Question 1

At a mall corridor, a 46-year-old female is being assessed. Your first impression of a scene includes hazards, patient count, and mechanism. What domain is this?

Accepted Answer

Correct answer: Scene Size-Up and Safety. Correct. Hazards, patient count, mechanism, and resources are core scene size-up elements.

Question 2

You are treating a patient at a residence when you smell natural gas — a faint but distinct odor. The patient's family says there may be a gas leak they have not reported. The patient has fallen and has a probable hip fracture. She is stable. What is the correct action?

Accepted Answer

Correct answer: Move the patient and yourself out of the structure immediately. Correct. Natural gas leak — immediate evacuation: any suspected gas leak requires immediate evacuation of everyone from the structure. Do not activate any electrical switches — even turning a light off creates a spark that can ignite gas. No radio transmissions inside. Remove the patient and yourself. Call the gas utility once outside. Treat the patient in the open air. Do not re-enter.

Question 3

You respond to a reported shooting at a shopping mall. Law enforcement dispatch says one shooter is down but the situation is still developing. You are staged outside. A mall security guard runs out and says there is a critically injured gunshot victim inside the main entrance, approximately 30 feet from the door, and the area appears clear. He offers to escort you in. What is the correct action?

Accepted Answer

Correct answer: Stage until law enforcement specifically clears the interior scene as safe. Correct. Active shooter scene clearance requires law enforcement incident command authorization after a systematic tactical sweep. A security guard's visual observation is not a scene clearance. Appearing clear from one vantage point does not confirm the absence of threats. Stage until law enforcement incident command authorizes EMS entry.

Question 4

At a clinic waiting room, a 63-year-old male is being assessed. At a crash, you see two vehicles, leaking fluid, and three patients. What should happen early?

Accepted Answer

Correct answer: Request resources. Correct. Multiple patients and hazards require early resource request and triage.

Question 5

A bystander crowd is pressing around the patient. What improves scene control?

Accepted Answer

Correct answer: Assign one spokesperson. Correct. Create space and assign one person to provide information. This improves safety and assessment quality.

Question 6

You respond to a 911 call from a person who says they are being held against their will in an apartment. The caller disconnected. You arrive with law enforcement. Officers enter and clear the apartment — they find no one present. As you start to leave you notice a closet door that is slightly ajar. You can hear very faint breathing inside. What do you do?

Accepted Answer

Correct answer: Notify the law enforcement officers immediately and let them investigate the closet. Correct. A space that was not searched is an uncleared space. Law enforcement must clear it before EMS enters. A person being held could mean a captor is also nearby. Never enter an uncleared space without law enforcement. Notify the officers immediately and allow them to investigate the closet.

Question 7

You respond to a house where a 67-year-old male called 911. As you arrive a neighbor stops you and says the man inside has been making threats to harm himself all morning and has a gun. Law enforcement has not been dispatched. What is your immediate action?

Accepted Answer

Correct answer: Stage at a safe distance and immediately notify. Correct. Armed suicidal patient = law enforcement scene first. EMS does not enter scenes with armed patients without law enforcement clearance. Stage safely, notify dispatch, and wait for law enforcement to secure the scene. The safety of the crew is paramount.

Question 8

At a dialysis center, a 67-year-old male family is crowding your patient and shouting over each other. What should you do?

Accepted Answer

Correct answer: Create space and assign one historian. Correct. Scene control improves assessment and privacy. Assign one person to answer questions.

Question 9

You respond to a 51-year-old male who is unresponsive on the floor of a garage. The garage door is closed. As you enter you immediately smell gasoline fumes — very strongly. The car engine is off but warm. Your patient appears pulseless. What is the correct sequence of actions?

Accepted Answer

Correct answer: Exit the garage immediately and ventilate it. Correct. Gasoline vapor in an enclosed space: explosive and toxic concentration is possible. Any electrical spark (monitor, defibrillator, radio) can ignite vapor. Open the garage door fully to ventilate before patient contact. Alternatively drag the patient to the open air before initiating resuscitation. Entering a potentially explosive environment puts both providers at risk of being killed.

Question 10

At a soccer field, a 30-year-old female call is dispatched as an assault and the scene is not secured. What should EMS do?

Accepted Answer

Correct answer: Stage until secured. Correct. EMS should stage until law enforcement secures a potentially violent scene.

Question 11

You are treating a patient at the scene of a violent crime. A detective asks you to preserve the scene as much as possible and requests that you avoid touching certain items on a table near the patient. Your assessment requires moving the patient through the area with those items. What is the correct approach?

Accepted Answer

Correct answer: Provide necessary medical care. Correct. Patient care vs crime scene preservation: patient care always takes priority over crime scene preservation. Minimize unnecessary disturbance but do not delay or withhold care. Document everything you touched, moved, or disturbed and why. Communicate your actions to law enforcement. Thorough documentation allows forensic reconstruction. Do not touch items unnecessarily beyond what patient care requires.

Question 12

You and your partner are treating a critically ill 72-year-old male on the 4th floor of an apartment building. You need to move him to the ambulance quickly. The elevator is functional and available. He is on a stretcher. What is the standard recommendation for transporting a critically ill patient in an elevator and why?

Accepted Answer

Correct answer: Use the elevator when stairs are unsafe or impractical for a critically ill patient on a stretcher. Correct. Elevator transport of critically ill patients: elevators are appropriate when stairs are impractical but require continuous patient monitoring, AED immediately accessible, and awareness that intervention capability is limited in a confined elevator. Notify the hospital of the delay. Assign one crew member solely to patient monitoring during the elevator ride. Prepare for possible cardiac arrest.

Question 13

You arrive at a farm driveway and see downed wires near the patient. What should you do?

Accepted Answer

Correct answer: Stay back and request utility help. Correct. Downed wires are a scene hazard. Stay away and request appropriate resources.

Question 14

You respond to a reported assault in a public park. Law enforcement is en route but not yet on scene. As you approach you see your patient — a 35-year-old male on the ground — and two bystanders arguing loudly approximately 15 feet away. The argument appears to be escalating toward physical violence. What do you do?

Accepted Answer

Correct answer: Stage at a safe distance and do not approach until. Correct. Escalating bystander conflict near assault scene: an argument escalating toward violence near a recent assault scene constitutes an unsafe scene. Stage and wait for law enforcement. You cannot simultaneously safely treat a patient and manage a potential physical altercation between bystanders. Notify dispatch to expedite law enforcement. Approach only when the scene is controlled.

Question 15

You arrive on scene of a reported domestic disturbance where a person has been hurt. Before exiting your unit you observe through your windshield that an individual outside the home appears agitated and is holding an object in his hand. Law enforcement has not yet arrived. What is the correct action?

Accepted Answer

Correct answer: Stage at a safe distance and do not approach until. Correct. Domestic disturbance scenes with a visibly agitated individual holding an object are unsafe. Providers do not approach until law enforcement clears the scene. Providers are not trained for threat neutralization. An injured EMT cannot help anyone. Stage at a safe distance and update dispatch.

Question 16

You respond to a call at a rural farmhouse. The caller says her husband was doing something with propane tanks in the barn and stopped answering. The barn door is cracked open. You can smell a faint propane odor outside. You can see the patient lying on his side through the crack. No fire is visible. What steps must occur before patient contact?

Accepted Answer

Correct answer: Do not enter; call fire/utility. Correct. Propane accumulation: propane is heavier than air and accumulates at floor level — exactly where the patient is lying. Any spark (vehicle ignition, radio, light switch, metal-on-metal contact) can detonate accumulated propane. Do not enter without combustible gas meter confirmation of safe levels. Open barn doors from outside for ventilation. Request fire department with atmospheric monitoring. Stage upwind.

Question 17

At a clinic waiting room, a 62-year-old male mass gathering has several fainting patients in heat. What should you request early?

Accepted Answer

Correct answer: Additional resources. Correct. Multiple patients require resource request, triage, and operational coordination.

Question 18

You respond to a warehouse where a worker was reported to have fallen from a height. On arrival you note the patient is at the base of a 20-foot shelving unit that appears unstable. The patient is conscious and calling out to you. Which action is MOST appropriate?

Accepted Answer

Correct answer: Assess structural stability first. Correct. An unstable overhead structure poses a secondary collapse hazard — approaching could injure or kill the provider. Scene safety requires structural assessment before approach. This may require fire or industrial rescue to stabilize the environment. A conscious patient does not override the scene safety priority.

Question 19

You arrive at a apartment hallway and see downed wires near the patient. What should you do?

Accepted Answer

Correct answer: Stay back and request utility help. Correct. Downed wires are a scene hazard. Stay away and request appropriate resources.

Question 20

You are treating a 44-year-old male at the scene of a motor vehicle accident when you smell a strong odor of fuel. You can see liquid pooling under the vehicle. The patient is still inside with a femur fracture. The car engine is ticking loudly. Law enforcement is present. What is your priority action?

Accepted Answer

Correct answer: Assess the fuel leak urgency and request. Correct. Fuel pooling under a vehicle with a hot engine creates fire and explosion risk. Request fire department immediately. Rapidly assess whether quick extrication is safer than leaving the patient. If ignition risk is imminent, the safety perimeter takes priority. A provider killed in an explosion cannot help anyone.

Question 21

You respond to a residential structure fire that has been knocked down. The IC clears EMS for entry. As you enter you feel the floor give slightly underfoot and hear creaking joists above. What is the correct action?

Accepted Answer

Correct answer: Exit immediately and notify the incident commander. Correct. Soft floors and creaking joists after a structural fire indicate fire-weakened structural elements. Floor collapse is a leading cause of rescuer fatalities at fire scenes. Exit and notify the IC immediately. IC clearance at a given time does not guarantee safety as you assess the structure in real time.

Question 22

At a fitness center, you arrive at a farm injury with machinery still running. What is first?

Accepted Answer

Correct answer: Shut down hazard safely. Correct. Mechanical hazards must be controlled before patient contact.

Question 23

You respond to a warehouse district for a reported person down. As you approach the area you notice multiple other people are also sitting or lying on the ground near the building. You count at least 5 people in various states of distress. This is an unusual pattern. What scene safety concern does this pattern suggest before you approach any patients?

Accepted Answer

Correct answer: Multiple simultaneous victims in a confined area. Correct. Multiple simultaneous victims pattern = suspect toxic or environmental hazard: when multiple people are incapacitated in a confined area without apparent trauma, a toxic exposure (gas leak, chemical release, intentional chemical attack) is the most likely cause. Stage upwind and uphill. Request hazmat and fire department. Do not approach without atmospheric monitoring. Approaching without assessment can make you the next victim.

Question 24

You arrive at a crash scene with traffic passing close to the patient. What comes first?

Accepted Answer

Correct answer: Control scene safety. Correct. Scene safety comes before patient contact. Position safely and request traffic control or additional resources.

Question 25

You respond to a multi-vehicle accident on a divided highway. You are the first EMS unit. On arrival you count 7 visible patients. Two are pulseless and apneic. Three are critically injured with life-threatening hemorrhage. Two have minor injuries and are ambulatory. You have one partner. What is your first priority action?

Accepted Answer

Correct answer: Establish incident command. Correct. Multiple casualty incident — first action is establishing command and calling for resources: a two-person unit cannot manage 7 patients. Call dispatch immediately for additional units, establish incident command, then perform START triage to prioritize. Beginning CPR on two pulseless patients in an MCI removes you from triage and leaves 5 unassessed patients. Resources must be activated first.

Scene Size‑Up and Safety

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