Disaster Field Operations: Evacuation, Rescue Coordination, Communications, Fatalities, and Reunification Practice Questions

25 multiple-choice questions on Disaster field operations: evacuation, rescue coordination, communications, fatalities, and reunification for paramedic and EMT students, from Chapter 52 (Disaster Response). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. A hurricane is approaching. A family lives in a well-built home inland, outside the storm-surge zone, and no evacuation order covers them. They are best advised to:

   1. A. Evacuate with the surge-zone residents
   2. B. Wait out the storm in their parked car
   3. C. Go to the nearest hospital until it passes
   4. D. Shelter in place in an interior room
   Show answer

   Answer: D. Shelter in place in an interior room

   The guiding rule is 'run from water, hide from wind': people in surge or flood zones evacuate, while those in sturdy homes outside them usually shelter in place. Unneeded evacuation clogs roads for people who must leave.

2. A hurricane evacuation order is issued. Residents who have no car are best helped by:

   1. A. Preplanned public transport pickups
   2. B. Asking them to find rides on their own
   3. C. Ambulance transport for each person
   4. D. Telling them to shelter in place instead
   Show answer

   Answer: A. Preplanned public transport pickups

   Transportation-dependent residents need preplanned pickup points, buses, and paratransit, often arranged through registries before the storm. Using ambulances for people who simply lack a car wastes units needed for patients.

3. A hospital begins a planned evacuation 48 hours before a hurricane. Critically ill patients are often moved early in this kind of evacuation mainly because they:

   1. A. Need special transport and the most time
   2. B. Are the quickest and simplest to move
   3. C. Have families who demand that they go first
   4. D. Can ride on buses with other patients
   Show answer

   Answer: A. Need special transport and the most time

   In a planned evacuation, ICU and ventilated patients need critical care transport, receiving ICU beds, and the longest lead time, so they are often moved while roads and aircraft are still available. In a sudden fire, by contrast, patients nearest the danger are moved first.

4. A fire breaks out in one wing of a hospital floor. The first evacuation step is usually to move patients:

   1. A. Vertically down the stairs at once
   2. B. Out to the nearest exit to the street
   3. C. To the floor above the fire
   4. D. Horizontally past a fire barrier
   Show answer

   Answer: D. Horizontally past a fire barrier

   Hospitals are built in fire-rated compartments, so patients are first moved horizontally to a safe area on the same floor. Vertical evacuation down stairs is slower and harder and is used only if the floor itself becomes unsafe. Moving up to the floor above puts patients in the path of rising smoke, and leaving the building entirely is the last step, not the first.

5. A frail nursing home in the hurricane's path has a generator, 7 days of fuel and supplies, full staff, and is outside the surge zone. The best plan is usually to:

   1. A. Evacuate the residents together by bus at once
   2. B. Send the residents to the hospital
   3. C. Shelter in place, ready to move if needed
   4. D. Discharge residents to their families
   Show answer

   Answer: C. Shelter in place, ready to move if needed

   Long evacuations of frail residents carry real risk of injury and death, as seen in past hurricanes, so a well-prepared facility outside the hazard zone may be safer sheltering in place. Moving everyone by bus exposes residents to travel stress, heat, and crashes.

6. When nursing home residents are evacuated by ambulance, each resident should travel with:

   1. A. The clothes and shoes the resident has on
   2. B. Medication list, records, and ID
   3. C. A copy of the facility's insurance
   4. D. Family contact numbers on a sign-out
   Show answer

   Answer: B. Medication list, records, and ID

   Records, medication lists, advance directives, and identification must go with each resident so receiving staff can continue care. Patients separated from their records are at risk of medication errors and loss of tracking.

7. During a regional evacuation of three hospitals, the best way to know where every patient has gone is:

   1. A. A patient tracking system with ID bands
   2. B. Staff memory and phone calls afterward
   3. C. Asking families to report where they went
   4. D. A list made after the evacuation ends
   Show answer

   Answer: A. A patient tracking system with ID bands

   Electronic or paper tracking linked to ID bands records each patient's unit and destination as they leave, which supports care and family reunification. Reconstructing the list afterward loses patients.

8. When evacuating ICU patients during a hospital evacuation, destinations should be chosen by:

   1. A. Taking patients to the nearest site
   2. B. Letting each crew pick its own hospital
   3. C. Sending patients wherever families live
   4. D. Matching needs to beds at each hospital
   Show answer

   Answer: D. Matching needs to beds at each hospital

   Receiving hospitals must have the right type of bed and staff, so a coordinating center matches each patient's needs to available capacity. Sending all patients to the nearest hospital overwhelms it.

9. A ventilator-dependent man must leave his home during an evacuation. The crew should bring:

   1. A. His ventilator and its wall power cord
   2. B. His vent, spare batteries, and a BVM
   3. C. A BVM in place of the heavy ventilator
   4. D. His vent tubing but not the vent itself
   Show answer

   Answer: B. His vent, spare batteries, and a BVM

   Home ventilator patients need their own device, enough battery power for travel and delays, and a bag-mask device as backup in case the ventilator fails. Relying on the power cord alone fails when power is unavailable.

10. During a power outage in a high-rise, a wheelchair user on the 15th floor needs to evacuate. The best option is to:

    1. A. Wait for the elevator to come back on
    2. B. Carry her in her heavy power wheelchair
    3. C. Use an evacuation chair down the stairs
    4. D. Leave her on the floor for the night
    Show answer

    Answer: C. Use an evacuation chair down the stairs

    Stair evacuation chairs let a small team move a nonambulatory person safely down stairwells when elevators are out. Carrying a person in a power wheelchair, which can weigh over 100 kg, risks falls for everyone.

11. Many residents refuse to leave before a hurricane. A common reason, addressed by the federal PETS Act, is that they:

    1. A. Cannot afford the cost of a hotel
    2. B. Will not leave their pets behind
    3. C. Are afraid of crime in the shelters
    4. D. Want to protect homes from looters
    Show answer

    Answer: B. Will not leave their pets behind

    The PETS Act of 2006 requires disaster plans to account for household pets and service animals, after many people stayed in danger during Hurricane Katrina rather than abandon their animals. Pet-friendly shelters raise evacuation rates.

12. A paramedic from another state drives to a hurricane zone without being requested and asks to help. The main problem with self-deployed responders is that they:

    1. A. Usually have more skills than local crews
    2. B. Lack the skills to work in disasters
    3. C. Are paid at higher rates by FEMA
    4. D. Are not tracked, vetted, or supported
    Show answer

    Answer: D. Are not tracked, vetted, or supported

    Self-deployed responders strain food, fuel, and lodging, and their credentials, safety, and assignments are not tracked, which makes them a burden. Help should come through official requests such as EMAC or registered volunteer systems.

13. During wide-area flood rescues by boat, the best place for EMS to set up a medical post is:

    1. A. At the boat landing where rescues return
    2. B. Deep inside the flooded neighborhood
    3. C. At the receiving hospital's emergency department
    4. D. At the county EOC beside dispatch
    Show answer

    Answer: A. At the boat landing where rescues return

    A medical post at the landing site lets EMS triage and treat rescued people as soon as they reach dry land, then send them on. Entering the flooded zone exposes crews to water hazards they are not equipped for.

14. After an earthquake, many roads are blocked by debris and damaged bridges. Before sending units into the area, EMS should:

    1. A. Use the usual fastest routes from the GPS
    2. B. Send units along the major highways
    3. C. Obtain reports of damage and safe routes
    4. D. Wait until the roads are inspected
    Show answer

    Answer: C. Obtain reports of damage and safe routes

    Route assessments from public works, police, and aerial views let dispatch send units by passable roads and avoid damaged bridges. Normal GPS routes may lead units onto unsafe or blocked roads.

15. During a disaster, cell networks are jammed. Which service gives authorized responders priority for landline and cell calls?

    1. A. Amateur radio ARES networks
    2. B. Text-to-911 emergency service
    3. C. GETS and WPS priority calling
    4. D. The NOAA weather radio system
    Show answer

    Answer: C. GETS and WPS priority calling

    The Government Emergency Telecommunications Service (GETS) and Wireless Priority Service (WPS) move authorized responders' calls ahead of others on congested networks. Amateur radio is a separate backup, not a priority service on phone networks.

16. After a hurricane, phone and agency radio systems are down across the county. A backup that many EMS plans use is:

    1. A. Amateur (ham) radio volunteers
    2. B. Public social media posts
    3. C. Commercial television news stations
    4. D. Personal cell phone texting
    Show answer

    Answer: A. Amateur (ham) radio volunteers

    Organized amateur radio groups, such as ARES and RACES, can pass messages across damaged areas without the commercial or public safety infrastructure. Social media and cell texting both depend on the networks that have failed.

17. Text messages are more likely than voice calls to get through on a jammed disaster network because they:

    1. A. Travel over a separate satellite
    2. B. Use much less network capacity
    3. C. Are routed ahead of voice calls
    4. D. Do not need a working cell tower
    Show answer

    Answer: B. Use much less network capacity

    Texts use little bandwidth and can wait in a queue until a moment of capacity, so they often go through when calls fail. They still need a working cell tower and are not given priority over calls.

18. Radios and phones fail at a large disaster site, and the treatment area must send patient counts to command. The most reliable backup is:

    1. A. Shouting messages across the site
    2. B. Waiting until the radios recover
    3. C. Hand signals from the treatment area
    4. D. Runners carrying written messages
    Show answer

    Answer: D. Runners carrying written messages

    Runners with written messages are slow but reliable when all electronic systems fail, and writing prevents details from changing as they are passed along. Shouting and hand signals are easily misunderstood.

19. During a disaster, legal authority over the dead rests with the:

    1. A. Incident commander on scene
    2. B. Medical examiner or coroner
    3. C. Local funeral home director
    4. D. State EMS medical director
    Show answer

    Answer: B. Medical examiner or coroner

    The medical examiner or coroner has legal authority over remains, including identification, cause of death, and release to families, even in disasters. The incident commander manages the incident but not the legal handling of the dead.

20. When disaster remains must be moved, personal effects such as jewelry and wallets should be:

    1. A. Bagged and given to family on the scene
    2. B. Removed and held by the EMS crew for safekeeping
    3. C. Kept with the body to aid identification
    4. D. Handed to police at the morgue gate
    Show answer

    Answer: C. Kept with the body to aid identification

    Personal effects found with remains are key identification evidence and must stay with the body, documented, until the medical examiner's team takes custody. Giving items to people on scene can lead to misidentification.

21. At a family assistance center after a disaster, families are asked for dental records, medical details, and DNA samples. These are used to:

    1. A. Match with remains to confirm identity
    2. B. File the family's insurance claims
    3. C. Decide which family members to notify
    4. D. Screen relatives for inherited illness
    Show answer

    Answer: A. Match with remains to confirm identity

    Antemortem data, such as dental records, fingerprints, medical implants, and family DNA, are compared with postmortem findings to make scientific identifications. Visual identification by relatives is often wrong after severe trauma.

22. When the number of dead exceeds morgue space after a disaster, bodies are best stored temporarily in:

    1. A. Mass graves to be opened later on
    2. B. School gyms packed with bags of ice
    3. C. Local funeral homes in the area
    4. D. Refrigerated trailers at 2 to 4 °C
    Show answer

    Answer: D. Refrigerated trailers at 2 to 4 °C

    Refrigeration at about 2 to 4 °C (36 to 39 °F) slows decomposition and preserves remains for identification. Temporary mass burial makes identification much harder and distresses families.

23. A mother at a shelter cannot find her 8-year-old son, who was evacuated on a different bus. Besides checking local shelters, she should be referred to:

    1. A. The county medical examiner's office
    2. B. The national child locator center
    3. C. The state EMS licensing office
    4. D. The National Disaster Medical System
    Show answer

    Answer: B. The national child locator center

    The National Center for Missing and Exploited Children runs a national emergency child locator center and registry for children separated from families in disasters. NDMS moves patients, not displaced children, and the medical examiner is involved only with the dead.

24. During a hospital evacuation, an unconscious patient with no identification is moved to another facility. To help reunite him with his family, staff should:

    1. A. Tag him and record photos and features
    2. B. Wait until he wakes up to identify him
    3. C. List him by his old bed number
    4. D. Assign him a name from his belongings
    Show answer

    Answer: A. Tag him and record photos and features

    Assigning a unique tracking number, photographing him, and recording features such as tattoos and clothing let families and reunification centers match him to missing-person reports. Guessing a name from belongings risks misidentification.

25. During a hurricane evacuation, state officials reverse the inbound lanes of a highway so all lanes carry traffic away from the coast. This is called:

    1. A. Convergence
    2. B. Staging
    3. C. Diversion
    4. D. Contraflow
    Show answer

    Answer: D. Contraflow

    Contraflow turns inbound lanes outbound to move more people out of the threatened area. EMS must plan for it, because units heading toward the coast may face closed lanes and need set emergency routes.