Scene Size-Up & Safety makes up about 15–19% of the NREMT EMT exam. Here are 8 to work
through. When you open an answer, you'll see why it's right and why the other options aren't.
Question 1
SCENE — A patient is reported unconscious in a domestic garage. The door is closed and a car engine can be heard running inside.
The crew should
Await for the fire service before taking any action at all
Bopen from outside, ventilate and withdraw until clear
Center immediately and switch off the running car engine
Denter briefly holding your breath to drag the patient out
Show the answer
Correct answer: B. open from outside, ventilate and withdraw until clear
Opening up from outside starts clearing the air without anyone stepping into it. Walk in to switch off the engine and you're breathing the exact atmosphere that put your patient down.
A. There's something you can do from outside without waiting.
B. Opening from outside starts ventilation without exposing the crew.
C. Going in to reach the engine exposes the crew to the same atmosphere.
D. At high concentrations, a brief entry is enough to incapacitate you.
Question 2
A crew that has been on scene a long time without resolving access should consider
Aasking the patient to assist actively with their own extrication
Brequesting permission from medical control to clear the call
Cwhether the patient's condition justifies continued effort
Dwhether a different approach or an added resource would work
Show the answer
Correct answer: D. whether a different approach or an added resource would work
It's easy to keep doing the thing that isn't working. The fix is usually a different tool or an extra pair of hands, not more of the same effort. Stepping back to rethink is faster than pushing on.
A. Having the patient help with their own extrication may make their injuries worse.
B. Clearing a call without reaching the patient is rarely appropriate.
C. The patient's condition doesn't tell you whether access is achievable.
D. A new approach or more resources goes after the reason it isn't working.
Question 3
SCENE — Attending a patient who has fallen at home. During the assessment the patient's adult son becomes increasingly agitated and begins shouting at the crew.
The response most likely to help is
Anaming his concern and telling him what is happening
Bwarning him the police will be called if he continues
Ccontinuing the assessment without responding to him
Dasking him to step outside the room until you finish
Show the answer
Correct answer: A. naming his concern and telling him what is happening
Most agitation in a family member comes from fear and not knowing what's going on. Name that and tell him what you're doing. It defuses more of these than any instruction will, and it costs you one sentence.
A. Acknowledging him and keeping him informed goes after the fear that usually drives this.
B. Threatening him should come after you've tried to de-escalate, not before.
C. Ignoring him will likely make the agitation worse.
D. Telling him to leave often makes things worse instead of settling them.
Question 4
SCENE — A patient is trapped by the legs beneath a heavy machine that has toppled. He is alert and talking. Extrication is expected to take forty minutes.
The crew should begin
Aattempting the extrication with their own equipment
Bplanning the transport route and alerting the hospital
Cwaiting until he is freed before starting treatment
Dtreatment now, anticipating the effects of release
Show the answer
Correct answer: D. treatment now, anticipating the effects of release
Crushed muscle builds up products that hit the circulation the moment the weight comes off. Fluid running beforehand dilutes that load, and you can't go back and start it after release. The extrication time is your window.
A. Extrication takes equipment and training the crew doesn't have.
B. Planning transport alone skips the clinical preparation.
C. Wait, and you lose the only window for prevention.
D. Treating before release gets ahead of the metabolic load that arrives when the weight lifts.
Question 5
SCENE — Called to a hostel for a person who is unresponsive. Staff say several residents have been unwell today with similar symptoms.
The report of other unwell residents should prompt
Aassessment of this patient in isolation from the others
Bconsideration of a shared cause that may still be present
Creassurance that a common illness is circulating
Da request for the hostel to move the other residents
Show the answer
Correct answer: B. consideration of a shared cause that may still be present
Several people unwell in one building points to something in the building. In a hostel, that includes contaminated substances going around as well as gas or infection. It changes both your assessment and your own safety.
A. Assessing this patient in isolation ignores the pattern.
B. Multiple people affected in one place means a shared cause that may still be there.
C. Assuming a circulating illness may miss a toxic or environmental cause.
D. Moving residents isn't the crew's decision or priority.
Question 6
SCENE — Attending a patient in an upstairs flat. During assessment you notice the smell of gas that was not present when you entered.
The correct action is
Asearch for the source before deciding
Bevacuate with the patient and report it from outside
Copen windows and continue the assessment
Dturn off any electrical equipment in the room
Show the answer
Correct answer: B. evacuate with the patient and report it from outside
A gas smell that shows up while you're in the building means the situation is escalating, and switching anything on or off can give it an ignition source. Everyone leaves, and you make the report from outside.
A. Searching for the source prolongs exposure and risks ignition.
B. Evacuating gets everyone away from an escalating hazard before you report it.
C. Ventilating doesn't remove the risk while the leak continues.
D. Operating switches can create an ignition source.
Question 7
SCENE — Called to a multi-story parking lot for a person who has fallen from an upper level. Bystanders are pointing upward and one says someone else is still up there at the edge.
The crew should
Atreat the patient while others address the area above
Bmove the patient indoors before starting treatment
Cwait for police to arrive before approaching the patient
Dgo upstairs to talk the person at the edge back inside
Show the answer
Correct answer: A. treat the patient while others address the area above
Your patient is the one on the ground. The person above needs someone trained for that, and it isn't the ambulance crew. You're also working under someone who may fall, so that area has to be managed.
A. Treat your patient while others deal with the person above. That's your role, and it keeps the working area managed.
B. Moving indoors delays treatment and does nothing about the overhead risk.
C. Waiting to treat a fallen patient burns time they may not have.
D. Talking someone back from an edge isn't the crew's role or training.
Question 8
A crew should be cautious about a patient who is unusually still and quiet during a violent scene because
Asilence indicates the patient does not speak the language
Bstillness suggests a spinal injury has occurred
Cstillness can precede sudden action rather than indicating calm
Dquiet patients are usually the most seriously injured
Show the answer
Correct answer: C. stillness can precede sudden action rather than indicating calm
When someone stops engaging and goes quiet while things are escalating, they may have decided what they're about to do. Quiet here is a recognized warning sign, not a reassuring one.
A. A language barrier is possible, but less likely in this context.
B. Spinal injury doesn't produce this behavior.
C. Going still during escalation can come before action; it doesn't mean things are calming down.
D. How badly they're hurt is a separate assessment.
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