Rope Rescue, Wilderness, and Search Practice Questions

25 multiple-choice questions on Rope rescue, wilderness, and search 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 rope rescue, low-angle terrain is a slope on which rescuers:

   1. A. Hang their full weight on the rope system
   2. B. Can move the litter with no rope system in place
   3. C. Have to rappel down to reach the patient below
   4. D. Bear their weight on their feet, aided by rope
   Show answer

   Answer: D. Bear their weight on their feet, aided by rope

   On a low-angle slope, rescuers walk with their weight mainly on their feet and use ropes for balance and to keep the litter from sliding. When their weight hangs mainly on the rope, or they must rappel to reach the patient, the terrain is high angle. Ground where the litter can be moved with no rope system is flat or nontechnical terrain, not low angle.

2. A climber is stuck on a vertical cliff face, and rescuers must hang on ropes to reach him. This is a:

   1. A. Low-angle rescue
   2. B. Flat-terrain rescue
   3. C. High-angle rescue
   4. D. Confined space rescue
   Show answer

   Answer: C. High-angle rescue

   High-angle rescue is done on steep or vertical terrain where rescuers and the patient are supported mainly by the rope system. It needs technician-level rope rescuers.

3. Carrying a loaded basket litter a long distance over rough, flat ground usually takes:

   1. A. Two bearers, one at each end of it
   2. B. Six to eight bearers, with relief crews
   3. C. Three bearers and a long backboard
   4. D. Four bearers who stay in place the whole way
   Show answer

   Answer: B. Six to eight bearers, with relief crews

   A litter carry over rough ground is exhausting; six to eight bearers spread the weight, and relief teams rotate in often. Two or four bearers tire quickly and are more likely to drop the patient.

4. A patient is packaged in a basket litter for a vertical lowering. He should be:

   1. A. Strapped across the chest with the legs left free
   2. B. Held in place by the litter's side rails
   3. C. Secured so he cannot shift in any direction
   4. D. Strapped with the usual cot belts alone
   Show answer

   Answer: C. Secured so he cannot shift in any direction

   For a vertical or steep lowering, the patient must be secured so that he does not slide toward the head or foot of the litter or fall out if it tilts. Chest straps with free legs, or the three belts used on a cot, let him slide toward the foot of a vertical litter; foot loops or stirrups and full lacing are needed. Side rails do not hold a patient in a tilted or vertical litter.

5. You are helping package a 40-year-old hiker with a broken ankle for a vertical lowering in a basket litter. He should wear:

   1. A. A cervical collar and no helmet
   2. B. A helmet and eye protection
   3. C. No face covering, to see out
   4. D. An oxygen mask but no helmet
   Show answer

   Answer: B. A helmet and eye protection

   Falling rocks, debris, and the rope system itself can strike the patient's head and eyes, so a helmet and eye protection are part of packaging. A collar is used only if the patient has an indication for spinal motion restriction.

6. A window washer has hung motionless in a fall-arrest harness for 20 minutes. The main danger to him while he hangs is:

   1. A. Blood pooling in the legs, causing fainting
   2. B. Rib fractures from the chest straps
   3. C. Rapid rise in core body temperature
   4. D. Rope burns on the skin of his hands and neck
   Show answer

   Answer: A. Blood pooling in the legs, causing fainting

   Suspension trauma (harness hang syndrome) occurs when leg straps and immobility let blood pool in the legs, reducing venous return; the person can faint and die if not rescued quickly. Speedy rescue is the key treatment.

7. A worker who hung in a harness for 30 minutes has been lowered to the ground. Current guidance for positioning him is to:

   1. A. Keep him seated upright for 30 minutes
   2. B. Hang him again to slow the blood return
   3. C. Keep him standing until his pulse slows
   4. D. Lay him flat and treat him as usual
   Show answer

   Answer: D. Lay him flat and treat him as usual

   Older teaching kept rescued patients sitting up to avoid sudden return of pooled blood, but reviews have found no evidence for this, and current guidance is to lay the patient flat and give standard care. Keeping a person with low blood pressure upright can worsen fainting.

8. In a rope rescue lowering system, the belay line serves to:

   1. A. Lower the load with the main rope
   2. B. Catch the load if the main line fails
   3. C. Pull the litter up the slope faster
   4. D. Guide the litter away from the cliff face
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   Answer: B. Catch the load if the main line fails

   The belay is a separate, backup safety line that stops the fall of the litter or rescuer if the main line or anchor fails. Guiding the litter away from a cliff is the job of a tag line.

9. Rescue lowering and raising systems use static (low-stretch) rope because it:

   1. A. Stretches little under a load
   2. B. Absorbs the shock of long falls
   3. C. Is lighter than other rescue ropes
   4. D. Floats well in moving water
   Show answer

   Answer: A. Stretches little under a load

   Low-stretch rope gives precise control and does not bounce when raising or lowering a load. Dynamic rope stretches to absorb a climber's fall, which makes it a poor choice for hauling.

10. A life-safety rope has been shock-loaded when a rescuer slipped and the belay caught him. The rope should be:

    1. A. Inspected and reused
    2. B. Used again for training
    3. C. Washed and then reused
    4. D. Taken out of service
    Show answer

    Answer: D. Taken out of service

    A rope that has taken a severe shock load may have hidden internal damage and is retired from life-safety use. Visual inspection cannot find all internal damage.

11. Where a rope passes over a cliff edge, rescuers place edge protection to:

    1. A. Make the rope easier to see at night
    2. B. Keep the rope from sliding off the edge
    3. C. Keep the rope from being cut or worn
    4. D. Allow two ropes to share one anchor
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    Answer: C. Keep the rope from being cut or worn

    A loaded rope moving over a sharp or rough edge can be abraded or cut through, so pads or rollers are placed at the edge. Edge protection prevents damage, not slipping.

12. In a 3:1 mechanical advantage haul system, lifting a 90-kg (200-lb) load ideally takes a pull of about:

    1. A. 90 kg (200 lb)
    2. B. 30 kg (67 lb)
    3. C. 45 kg (100 lb)
    4. D. 270 kg (600 lb)
    Show answer

    Answer: B. 30 kg (67 lb)

    A 3:1 system divides the load by three, so 90 kg needs about 30 kg of pull, before friction losses. In return, the haul team must pull three times as much rope.

13. Before a rope system is loaded with a patient, the best practice is to:

    1. A. Have a second rescuer check every part of it
    2. B. Have the rigger recheck his own work
    3. C. Check the anchors and knots, then load it
    4. D. Load it slowly and look for failure as it goes
    Show answer

    Answer: A. Have a second rescuer check every part of it

    An independent safety check of anchors, knots, hardware, and harnesses catches errors before a life depends on them. A rigger checking his own work tends to miss his own errors, and a partial check of anchors and knots skips the hardware and harnesses. Watching for failure during the lift is too late.

14. A litter attendant will be lowered with the patient during a high-angle rescue. This role is best filled by:

    1. A. The paramedic with the most years on duty
    2. B. The rescuer who rigged the system
    3. C. A rope-trained rescuer who can give care
    4. D. A rope technician with no medical training
    Show answer

    Answer: C. A rope-trained rescuer who can give care

    The litter attendant must be trained to work on rope and also be able to monitor and treat the patient on the way down. A paramedic without rope training is a hazard on the line. The rigger is needed at the top to run the system, and a rope technician without medical training cannot monitor and treat the patient during the lowering.

15. Which lost person needs the most urgent search response?

    1. A. A fit adult hiker with gear on a mild day
    2. B. A hunter overdue by 2 hours in fair, mild weather
    3. C. A scout troop of six with tents and food
    4. D. A 6-year-old in shorts as a cold night falls
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    Answer: D. A 6-year-old in shorts as a cold night falls

    Search urgency rises with young or old age, medical problems, poor clothing or gear, and bad weather. A young child without warm clothing facing a cold night has the least ability to survive on his own.

16. A 2-year-old wandered from a campsite an hour ago. Search planners expect that lost children of this age typically:

    1. A. Walk long distances in a straight line
    2. B. Do not know they are lost and wander
    3. C. Head straight back to their own home
    4. D. Climb to high ground to look around
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    Answer: B. Do not know they are lost and wander

    Toddlers do not understand that they are lost; they wander short distances and often sit or fall asleep in a sheltered place. They usually travel less far than older children.

17. A 9-year-old has been missing in the woods overnight. Which behavior should searchers plan for, because it can make them walk right past him?

    1. A. Hiding from searchers, fearing he is in trouble
    2. B. Calling out to searchers as soon as he hears them
    3. C. Walking straight toward the sound of a road
    4. D. Using a map or a phone to find his own way home
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    Answer: A. Hiding from searchers, fearing he is in trouble

    School-age lost children may hide from or not answer strangers, often because they fear being punished or were taught to avoid strangers, so searchers check hiding places, use familiar voices, and tell the child he is not in trouble. A child who calls out as soon as he hears searchers is easy to find, so that behavior does not make searchers walk past him. Walking toward a road and using a map or phone move the child toward rescue and away from the search area's hidden spots; they do not explain how searchers can miss a child close by.

18. A man with dementia has wandered from his home. Search data suggest he is most likely to be found:

    1. A. Many miles away, walking along a hiking trail
    2. B. At a bus station waiting to go home
    3. C. Close by, often stuck in brush or a ditch
    4. D. On a hilltop looking for landmarks
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    Answer: C. Close by, often stuck in brush or a ditch

    People with dementia often walk until they get stuck, frequently in brush, ditches, or drainages, and usually within a short distance of where they were last seen. They often do not answer when called.

19. In a search, the point last seen (PLS) matters because it:

    1. A. Marks where the base camp must be set
    2. B. Shows where the person is most likely
    3. C. Is the spot where dogs will be released
    4. D. Defines the center of the search area
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    Answer: D. Defines the center of the search area

    The point last seen is the starting point for working out how far and in which direction the person may have gone. The person is often not still there, so it centers the search area rather than marking the likely spot.

20. Early in a wilderness search, small, fast hasty teams are sent mainly to:

    1. A. Search every square meter of the whole area
    2. B. Check trails, likely spots, and hazards
    3. C. Set up the command post and staging
    4. D. Interview the lost person's family
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    Answer: B. Check trails, likely spots, and hazards

    Hasty teams move quickly through high-probability areas such as trails, streams, and cliffs, looking for the person or clues. Thorough grid searching is slower and comes later if needed.

21. To help search dogs, the area around the point last seen and the subject's car should be:

    1. A. Kept clear of searchers and left alone
    2. B. Searched first by as many people on foot as possible
    3. C. Sprayed with water to raise the scent
    4. D. Driven over to mark the trail start
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    Answer: A. Kept clear of searchers and left alone

    Each searcher who walks through the area adds scent and can destroy tracks, which confuses dogs and trackers. Keeping the area clear preserves the clues.

22. Search dog handlers will usually ask the family for:

    1. A. A towel the whole family has used
    2. B. A list of places the person liked
    3. C. An unwashed item the person wore
    4. D. The person's freshly washed coat
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    Answer: C. An unwashed item the person wore

    A scent article, such as worn clothing that has not been washed, gives a trailing dog the person's scent to follow. Washing removes the scent, and a towel used by the whole family mixes several scents. A list of favorite places helps search planners, not the dog's scent work.

23. Search teams are trained in clue awareness because:

    1. A. Clues are needed as evidence for any later court case
    2. B. Clues can be found faster by search dogs
    3. C. Finding clues ends the search operation
    4. D. Clues outnumber the subject and narrow the area
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    Answer: D. Clues outnumber the subject and narrow the area

    A lost person leaves many clues, such as footprints, wrappers, and dropped items, and each one helps narrow where to look. Searchers who look only for the person often walk past clues.

24. After an avalanche, the companions of a buried skier who wore a transceiver should first:

    1. A. Go for help at the nearest ski patrol station
    2. B. Search for him with their transceivers
    3. C. Wait for rescue dogs before digging
    4. D. Dig at random around the last point
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    Answer: B. Search for him with their transceivers

    Survival drops quickly after the first 15 minutes, so companions on scene give the best chance: they switch transceivers to search, pinpoint with probes, and dig. Leaving to get help wastes the most important minutes.

25. A conscious worker is hanging in a fall-arrest harness, and rescue will take about 10 minutes. His harness has foot loops (relief straps). You should tell him to:

    1. A. Stand in the loops and keep his legs moving
    2. B. Hang still to save his energy for rescue
    3. C. Loosen his leg straps to ease the pressure
    4. D. Hold his breath and bear down to raise his BP
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    Answer: A. Stand in the loops and keep his legs moving

    Blood pools in the legs of a person hanging still in a harness, and venous return falls until he faints. Standing in relief straps takes the pressure off the leg straps, and working the leg muscles pumps blood back to the heart, buying time until rescue. Hanging still is exactly what lets the blood pool. Loosening the leg straps can let him slip out of the harness and fall. Holding the breath and bearing down (a Valsalva maneuver) lowers venous return and can bring on fainting sooner.