Rescue Principles, Phases, and PPE Practice Questions

25 multiple-choice questions on Rescue principles, phases, and PPE for paramedic and EMT students, from Chapter 49 (Vehicle Extrication and Special Rescue). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. In the sequence of rescue phases used in this text, which phase comes right after gaining access to the patient?

   1. A. Stabilization
   2. B. Hazard control
   3. C. Arrival and size-up
   4. D. Disentanglement
   Show answer

   Answer: D. Disentanglement

   This text uses the sequence preparation, response, arrival and size-up, stabilization, access, disentanglement, removal, and transport; other texts name or group some phases differently, but stabilization comes before access in each. Stabilization is the tempting choice, but it must come before access so that a shifting vehicle or structure cannot injure the rescuers who reach in. Hazard control is part of arrival, size-up, and stabilization, before anyone reaches the patient. Arrival and size-up is the first on-scene phase.

2. During the response phase of a rescue call, the crew should mainly:

   1. A. Choose the cutting tools for the vehicle
   2. B. Give the receiving hospital a full report
   3. C. Gather details and plan roles en route
   4. D. Decide whether the patient needs a board
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   Answer: C. Gather details and plan roles en route

   The response phase is the trip to the scene: the crew gathers information from dispatch, anticipates hazards, and decides who will do what on arrival. Tool choice and packaging decisions depend on what is found at size-up, so they cannot be settled before arrival.

3. Your service area includes a river with a low-head dam and several grain elevators. The best preparation for rescues at these sites is to:

   1. A. Wait for a call there, then ask dispatch for help
   2. B. Preplan with rescue teams and visit the sites
   3. C. Keep a throw bag and a shovel on each ambulance
   4. D. Read about the hazards once a call is dispatched
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   Answer: B. Preplan with rescue teams and visit the sites

   Preparation is the first phase of rescue: training, preincident planning, site visits, and knowing which teams respond to which hazards. Carrying a single piece of gear is not a plan, and learning about a hazard while en route leaves no time to train for it.

4. A car went into a fast, flooded river 90 minutes ago at night. No one has been seen, and the car is fully under water. The operation should be run as:

   1. A. A body recovery with little rescuer risk
   2. B. A rescue with immediate diver entry
   3. C. A rescue using swimmers who have no tethers
   4. D. A rescue with crews wading to the car
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   Answer: A. A body recovery with little rescuer risk

   After prolonged submersion in a fast current with no survivor seen, the chance of a viable patient is very low, so the operation becomes a recovery and rescuers should accept little risk. Sending divers into swift water at night risks rescuers' lives for a patient who almost certainly cannot be saved.

5. The risk-benefit principle in rescue holds that rescuers may accept greater personal risk only when:

   1. A. The patient's family is present
   2. B. The work can be done more quickly
   3. C. A savable life is at stake
   4. D. High-value property can be saved
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   Answer: C. A savable life is at stake

   Rescuers may take calculated risks for a savable life, little risk for a likely recovery, and no risk for property. Speed alone does not justify risk: a faster but unsafe plan can create more victims than it saves.

6. A provider trained to the awareness level for technical rescue is expected to:

   1. A. Enter the hazard zone alongside a team of rescue technicians
   2. B. Rig rope systems and haul under a technician's lead
   3. C. Lead the rescue and supervise the technician teams
   4. D. Recognize the hazard, secure the area, and call for help
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   Answer: D. Recognize the hazard, secure the area, and call for help

   Awareness is the entry level: recognize the hazard, keep others out, and request the right resources. Working in the hazard zone, even beside technicians, requires operations or technician training and equipment.

7. You are an operations-level paramedic at a trench rescue. The technicians ask you to carry shoring panels from the tool area to the edge of the work zone. This task is:

   1. A. Beyond your level; you must stay at the ambulance
   2. B. Within your level when done under their direction
   3. C. Beyond your level unless you also enter the trench
   4. D. Within your level if you take over the operation
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   Answer: B. Within your level when done under their direction

   Operations-level rescuers support technicians outside the most hazardous area, such as moving tools and equipment, under the technicians' direction. Entering the trench or leading the rescue is technician-level work, but simple support tasks are an expected operations-level role.

8. In technical rescue, the technician level of training prepares a rescuer to:

   1. A. Perform and supervise the hands-on rescue
   2. B. Recognize hazards and call for more help
   3. C. Assist from outside the hazard zone
   4. D. Manage the incident's finances and supply
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   Answer: A. Perform and supervise the hands-on rescue

   Technicians are trained and equipped to work in the hazard zone and direct the rescue itself. Assisting from outside the hazard zone describes the operations level, and recognizing hazards and calling for help is the awareness level.

9. At a technical rescue, a paramedic who is not trained in that rescue discipline should mainly:

   1. A. Direct the rescue team's technical tactics
   2. B. Enter with the team to reach the patient first
   3. C. Stay in quarters until the patient is freed
   4. D. Prepare for patient care and advise the team
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   Answer: D. Prepare for patient care and advise the team

   The paramedic's role is to be ready for the patient and to advise the rescue team on medical needs, such as when pain control or fluids are needed before a release. Entering with the team without training adds a victim; directing technical tactics belongs to the rescue officer.

10. Before disentanglement starts, the rescue officer sets a primary plan and a backup plan for freeing the patient. The main reason for the backup plan is that:

    1. A. It lets the paramedic choose the better plan
    2. B. The team can switch at once if Plan A fails
    3. C. Two written plans are required by OSHA rules
    4. D. It halves the time it takes to free him
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    Answer: B. The team can switch at once if Plan A fails

    Extrication plans fail often: a cutter may not get through a high-strength steel post, a door may not open, or the patient may get worse and need a faster route out. Teams therefore set Plan A and Plan B and often stage tools for B while A is under way, so they can change course without losing minutes. The paramedic gives input on the patient's condition, but the rescue officer chooses the technical plan. No rule requires two written plans for every rescue, and a backup plan saves the minutes lost when Plan A fails rather than halving the overall time.

11. Rescuers are using hydraulic tools on a crashed car. Which PPE is most appropriate for the paramedic working beside the vehicle?

    1. A. Exam gloves, a surgical mask, and a reflective vest
    2. B. A ball cap, safety glasses, and nitrile exam gloves
    3. C. Helmet, eye protection, gloves, and turnout gear
    4. D. A bump cap, a face shield, and a cotton uniform
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    Answer: C. Helmet, eye protection, gloves, and turnout gear

    Extrication exposes rescuers to sharp metal, flying glass, and falling objects, so a helmet, eye protection, sturdy gloves, and turnout gear are needed. A reflective vest and exam gloves suit roadside medical care but give no protection against cut or flying debris.

12. To handle a patient amid broken glass and torn metal, the best hand protection is:

    1. A. Exam gloves worn under leather extrication gloves
    2. B. Two pairs of nitrile exam gloves worn together
    3. C. Leather extrication gloves with no gloves under them
    4. D. Sterile surgical gloves worn under exam gloves
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    Answer: A. Exam gloves worn under leather extrication gloves

    Leather or cut-resistant extrication gloves resist sharp edges, and exam gloves underneath give a barrier against blood. Doubling nitrile gloves helps with body fluids but is easily cut by glass and metal.

13. During glass breaking, a flip-down helmet face shield used alone is inadequate eye protection because:

    1. A. It blocks the paramedic's field of view
    2. B. It cannot be worn with a rescue helmet
    3. C. Fragments can enter around its edges
    4. D. Its plastic melts at a low temperature
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    Answer: C. Fragments can enter around its edges

    A face shield is open at the sides and bottom, so glass fragments and dust can reach the eyes; goggles or safety glasses should be worn under it. Shields are designed to fit on rescue helmets, and visibility is not the main problem.

14. Air chisels, power saws, and generators at an extrication scene make which protection important for both rescuers and the patient?

    1. A. Hearing protection
    2. B. A filter respirator
    3. C. Flame-resistant gowns
    4. D. Knee and elbow pads
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    Answer: A. Hearing protection

    Rescue tools and generators produce noise loud enough to damage hearing and to frighten a trapped patient, so ear protection is used for rescuers and offered to the patient. Respirators are needed for dust or toxic atmospheres, not routine tool noise.

15. At a vehicle extrication, the inner circle (action circle) around the vehicle should contain:

    1. A. All EMS crews waiting to treat the patient
    2. B. Bystanders who saw the collision happen
    3. C. Command staff and the public information officer
    4. D. Rescuers with an assigned task, in full PPE
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    Answer: D. Rescuers with an assigned task, in full PPE

    The inner circle, the area right around the vehicle, is limited to rescuers who are working there and wearing full PPE; everyone else stays in the outer circle. Extra EMS crews crowd the work area and are at risk from tools, glass, and a shifting vehicle.

16. At an extrication, tools and equipment should be staged:

    1. A. Beside the vehicle doors where crews will work
    2. B. In one area at the edge of the inner circle
    3. C. In the ambulance until a rescuer asks for them
    4. D. Spread around the car so each is close at hand
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    Answer: B. In one area at the edge of the inner circle

    A single staging area near the inner circle keeps tools ready but out of the way, so rescuers do not trip over them. Laying tools beside the doors clutters the work space, and leaving them in a vehicle delays the rescue.

17. Which size-up finding most clearly turns a crash call into a technical rope rescue?

    1. A. The car came to rest far down a steep ravine
    2. B. The driver's door is jammed shut by damage
    3. C. Two occupants are trapped in the back seat
    4. D. The frontal airbags have deployed in the car
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    Answer: A. The car came to rest far down a steep ravine

    A vehicle down a steep slope means rescuers cannot safely reach or remove the patient on foot, so rope systems and a technical team are needed. A jammed door or trapped occupants call for extrication tools, not rope rescue.

18. Before any rescuer reaches into a crashed vehicle, the stabilization phase should ensure that:

    1. A. The patient has been fully assessed
    2. B. The patient is packaged on a board
    3. C. All of the glass has been removed
    4. D. The vehicle cannot move or shift
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    Answer: D. The vehicle cannot move or shift

    Stabilization makes the scene and vehicle safe for entry, so it comes before access and patient care. Assessment and packaging happen after access, and glass is managed only as needed for entry.

19. In the removal phase of rescue, the main goal is to:

    1. A. Cut away the parts that pin the patient
    2. B. Make the vehicle stable before entry
    3. C. Package and move the patient safely to EMS
    4. D. Reach the patient so the assessment can begin
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    Answer: C. Package and move the patient safely to EMS

    Removal means packaging the freed patient and moving him along a planned path to the ambulance. Cutting away what pins the patient is disentanglement, which comes just before removal.

20. Rescuers plan a dash roll that will take 25 more minutes. Your trapped patient's blood pressure falls from 118/76 to 84/50 mmHg, and he is becoming confused. You should:

    1. A. Pull the patient out through the side window yourself
    2. B. Tell the rescue officer and ask for a faster plan
    3. C. Give fluids and let the dash roll go on as planned
    4. D. Ask the crew to stop cutting until he is stable
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    Answer: B. Tell the rescue officer and ask for a faster plan

    The paramedic must tell the rescue officer when the patient's condition changes so that the plan can be adjusted, for example to a faster removal route. Pulling the patient out alone ignores entrapment and spinal concerns. Treating him without telling the rescue officer leaves the team working on an outdated plan, and stopping the cutting only prolongs entrapment when he needs to come out faster.

21. At a complex extrication, decisions about which tools to use and where to cut the vehicle are made by:

    1. A. The senior paramedic caring for the patient
    2. B. The incident commander by radio for each cut
    3. C. The tool operator making each cut
    4. D. The rescue officer or extrication leader
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    Answer: D. The rescue officer or extrication leader

    One rescue leader directs the technical work so that cuts and tool use are coordinated and safe. The paramedic gives input on the patient's needs and timing but does not direct cutting, which avoids conflicting orders. The incident commander sets overall objectives rather than approving each cut by radio, and each tool operator works under the extrication leader's plan rather than choosing cuts alone.

22. Twenty minutes into an extrication, you notice the smell of gasoline growing stronger under the car. You should:

    1. A. Alert the rescue officer so it can be controlled
    2. B. Hurry the rescue and pull him out before it ignites
    3. C. Cover the spill under the car with a blanket
    4. D. Move the ambulance closer to speed removal
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    Answer: A. Alert the rescue officer so it can be controlled

    Size-up continues through the whole rescue, and a growing fuel leak is a new fire hazard that must be reported and controlled. Rushing him out before disentanglement risks new injury and does nothing to control the fuel, and a blanket over the spill does not stop the vapor. Moving the ambulance closer puts another ignition source near the spill.

23. A 4-year-old has fallen into a dry, narrow well 6 m (20 ft) deep and is crying. A parent wants you to climb down holding a garden hose. You should:

    1. A. Climb in feet-first while your partner holds your belt
    2. B. Stay out, talk to the child, and call technical rescue
    3. C. Lower a ladder and climb down to carry the child up
    4. D. Lower your partner on a hose tied to the ambulance
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    Answer: B. Stay out, talk to the child, and call technical rescue

    A narrow well is a confined space that may have a poor atmosphere and no safe way out, so entry without training and equipment risks a second victim. Talking to the child keeps her calm and gives you information while a technical team brings rope and atmospheric monitors.

24. You are first on scene at a crash. The driver is pinned, and a firefighter tells you the engine company is 10 minutes away. Before patient contact, the best use of your time is to:

    1. A. Start an IV through the broken window
    2. B. Crawl into the car to hold his head still
    3. C. Size up hazards and keep bystanders back
    4. D. Pull the driver out before help arrives
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    Answer: C. Size up hazards and keep bystanders back

    The first unit sets up a safe scene: it looks for traffic, fuel, electrical, and stability hazards and keeps bystanders away. Crawling in to hold the head or reaching in to start an IV before the scene is sized up and the car is stabilized puts you at risk, and pulling him out before help arrives can worsen his injuries.

25. During a long rescue, the reason rescuers rotate crews and track time on task is to:

    1. A. Let every rescuer gain some experience
    2. B. Record hours for the after-action report and billing
    3. C. Keep the tools from overheating with use
    4. D. Limit fatigue that leads to injury and error
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    Answer: D. Limit fatigue that leads to injury and error

    Rescue work is physically demanding, often in heat, cold, or tight spaces, and tired rescuers make mistakes and get hurt. Rotating crews and tracking time protects rescuer safety; it is not done to share training, to keep tools cool, or to build records for later reports.