: immediate (RED)

15-45/min: continue assessment
After assessing the breathing and respiratory rate of a child using JumpSTART, you should next check _______.
The hemodynamic status by checking any distal pulse you feel comfortable checking.
After checking the breathing and respiratory rate of a child using JumpSTART, you find the distal pulse is absent. This triage category is: _____.

If there is a distal pulse, you should ______.
Immediate

continue assessement.
According to JumpSTART, a child who is unresponsive or responds to pain by posturing or with incomprehensible sounds or is unable to localize pain is considered this priority:_______.

("P" inappropriate, or "U" on AVPU)
Immediate
According to JumpSTART, a child who responds to pain by localizing it or withdrawing from it or is alert is considered what priority patient?

("A", "V", or "P" appropriate)
delayed.
A hysterical or disruptive patient may be categorized as ________ despite their condition.
immediate

This type of behavior could create panic for other patients and rescuers.
An injured or sick responder should be categorized as __________ and transported away from the scene so other responders do not loose morale.
immediate
If hazardous materials or weapons of mass destruction are present, the HazMat team must ___________ before regular triage can begin.
categorize patients as contaminated or uncontaminated
What are some considerations when sending multiple patients, such as the walking wounded by bus?
Have at least 1 EMT or paramedic on the bus, and have the bus followed by an ambulance in case the status of a patient deteriorates.