Command Structure and Command Staff Practice Questions

25 multiple-choice questions on Command structure and command staff for paramedic and EMT students, from Chapter 48 (Incident Management and Mass-Casualty Incidents). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. Single command is most appropriate when an incident:

   1. A. Crosses two counties and involves state police
   2. B. Involves fire, EMS, and police with shared authority
   3. C. Requires a federal agency to lead the investigation
   4. D. Falls within one agency's jurisdiction and scope
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   Answer: D. Falls within one agency's jurisdiction and scope

   Single command works when one agency has clear jurisdiction and responsibility, so one IC can make decisions. When several agencies or jurisdictions share legal responsibility, unified command is the better fit.

2. Unified command differs from single command in that:

   1. A. Each agency runs its own separate command post
   2. B. Agencies with authority jointly set objectives
   3. C. The highest-ranking person on scene takes over
   4. D. EMS defers its decisions to law enforcement
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   Answer: B. Agencies with authority jointly set objectives

   In unified command, the agencies that share jurisdiction or responsibility work from one command post and agree on a common set of objectives and one IAP. Separate command posts and command by rank are exactly the problems unified command is designed to avoid.

3. A tanker truck overturns on an interstate at a county line, spilling fuel near a school. Fire, EMS, state police, and two county agencies respond. The best command model is:

   1. A. Unified command at one command post
   2. B. Single command by the first-arriving unit
   3. C. Separate command posts for each agency
   4. D. Area command run from the state capital
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   Answer: A. Unified command at one command post

   Multiple agencies and jurisdictions share legal responsibility here, so unified command lets them agree on one set of objectives from a single command post. Separate posts would duplicate effort, and area command is for overseeing several separate incidents.

4. Under unified command, the agencies involved still each keep:

   1. A. A separate incident action plan for their crews
   2. B. A separate staging area and a separate radio plan
   3. C. Their own legal authority and responsibility
   4. D. The right to change objectives without the others
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   Answer: C. Their own legal authority and responsibility

   Unified command does not take away any agency's legal authority; it brings them together to set shared objectives and a single IAP. Separate plans and unilateral changes would break the coordination unified command is meant to create.

5. Area command is established when:

   1. A. Several separate incidents need coordination
   2. B. One incident outgrows a single command post
   3. C. The first IC must hand over to a senior officer
   4. D. A hospital activates its own internal plan
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   Answer: A. Several separate incidents need coordination

   Area command oversees multiple incidents, each with its own ICS organization, such as several fires in one region competing for the same resources. One large incident is managed by expanding its own ICS structure, not by area command.

6. Which is a core responsibility of the incident commander?

   1. A. Directing each crew's tasks in the treatment area
   2. B. Calling each hospital with patient updates
   3. C. Briefing the media in person on each update
   4. D. Setting incident objectives and approving the IAP
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   Answer: D. Setting incident objectives and approving the IAP

   The IC is responsible for the overall incident: assessing the situation, setting objectives, approving the incident action plan, and managing resources. Direct patient care pulls the IC away from command and leaves the incident unmanaged. Directing treatment crews belongs to the treatment unit leader under operations, hospital calls to the medical communications coordinator, and routine media briefings to the public information officer.

7. The incident command post (ICP) should ideally be located:

   1. A. Right beside the triage area for quick contact
   2. B. Close to the scene but outside the hazard area
   3. C. At the county emergency operations center
   4. D. At the fire station closest to the incident site
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   Answer: B. Close to the scene but outside the hazard area

   The ICP should be close enough for the IC to understand and manage the scene, but outside the hazard area, often upwind and uphill, and easy for arriving units to find. A post right beside triage puts command in the middle of patient flow and noise. The county emergency operations center supports the incident from afar and does not replace an on-scene command post. A nearby fire station is usually too far from the scene, and the closest one may be in the affected area.

8. Your engine company is first to arrive at a train derailment with dozens of injured passengers. The officer should first:

   1. A. Begin CPR on the closest pulseless patient
   2. B. Start carrying patients to the nearest road
   3. C. Establish command and give a size-up report
   4. D. Wait for a chief officer before doing anything
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   Answer: C. Establish command and give a size-up report

   The first-arriving officer establishes command, names the command post, and gives a size-up and resource request. Starting hands-on care right away leaves no one managing the scene, while waiting for a chief wastes the critical first minutes.

9. The ICS command staff consists of the safety officer, the liaison officer, and the:

   1. A. Operations section chief
   2. B. Medical branch director
   3. C. Finance/admin section chief
   4. D. Public information officer
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   Answer: D. Public information officer

   The command staff report directly to the IC and are the safety officer, the liaison officer, and the public information officer. The operations and finance/administration section chiefs belong to the general staff, together with planning and logistics. The medical branch director works under operations, two levels below the IC.

10. At a chemical plant MCI, the IC brings in a chemist to advise on the toxic release. In ICS, a technical specialist like this is most often assigned to:

    1. A. The planning section
    2. B. The logistics section
    3. C. The safety officer
    4. D. The finance section
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    Answer: A. The planning section

    Technical specialists, such as chemists, structural engineers, or toxicologists, bring expertise the incident needs. NIMS places them most often in the planning section, where their input shapes the situation picture and the incident action plan, although they can be assigned wherever they are needed. Logistics provides facilities, supplies, and services, not technical analysis. The safety officer may consult the chemist but is a single command staff position, not the usual home for specialists. Finance/administration tracks costs, time, and claims.

11. During a collapse rescue, the safety officer sees crews working under an unshored concrete slab. The safety officer should:

    1. A. Note it in the log for the after-action review
    2. B. Stop the operation and then notify the IC
    3. C. Ask the operations chief to look at it later
    4. D. Wait for the IC to issue an order to stop work
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    Answer: B. Stop the operation and then notify the IC

    The safety officer can stop unsafe actions on the spot when the danger is imminent and then informs the IC. Waiting or simply logging the hazard could get responders killed under the slab.

12. The Red Cross sends a manager to the command post who can commit its shelters and staff to the incident. In ICS, this person is called:

    1. A. An agency representative
    2. B. A technical specialist
    3. C. A deputy incident commander
    4. D. An assistant safety officer
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    Answer: A. An agency representative

    An agency representative is sent by an assisting or cooperating agency and has full authority to make decisions for that agency at the incident, such as committing its shelters and volunteers. A technical specialist gives expert advice but does not commit an outside agency's resources. A deputy IC must be qualified to take over command of the whole incident. An assistant safety officer supports the safety officer. Neither of those two speaks for an outside agency.

13. A representative from the local utility company arrives at the command post asking how to help with a downed power line at an MCI. The IC should direct this person to the:

    1. A. Safety officer
    2. B. Liaison officer
    3. C. Staging manager
    4. D. Treatment leader
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    Answer: B. Liaison officer

    The liaison officer coordinates with assisting and cooperating agencies such as utilities. The safety officer watches hazards on scene but does not manage agency representatives, and staging handles arriving response units.

14. The public information officer (PIO) at an MCI should:

    1. A. Release victims' names as soon as they are known
    2. B. Allow reporters into treatment areas for footage
    3. C. Avoid the media to protect patient confidentiality
    4. D. Give the media accurate, approved information
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    Answer: D. Give the media accurate, approved information

    The PIO is the single point for releasing accurate, IC-approved information to the media and the public. Releasing names before families are notified or letting cameras into treatment areas violates privacy, but refusing all contact fuels rumor.

15. After checking in at a large MCI, your crew is assigned to the treatment unit. Before you start work, the treatment unit leader should give you:

    1. A. Copies of the triage tags for your patients
    2. B. Approval of the overtime hours for your crew
    3. C. A briefing on the task, hazards, and radios
    4. D. A written IAP for the next operational period
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    Answer: C. A briefing on the task, hazards, and radios

    NIMS common responsibilities call for each responder to get a briefing on arrival at an assignment: what the task is, where to work, who the supervisor is, known hazards and safety rules, and which radio channels to use. Triage tags stay on the patients and are not handed out as paperwork. Time and overtime are recorded through finance/administration after the work is done. A written IAP for the next period comes from the planning section, and a crew does not need it to start its current task.

16. When several agencies' PIOs must coordinate messages during a large incident, they work from a:

    1. A. Unified staging area
    2. B. Emergency triage desk
    3. C. Joint information center
    4. D. Area command information post
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    Answer: C. Joint information center

    A joint information center (JIC) is where PIOs from involved agencies work together so the public hears one consistent message. Staging and area command serve other ICS functions.

17. The ICS general staff consists of the chiefs of:

    1. A. Safety, liaison, public information, and medical
    2. B. Operations, planning, logistics, and finance
    3. C. Fire, EMS, law enforcement, and public works
    4. D. Triage, treatment, transport, and staging units
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    Answer: B. Operations, planning, logistics, and finance

    The general staff are the section chiefs for operations, planning, logistics, and finance/administration. Safety, liaison, and PIO make up the command staff, and triage, treatment, and transport are units within the medical branch or group.

18. Transfer of command from the first-arriving officer to a more senior officer should ideally occur:

    1. A. By text message to avoid tying up the radio
    2. B. Without a briefing to save valuable time
    3. C. After the incident is under control
    4. D. Face to face with a full situation briefing
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    Answer: D. Face to face with a full situation briefing

    Command should transfer face to face when possible, with a briefing on the situation, objectives, resources, and hazards. Skipping the briefing means the new IC starts without key information.

19. A battalion chief arrives at a crash where a paramedic lieutenant has been IC for 10 minutes. The chief decides to assume command. After the face-to-face briefing, the next step is to:

    1. A. Announce the change of command to everyone
    2. B. Have the lieutenant leave the scene right away
    3. C. Restart the size-up and triage from the start
    4. D. Close the old command post and open a new one
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    Answer: A. Announce the change of command to everyone

    Everyone on the incident must know who is in command, so the transfer is announced by radio after the briefing. The former IC is usually reassigned to help, and restarting triage would waste the work already done.

20. A senior officer arriving on scene should assume command when:

    1. A. They outrank the officer who is now in command
    2. B. There is a reason, such as a growing incident
    3. C. The current IC has been in charge 5 minutes
    4. D. The current IC is from a different agency
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    Answer: B. There is a reason, such as a growing incident

    A transfer of command should happen for a reason: the incident is growing beyond the current IC's experience, command is not working well, or agency policy calls for it. Rank alone is not a reason, because each transfer costs time and risks losing information. Time in command has no set limit. A different agency affiliation is handled by unified command, not by taking command away from someone.

21. The ICS form commonly used to brief an incoming incident commander, with a map, objectives, and resources, is the:

    1. A. ICS 201 incident briefing
    2. B. ICS 213 general message
    3. C. ICS 214 unit activity log
    4. D. ICS 206 medical plan form
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    Answer: A. ICS 201 incident briefing

    The ICS 201 summarizes the situation, objectives, current actions, organization, and resources, so it is used for the initial briefing and command transfer. The 206 is the responder medical plan and the 214 logs a unit's activities.

22. The incident commander on a large MCI wants a deputy. A deputy incident commander must be:

    1. A. From a different agency than the current IC
    2. B. The highest-ranking paramedic on the scene
    3. C. Assigned to handle the media inquiries
    4. D. Fully qualified to take over as IC
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    Answer: D. Fully qualified to take over as IC

    A deputy must be able to assume the primary position if needed, so they must be fully qualified for it. Deputies differ from assistants, who serve command staff positions with less authority; agency and rank are not the deciding factors.

23. A paramedic serving as IC on a small MCI realizes that responders are arriving faster than she can track them. Her best action is to:

    1. A. Order all units to stop responding for now
    2. B. Track everyone on her own notepad and radio
    3. C. Delegate functions such as staging
    4. D. Hand command to the next unit to arrive
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    Answer: C. Delegate functions such as staging

    When the IC's span of control is exceeded, she should delegate functions such as staging, triage, and transport to supervisors. Stopping resources or trying to track everyone alone overwhelms command, and passing command without reason adds confusion.

24. Under unified command at a train crash, fire, EMS, and police agree on one set of objectives. Tactical direction of all crews then comes from:

    1. A. Each agency's own commander, separately
    2. B. One operations chief across the agencies
    3. C. The highest-ranking police officer present
    4. D. The liaison officer at the command post
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    Answer: B. One operations chief across the agencies

    Under unified command, the agencies set objectives together, but the plan is carried out through a single operations section chief, so every crew gets one set of tactical orders. If each agency directs its own crews separately, the conflicting orders that unified command is meant to prevent come back. Rank alone does not make anyone the tactical lead. The liaison officer coordinates with outside agencies and does not direct tactics.

25. The incident commander's overall priorities, in order, are:

    1. A. Life safety, incident stability, property
    2. B. Property, life safety, incident stability
    3. C. Incident stability, property, life safety
    4. D. Patient transport, life safety, property
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    Answer: A. Life safety, incident stability, property

    Life safety of responders and the public comes first, then stabilizing the incident, then protecting property and the environment. Putting stability or property first risks lives.