Toxic substances being metabolized through the liver is a process called:
biotransformation
isolation
distribution
synergism
Signs and symptoms that a patient exhibits shortly after an exposure to a hazardous material are best described as:
the chronic effects of long-term exposure from hazardous chemicals.
the delayed effects of a hazardous material.
the potential effects of a toxin.
the acute effects of a hazardous material.
An information sheet that is required by law to be kept on the premises of a fixed facility that contains detailed information about specific hazardous substances being kept on site is called:
shipping papers.
a National Fire Protection Association (NFPA) 704 placarding system.
a safety data sheet (SDS).
a bill of lading.
When a person or equipment comes in direct contact with a hazardous substance, this is known as:
primary contamination.
cross-contamination.
direct exposure.
secondary contamination.
How many levels of hazmat training are available for emergency medical services (EMS) providers?
Five
Four
Three
Two
The paramedic who has completed the "technician level" of hazmat training for emergency medical services (EMS) providers has completed education on all of these topics EXCEPT:
how to serve as the incident commander (IC) on a hazmat scene.
decontamination procedures.
focus on personal protection.
perform care in the "warm zone."
The technician level of training in hazardous materials is equivalent to:
Emergency medical services (EMS) Level 3.
Emergency medical services (EMS) Level 1.
Emergency medical services (EMS) Level 2.
a hazardous materials operational level training.
You are a paramedic who maintains an EMS Level 1 in hazardous materials. The incident commander (IC) assigns you to immediately initiate lifesaving care for a patient who is in the warm zone who is being prepared for decontamination. You should:
have the IC repeat the order, and only then comply.
dress in the appropriate protective equipment and report to the leader of the warm zone.
refuse to follow the order, and report the infraction to your immediate supervisor.
advise the IC that you do not meet the training qualifications.
You and your partner have been dispatched by law enforcement to a report of several residents who have been exposed to the hazardous substances inside a confirmed meth lab. You should:
work with the fire department to set up a gross decontamination station.
transport contaminated patients to the nearest emergency department.
immediately don protective equipment before making patient contact.
begin immediate triage and treatment of affected victims.
At a hazmat incident, paramedics may:
perform both defensive and offensive hazmat functions.
activate the Incident Command System (ICS).
contain the hazardous materials.
control the spread of hazardous materials.
The single most important step for a paramedic to remember when functioning at any hazardous materials scene is to:
identify the hazardous substance.
remove critical victims from the hot zone.
function in the warm zone.
maintain a safe distance uphill and upwind of the scene until safe.
You have arrived on the scene of an MVA involving an automobile and a tractor trailer carrying a hazardous substance that appears to be leaking from a valve. You are staging at a safe distance uphill and upwind of the incident. You should:
order victims using the PA system on your ambulance to walk toward you if able.
attempt to identify the hazardous substance using binoculars.
make a decision to approach the scene carefully to rescue any critical victims.
Begin triaging victims and creating an evacuation plan.
You are responding to a report of numerous people sick with nausea and dyspnea. As you approach the facility, you observe the National Fire Protection Association (NFPA) 704 placard located on the exterior of the building that identifies the blue left segment of the placard with the number 3. You should suspect:
that any contact with the product within the facility will be lethal.
that exposure to a product within the facility may cause serious or permanent injury.
that there is no hazard beyond normal combustion.
that if the product is inhaled, there should not be any significant problems.
Structures of all types can contain hazardous substances. A visual recognition aid used to identify hazardous materials within a fixed facility is:
the bill of lading.
Computer-Aided Management of Emergency Operations (CAMEO).
U.S.Department of Transportation (DOT) Emergency Response Guidebook (ERG) and material safety data sheet (MSDS) papers.
the National Fire Protection Association (NFPA) 704 System.
Which National Fire Protection Association (NFPA) standard deals with the training standards for emergency medical services (EMS) personnel assigned to hazmat incidents?
NFPA 473
NFPA 472
NFPA 1006
NFPA 1561
What is the designated area at a hazardous materials incident where only the highest trained and equipped hazardous materials personnel are allowed to function?
Support zone
Spill control zone
Hot zone
Cold zone
In a hazardous materials incident, normal patient triage takes place in which zone?
Warm
Contamination reduction
Exclusionary
Cold
The hot zone, also referred to as the exclusionary zone, is best described as:
the area of contamination where only responders equipped with appropriate personal protective equipment (PPE) can enter to perform rescue operations.
the area that lies immediately adjacent to the hot zone where decontamination occurs.
the area where rescuers must dispose of contaminated gear before entering the warm zone.
the site where lifesaving emergency care is performed.
Which statement regarding the cold zone is most correct?
Once decontaminated, responders should remove their personal protective clothing in the cold zone.
Patient decontamination is conducted in the cold zone.
The cold zone should be free of any contamination.
Lifesaving care should be withheld until the patient reaches the cold zone.
The term boiling point refers to:
lowest temperature at which a liquid will give off enough vapors to support combustion it is slightly higher than flash point.
the temperature range in which a vapor concentration air will ignite and combust.
the lowest temperature at which a liquid will give off enough vapors to ignite.
the temperature at which a liquid becomes a gas.
What type of radiation is most damaging to human tissue?
Gamma radiation
Delta radiation
Beta radiation
Alpha radiation
While taking a paramedic refresher class, a local hazmat expert is discussing terms commonly used medical hazmat operations. To this end, what does ignition temperature refer to?
The lowest temperature at which a liquid will give off enough vapors to ignite.
Lowest temperature at which a liquid will give off enough vapors to support combustion.
The temperature at which a liquid becomes a gas.
The temperature range in which a vapor concentration air will ignite and combust.
What type of radiation, should an accident occur, does not require any decontamination of those exposed?
Which answer best explains the role of emergency medical services (EMS providers in preventing secondary contamination at a hazardous materials incident?
Rescuing patients from the hot zone
Taking initial actions to contain and isolate the hazardous material and patients
Creating a definitive plan of action for controlling the release of the hazard
Decontaminating patients
At the point of primary contamination, the contamination:
has traveled beyond the hot zone.
is in the cold zone.
is limited.
has spread to others.
What is a local effect of a chemical agent?
An effect occurring throughout the body
An effect involving multiple body systems
An effect involving the area around the immediate site of exposure
An effect that cannot be evaluated by standard criteria
Once substances enter the bronchial tree, they can be absorbed quickly, especially in:
oxygen-deficient atmospheres.
a confined space.
an open space.
oxygen-rich atmospheres.
In any situation involving chemical exposure, what should you do after ensuring your own safety?
Start all patients on oxygen.
Review the decontamination process.
See that all patients receive the necessary supportive measures.
Find a second source to agree on medication delivery.
A patient has been exposed to a pesticide through accidental ingestion. The primary treatment for this patient should be:
absorption
inducement of vomiting.
atropinization
dilution
A patient has ingested a corrosive, can swallow, and is not drooling. How should you treat this patient?
Administer sodium bicarbonate via intravenous (IV) push.
Administer furosemide.
Direct the patient to drink water.
Induce vomiting.
A patient with which type of primary exposure typically does not require decontamination?
CO exposure
Corrosive exposure
Organophosphate exposure
Hydrocarbon solvent exposure
What level of hazardous materials personal protective equipment provides chemically resistant splash protection, but not full encapsulation, and includes self-contained breathing apparatus (SCBA)?
Level B
Level C
Level D
Level A
Which protective ensemble offers the highest level of respiratory and splash protection against unknown substances?
In considering which type of personal protective equipment to use at a hazmat incident, you should base your decision on:
the chemical or substance involved.
the outside environmental conditions.
the cost of the ensemble.
the ease of donning and doffing the protective gear.
What is the universal decon method?
Vegetable oil
Water
Dry brush
Isopropyl alcohol
As a paramedic functioning on the scene of a hazardous materials incident at a fixed facility, you may be asked to:
perform preentry and postentry physical exams of the hazmat entry team.
conducting decontamination on the entry team personnel coming out of the hot zone.
assist the entry team in identifying the product.
research the properties of the hazardous substances.
As the hazmat entry team completes the decontamination process, they doff their personal protective equipment and move to the cold zone for you to conduct their postentry evaluation. Because the hazmat incident is occurring on a hot and humid July day, your greatest concern for the team members is:
abnormal heart rate.
respiratory distress.
nausea and vomiting.
environmental heat stress.
For prehydration of entry team personnel, sports drinks:
should be diluted with 50 percent water.
are inappropriate.
should be alternated with 8 to 16 ounces of water.
are most effective at full strength.
As the hazardous materials team prepares to make entry into the hot zone to mitigate an active leak, the process of the preentry physical should include documenting all of these bits of information except:
body temperature and weight.
pulse, blood pressure, and respirations.
current and past medical history.
Electrocardiogram (ECG) and mental/neurological status.
At which hazmat level should a paramedic be trained to before being able to function in the warm zone of a hazardous materials incident?
Hazmat operations level
Awareness level
Emergency medical services (EMS) Level 1
Emergency medical services (EMS) Level 2
At a hazmat incident involving a chemical spill, paramedics are least likely to:
evaluate decontamination methods.
treat and transport exposed patients.
neutralize and clean up the spilled chemicals.
perform medical monitoring of hazmat teams.
You are responding to a scene involving an overturned railway tanker, and you want to identify the material the tanker was transporting. Which is a disadvantage of relying on shipping papers for information about a hazardous material?
They do not carry the UN identification number of the substance.
They are not required to list the hazard class of the material.
Because they are kept onboard the vehicle, they may be inaccessible in the event of a spill.
They do not give information about the amount of the substance involved.
You are responding to a fire at a chemical factory involving an unknown substance. Your partner opens the copy of the Emergency Response Guidebook you have in the ambulance. In the Emergency Response Guidebook, what information is provided within this reference book?
A list of hazardous materials substance names, placard identification, and evacuation distances for most substances
Guidelines for cleaning up specific hazardous substances
Chemical compounds along with the periodical table
Treatment protocols for chemical exposure
Which statement regarding operations within the hot zone is most inaccurate?
Only personnel with appropriate personal protective equipment (PPE) will be allowed in the hot zone.
Only highly trained responders can operate within the hot zone.
The physical size of the hot zone is based on the magnitude of the contamination.
Patients in the hot zone found with compromised airways should be addressed before being moved to the warm zone.
During the postentry physical, you discover that an entry team member has an altered level of consciousness, hypotension, and tachycardia. You should:
check the team member's body weight before allowing reentry into the hot zone.
reevaluate the team member's vital signs in 15 minutes for improvement.
restrict the team member from being allowed to reenter the hot zone.
immediately assist the team member with drinking water or an energy drink.
The single most important step for a paramedic to remember when functioning at any hazardous materials in which a hazardous material spill is causing vapors to be released into the air is to:
While you are responding to a motor vehicle accident involving a tanker truck, the dispatcher notifies you that passing motorists are reporting that there are numerous bystanders experiencing acute respiratory distress. With this information, you should:
attempt to rescue the patients who are salvageable.
attempt to establish how many victims are affected and request additional resources.
stage at a safe distance off-site, uphill and upwind of the incident, and attempt to view the incident scene using binoculars.
activate the local multiple-casualty incident (MCI) protocol.
An emergency responder who may perform patient care in the warm zone on patients who still present a significant risk of secondary contamination describes:
an emergency medical services (EMS) Level 1, or the operations level responder.
a hazardous materials specialist level responder.
an awareness level responder.
an emergency medical services (EMS) Level 2, or the technician level responder.
A patient has accidentally ingested a hydrocarbon solvent and may have inhaled fumes from the solvent as well. Which statement about hydrocarbon solvents is most incorrect?
Primary effects of exposure to hydrocarbon solvents include dysrhythmias, pulmonary edema, and respiratory failure.
If the patient begins to present with seizures, consideration should be given to the administration of diazepam.
When the patient has ingested a solvent, you should give the patient ipecac syrup and induce vomiting.
In case of inhalation, maintain and support the airway, breathing, circulation (ABCs).
A patient who has undergone field decontamination prior to receiving medical treatment is best described as a:
semidecontaminated patient requiring a more invasive decon process.
patient who should not receive any care until he or she has been further decontaminated.
patient who is ready to be moved to the cold zone for initial treatment.
fully decontaminated patient not requiring any additional decontamination.
Where should an National Fire Protection Association (NFPA) 704 placard be expected to be found at?
A semitruck tanker carrying gasoline
A railroad tanker carrying liquid nitrogen
An outdoor storage tank holding liquid oxygen
Barrels of methyl alcohol on a towed barge
When approaching the scene of a potential hazardous materials incident that has a light whitish haze coming from it, you should:
use binoculars to make a visual inspection of the scene from a safe distance.
approach the scene and position as close as needed to visually read the placards with the naked eye if binoculars are not available.
approach the scene from a downwind and uphill direction.
establish a safety zone of initially 50 feet with the ability to increase it as necessary.
As you are performing a preentry physical on the assigned entry team, you assess a team member who is exhibiting abnormal vital signs that are outside of the allowable parameters of the department's standard operating procedures (SOPs). You should immediately:
overlook the findings if you are short entry team members.
advise the team member and report your findings to either the safety officer or the incident commander.
reassess the vital signs 5 minutes later.
allow for the entrant to don personal protective equipment (PPE) and enter into the hot zone.
The respirator designed for use in conjunction with Level C protective equipment that can be utilized during transport of patients with the potential of secondary contamination is:
a supplied-air breathing apparatus (SABA).
a self-contained breathing apparatus (SCBA).
an air-purifying respirator (APR).
an N-90 filter mask.
When hazardous materials are involved in or threatened by fire, the size of the danger zone is:
anywhere with flames or smoke from the fire.
dictated by the nature of the materials.
a 1-mile square area with the site of the fire at the center.
a 100-foot radius from the site of the fire.
In the case of topical absorption, a toxic substance has entered the body:
through inhalation.
by ingestion.
through the skin.
by injection.
What level of hazmat training for the emergency medical services (EMS) provider allows them to enter the "hot zone" at a hazmat incident?
EMS providers do not enter the "hot zone."
EMS Level 1
EMS Level 2
EMS Level 3
In terms of reducing your exposure to an alpha radioactive source, what is the best method?
A full protective suit with self-contained breathing apparatus (SCBA)
Several inches of lead
A concrete barrier
Standard precautions
When decontaminating a patient exposed to solid corrosives, first:
brush off dry particles.
flush the exposed area with large quantities of cold water.
rub the exposed area with a saline-moistened dressing.
flush the exposed area with a gallon of hot water.
A patient inhales chlorine, which causes the patient to develop pulmonary edema. What is a specific means of treating this pulmonary edema (select the most correct answer)?
Establishing an intravenous (IV) and administering fluids to dilute the irritants
Administering furosemide (Lasix)
Completing a primary decontamination
Maintaining and supporting the airway, breathing, circulation (ABCs)
As you arrive on scene of a motor vehicle incident involving a package delivery truck, you observe liquids dripping from the rear of the truck and forming a visible vapor as they hit the ground. With this information, you would suspect:
that it is highly unlikely that any hazardous materials are being carried in the truck.
if you work quickly, you and your partner can perform a rescue of the driver before you are affected by any potential harmful vapors.
that this could involve hazardous materials because not all delivery trucks are required to display placards.
that there may be shipping papers that you could access in the cab that list the contents of the truck.
Your ambulance has just arrived at a hazmat scene where incident command has established hot, warm, and cold zones. Both you and your partner are hazmat awareness level trained. Your most likely duty assignment will be:
to perform lifesaving patient care in the warm zone.
to move critical patients from the hot zone to your ambulance for transport.
to conduct decontamination of potentially injured patients.
to perform triage and treatment in the cold zone.
You and your partner respond to a scene at which multiple people are presenting with choking, coughing, and vomiting that seem to be related to the release of a chemical agent in the area. You should expect that:
the response to this event will involve multiple agencies and jurisdictions.
you will need law enforcement involvement only if the chemical agent was released as part of an attack.
the agent will already have dissipated, and its effects will be contained to these patients.
these patients have been contaminated but are not a contamination risk themselves.
Which configuration of protective equipment offers the least amount of protection to hazardous materials exposure?
Nonpermeable suit, boots, gloves, and eye protection along with an air-purifying respirator
Fully encapsulated, impermeable chemical suit with self-contained breathing apparatus (SCBA)
Nonencapsulating chemical-resistant suit, boots, gloves, and eye and respiratory protection
Structural firefighting gear
You are called to care for a man who is having pain when gasoline got into his eyes. He stated he was refueling his lawn mower, and the gas had been sitting outside in the sun with the cap on tightly. When he removed the gas can lid, gas vapor rapidly expelled and got into his eyes and is now burning. The increase in the pressure inside the can was caused by?
Elevated vapor density
Increased specific gravity
Decreased water solubility
Increased vapor pressure
What is CHEMTREC?
A guidebook for identifying hazardous materials
An organization with a 24-hour information hotline regarding hazardous materials
The set of laws governing the transport of hazardous materials
The acronym for the levels of training for hazmat providers
An incident involving which of the following types of vehicles may result in a hazardous materials incident?
Cars powered by alternative fuels
Tractor-trailers
Tanker trucks
All of the above
Each year in the United States, an estimated ________ of hazardous materials are shipped via road, rail, and pipelines.
8 million tons
one hundred thousand pounds
4 billion tons
2 billion pounds
You have responded to a ranch where three adult male patients are complaining of abdominal cramping, vomiting, and diarrhea. They state they were applying chemicals to a field when they became ill. Based on this, which of the following should you suspect?
They have heatstroke.
They became contaminated with organophosphates.
They have been exposed to anhydrous ammonia.
They have been exposed to anthrax.
A substance that may be an acid or an alkali and that can damage the skin and other tissues best describes a(n):
solvent
corrosive
irritant
desiccant
Unless specially trained, EMS personnel operate in which of the following zones of a hazardous materials incident?
Green
Orange
Yellow
Red
On the scene of a hazardous materials emergency, which of the following individuals is best suited to serve as incident commander?
Fire service rescue technician
Paramedic
Hazardous materials technician
Hazmat specialist
You have just completed hazmat EMS level 2 training. This means that you are now trained to:
contain hazardous material spills
evacuate patients from the hot zone.
provide patient care in the warm zone.
clean up hazardous materials safely.
Which one of the following statements shows that the paramedic has a proper understanding of basic operations at the scene of a hazardous materials emergency?
"Life or health should never be risked if the threat is only to the environment."
"The most important thing is to identify the exact material involved in the incident."
"Olfactory clues are the most reliable way to identify a hazardous material incident."
"Identification of the material is not important, as the approach is the same for all materials."
As you approach the scene of a motor vehicle collision, you realize that there is a tanker truck involved and that it has tipped over. Which of the following actions is appropriate?
Stop a safe distance away, use binoculars to locate any placards on the tanker, and reference the Emergency Response Guide.
Stop a safe distance from the scene, use binoculars to locate any placards on the tanker, and reference the safety data sheet.
When you reach the scene, look for the NFPA 704 label and reference the safety data sheet.
When you reach the scene, look for any placards on the tanker and reference the Emergency Response Guide.
During transport of a patient exposed to a hazardous material, which of the following types of glove provides the paramedic with the best protection during patient care?
Leather
Reinforced mesh cloth
Latex
Nitrile
When providing medical monitoring of hazardous materials personnel, for which of the following should you keep a high index of suspicion?
Heat stress
Atrial fibrillation
Myocardial ischemia
Hypoglycemia
Which of the following would raise the most suspicion of a hazardous materials incident?
A pair of landfill workers with symptoms of sore throat and fever
Multiple patients at a factory with respiratory complaints
Rising incidence of suicide in a rural county
Multiple patients at an outdoor event complaining of "heatstroke"
The most accurate information about a transported substance can be found in which of the following?
NFPA 704 system
Safety data sheet
Shipping papers
Emergency Response Guide
Which of the following regarding hazardous materials is provided by the Emergency Response Guide?
A different UN for every material listed
Special information regarding long-term health and environmental hazards for each material
Specific decontamination and treatment information for each material listed
Evacuation distances for the most hazardous materials
Which of the following is used to identify hazardous materials in fixed facilities?
DOT placards
SDS
CAMEO tags
You have entered a manufacturing setting on a call and note a large storage container with a diamond-shaped label. The left side of the label is blue and contains the number 4. The top portion of the label is red and contains the number 1. What does this mean?
The substance is highly hazardous to health, but does not pose a significant fire risk.
The substance is highly flammable, but does not pose a significant health risk.
The substance is highly hazardous to health, but does not pose a significant risk of reactivity.
The substance is highly reactive, but does not pose a significant health risk.
You have arrived on the scene of a chemical leak at laboratory. The placard has a "1" in the blue diamond and a "4" in the red diamond, which means the material is:
flammable, but represents a low health hazard.
explosive with a high associated health hazard.
a solid that is very flammable.
a flammable liquid with radioactive properties.
On the National Fire Protection Association hazardous materials classification placard, the blue diamond represents:
reactivity
health hazard.
specific hazard
fire hazard.
You are working the scene of a collision involving a tractor-trailer that is hauling an unknown chemical. Because no material is leaking from the truck and the scene is safe, the incident commander asks you to get the truck's shipping papers. Where would these most likely be located?
Shipping vault on the trailer
Cab of the truck
Rear compartment on the tanker
Electrical box between the tractor and trailer
It has been determined that the concentration of a substance is at IDLH. This means that patients exposed to the area:
are at risk for adverse effects or death as soon as they are exposed
will suffer no adverse effects if they have been exposed for less than 15 minutes
have a 50 percent likelihood of dying.
require transport and inpatient hospitalization.
In a hazardous materials incident, decontamination begins in the ________ zone.
central
cold
warm
hot
At the scene of a hazardous materials emergency, you have been assigned to the cold zone. In this zone, which one of the following would you perform?
Initial decontamination
Initial triage
Removal of contaminated rescue gear
Obtaining vital signs
When working in the warm zone, the paramedic should remember that:
the area is actively contaminated.
there is no danger of contamination.
protective gear must be worn.
patient care is not performed
Which of the following is the most common route of exposure to hazardous materials?
Injection
Ingestion
Inhalation
Absorption
The highest level of respiratory and splash protection from hazardous materials exposure is provided by level ________ protective equipment.
A
B
C
D
Firefighter "turnout" gear is considered what level of protective equipment
Which of the following is the universal decontamination agent for hazardous materials exposure?
A low-sudsing detergent
Activated charcoal
Tincture of green soap
Which of the following is NOT recommended in managing patients exposed to carbamate pesticides?
Using tincture of green soap in the decontamination process
Administering pralidoxime
Decontaminating with water
Administering atropine
The driver of a truck carrying a caustic substance in powder form has accidentally come into contact with the material. You are first on the scene, and a quick observation indicates that he has powder on his arms. Your immediate action would be to:
brush off the powder, then rinse the area with water.
place the patient in the ambulance, but avoid touching his arms.
instruct the patient to remain still and wait for the incident safety officer.
wrap the arms in dry, sterile dressings.
You have been cleared by the incident commander at a hazmat incident to prepare to go off duty. After completing decontamination, which of the following should be your FIRST action?
Return to the ambulance and drive to your station.
Inform dispatch that you are off duty and leave the scene.
Report directly to EMS for post-entry monitoring.
Remove and bag your uniform.
Which of these is required for those who may perform patient care in the cold zone on patients who do not present a significant risk of secondary contamination?
EMS Level 1 training
EMS Level 2 training
Awareness Level
Multiple Casualty training
