Question 1

Your service has acquired the antidote for a nerve agent attack. As such, you realize that it will be given by what route?

Accepted Answer

The most effective way to administer an antidote for a nerve agent attack is by injection. This allows for a rapid delivery of the antidote directly into the bloodstream and can provide immediate relief from the effects of the nerve agent. Other routes, such as inhalation or oral, may not be as effective or may take longer to provide relief. Topical administration may also not be effective as the nerve agent may have already entered the body through inhalation or ingestion.

Question 2

A localized terrorist attack involves pepper spray being released at a high school dance. As you respond, the incident commander reports approximately 50 people have been exposed and is calling for activation of the county disaster plan. Given the nature of the weapon, which of the following should you anticipate doing on scene?

Accepted Answer

Irrigating eyes with saline is the most appropriate action to take in the event of exposure to pepper spray. It is important to remove the irritant from the eyes and provide relief to the patients. Positive pressure ventilation may be necessary if there is a concern for respiratory distress, but it is not the first priority. Decontamination with diluted bleach and administering an aerosolized antidote are not appropriate actions for pepper spray exposure.

Question 3

Multiple EMS agencies are involved in a WMD incident involving hundreds of patients. Which item regarding the different protocols and medical direction used by those different agencies is best?

Accepted Answer

In a mass casualty incident involving multiple EMS agencies, it is important to establish standardized standing orders to ensure efficient and effective care. Converting most protocols to standing orders will allow for timely care without the need for on-line medical direction for every treatment. However, there may still be certain treatments that require on-line medical direction. Allowing EMTs to administer any medication that a paramedic can administer (choice A) may not be safe or within their scope of practice. Suspending all on-line medical direction (choice D) would leave EMS providers without any guidance or oversight, which could lead to errors or inconsistent care.

Question 4

A chemical agent used by terrorists is described as having a high volatility. You should recognize this as meaning that the chemical is:

Accepted Answer

Volatility refers to a substance's ability to evaporate or vaporize quickly. Therefore, a chemical with high volatility is easily evaporated, making it easier to spread through the air and potentially causing harm to individuals who come in contact with it. It does not necessarily indicate radioactivity, explosivity, or state of matter.

Question 5

Why would iodine tablets be a benefit to administer to the general public following a nuclear bomb detonation?

Accepted Answer

Following a nuclear bomb detonation, radioactive iodine may be released into the atmosphere, which can be inhaled or ingested through contaminated food and water. Exposure to radioactive iodine can increase the risk of thyroid cancer. However, taking iodine tablets prior to exposure can block the thyroid gland from absorbing the radioactive iodine, thus decreasing the risk of thyroid cancer. Iodine does not help eliminate radiation from the body, protect against all types of cancer or boost the immune system.

Question 6

At a community meeting about the preparation for a biological terror attack, another member asks you how anthrax acquired naturally differs from anthrax caused by terrorism. Which of the following is your best response?

Accepted Answer

Anthrax, whether acquired through natural exposure or as a result of a bioterrorism attack, is caused by the bacterium Bacillus anthracis. The disease manifestation and treatment are the same, regardless of the mode of acquisition.

Question 7

An alert and oriented patient has been exposed to the biological toxin ricin. He presents with a fever, cough, and generalized weakness. His airway is patent and his breathing is adequate. His skin is warm and dry, and his radial pulse is weak. Which of the following interventions is most appropriate when caring for this patient?

Accepted Answer

The answer of An alert and oriented patient has been...

Question 8

You are teaching an EMT class about the role of an EMS response to a terror attack involving weapons of mass destruction (WMD). A student asks you what constitutes a WMD. You would inform him that a WMD is any:

Accepted Answer

A WMD is any agent, whether it be chemical, biological, radiological, or nuclear, that is used to cause indiscriminate death and destruction. The intent is to harm a large number of people, create fear and panic, and/or disrupt infrastructure and society. It does not necessarily target a specific segment of the population.

Question 9

A patient has an injury to his arm caused by an unknown vesicant. After assessing the airway, breathing, and circulation, you should:

Accepted Answer

If a patient has an injury caused by an unknown vesicant, the first step is to flush the affected area with water to remove any remaining agent and prevent further damage. This should be done for at least 20 minutes, or until medical help arrives. Applying a wet sterile dressing and transporting the patient to the hospital are also important steps, but the initial priority is to remove the agent from the skin. Brushing the powder from the skin should not be done, as this can spread the agent and cause further injury.

Question 10

For the EMT, what is the best means of protection against acquiring a disease such as smallpox prior to any sort of exposure?

Accepted Answer

Immunizations are the most effective means of protection against acquiring a disease such as smallpox. Antibiotics are used to treat bacterial infections, not viruses like smallpox. Face shields can provide protection from droplets containing the virus, but are not effective against airborne particles. Iodine tablets are used to purify water and are not effective against viruses.

Question 11

Which item best describes use of a weapon of mass destruction?

Accepted Answer

Use of a weapon of mass destruction involves intentional harm caused by a deliberate act, such as the intentional dispersal of a deadly bacteria in a crowded area. The other options involve accidents or natural disasters, which do not fit the definition of a weapon of mass destruction.

Question 12

For the patient exposed to a nerve agent, which of the following signs would the EMT expect?

Accepted Answer

Nerve agents typically cause an increase in secretions, such as salivation, due to their action on the muscarinic receptors. This is part of the cholinergic syndrome.

Question 13

How can an EMT best protect herself, as well as get the most appropriate resources to the scene of a multiple-casualty incident involving a weapon of mass destruction?

Accepted Answer

Identification of the specific agent or mechanism used is crucial in order to properly protect oneself and respond appropriately to a weapon of mass destruction incident, as different agents or mechanisms may require different protective measures and treatment protocols.

Answer: C 
 Overall determination of the number and types of injuries is also important, as it will allow for appropriate allocation of resources and triage of patients.

Answer: D 
 While turning over control of the incident to Homeland Security may ultimately be necessary, this should not be the first course of action or the only action taken by the EMT. The EMT should still take steps to protect themselves and respond appropriately to the incident.

Therefore, the best choices are B and C.

Question 14

Nerve agents typically cause death by what type of organ or system failure?

Accepted Answer

Nerve agents cause death by respiratory failure, as they attack the nerve endings that control respiration. This can lead to suffocation and ultimately death. Renal, cardiac, and liver failure may be possible secondary effects of nerve agent exposure but are not the primary cause of death.

Question 15

You are participating in a training exercise for an attack by a weapon of mass destruction involving the release of a nerve agent. In the triage area, you are presented with a patient who responds to painful stimuli and has an open airway. He is breathing 8 times a minute and has a weak radial pulse. He is wheezing and has pinpoint pupils. In his pocket is located a metered-dose inhaler containing albuterol. When caring for this patient, you should first:

Accepted Answer

Administering positive pressure ventilation is the first step in caring for a patient with a breathing rate of 8 times a minute, which indicates inadequate ventilation, especially in the context of a nerve agent attack. Albuterol would not address the primary issue of inadequate oxygenation due to the effects of the nerve agent.

Question 16

A triage officer at the scene of a suicide bombing assigns you to a patient who has been injured from the secondary effects of the blast. Which of the following injuries would you expect?

Accepted Answer

The patient's injuries are described as being caused by the secondary effects of the blast, which suggests that they were not directly in the path of the explosion. Therefore, injuries caused by flying debris such as glass are a likely possibility. A fractured arm from being thrown to the ground would be a primary effect of the blast, while a lung injury from the pressure wave would typically be a more severe injury and is not described as being present in this scenario. The closed head injury caused by striking a tree is also not directly related to the blast and seems unlikely given the context.

Question 17

A patient has inhaled cyanide gas. He is alert and complaining of shortness of breath. His airway is patent, his breathing is adequate, and his radial pulse is strong. His skin is warm and dry, and his breath sounds are clear. Given these assessment findings, what should the EMT do first?

Accepted Answer

The first priority in treating a patient who has inhaled cyanide gas is to administer high-flow oxygen via a nonrebreather mask to increase the patient's oxygen saturation and relieve the symptoms of shortness of breath. Administering the antidote for cyanide is not within the scope of practice for an EMT, and obtaining vital signs with the patient in a supine position may exacerbate respiratory distress. Monitoring the patient and transporting them to the hospital is important, but administering oxygen is the first priority.

Question 18

In planning for a response to an attack by a weapon of mass destruction involving an incendiary device, the EMT should be prepared to handle what types of injuries?

Accepted Answer

In an attack involving an incendiary device, the most common type of injury would be burns. EMTs must be prepared to manage and treat various degrees and types of burns, including thermal and chemical burns, in order to provide appropriate care to patients. Fractures, infection, and blast injuries may also occur, but they are not the primary concern in this type of attack.

Question 19

Which one of the following chemical agents will kill a person most quickly?

Accepted Answer

Aerosolized agents that are inhaled into the lungs can act quickly and cause respiratory distress, leading to death in a matter of minutes to hours.

Question 20

At the scene of a multiple-casualty incident caused by a weapon of mass destruction, the EMT's first priority is:

Accepted Answer

Ensuring the safety of yourself and your partner should be the first priority in any hazardous situation, including one involving a weapon of mass destruction. Without ensuring your own safety, you cannot effectively provide care to patients or implement the necessary resources for response.

Quiz 46: Ems Response to Terrorism Involving Weapons of Mass Destruction