EMS Operations
What this domain tests
Operations items test incident command, triage, hazardous materials, emergency driving, documentation, and consent. These are the questions candidates lose by ignoring scene and legal factors while focusing on medicine.
Core rules
- Incident command uses a single command structure with span of control around three to seven resources per supervisor.
- START triage: walking wounded are green; breathing after airway positioning with respiratory rate over 30, absent radial pulse, or inability to follow commands is red; lower-priority breathing and perfusion findings are yellow; apneic after airway opening is black.
- Hazardous materials: hot zone only with appropriate PPE and training, warm zone for decontamination, cold zone for treatment and command.
- Emergency vehicle operation requires due regard for public safety; lights and sirens do not create a legal right to drive recklessly.
- Refusal of care requires capacity, informed explanation of risks, and documentation, ideally witnessed.
- Landing zone roughly 100 by 100 feet, clear of debris and spectators; approach the aircraft only when signaled by the crew.
Worked example
At a bus collision with 12 patients, you establish command, request additional resources, and triage. A patient with a respiratory rate of 34 and no radial pulse is tagged red and moved to treatment; a patient who is ambulatory is tagged green and held for later transport.
Traps
Entering the hot zone without PPE, treating before triage at a multiple-casualty incident, and documenting a refusal without assessing capacity are common failures.