- Scene Size-Up and Safety 17.2%
- Primary Assessment 41.4%
- Secondary Assessment 7.1%
- Patient Treatment and Transport 22.2%
- Operations 12.1%
Free · 2026 · 17.2% of the NREMT EMT NREMT Scene Size-Up and Safety practice questions
Scene Size-Up and Safety is 17.2% of the NREMT EMT. Answer 10 questions (6 on Scene Size-Up and Safety) and see your score by domain, with every answer explained. Free, no sign-up.
At a school bus crash, you are triaging with JumpSTART. A girl who appears about 5 years old is sitting beside the bus and cannot walk because of a leg injury. She is breathing at 12 breaths/min, has a palpable radial pulse, and answers your questions appropriately. Which triage category should you assign?
Tap an answer, or press A to D
Dispatch planning, scene hazards and PPE, hazmat and crime scenes, finding every patient, START/JumpSTART/SALT triage and calling for resources.
What the NREMT EMT exam tests in Scene Size-Up and Safety
- Plan before arrival using all available information: dispatch information, nature of illness vs mechanism of injury, location, time of day and weather, likely equipment and resources, crew roles
- Protect self, other responders, the patient, the public and the scene from existing and potential hazards: traffic and roadway safety, ambulance positioning, unstable vehicles and extrication, fire, downed power lines, violence and crime scenes, hazardous materials (placards, ERG, control zones, upwind/uphill approach), confined spaces
- Don PPE based on known hazards: standard precautions, gloves, eye and face protection, gowns, surgical mask vs N95 (contact, droplet, airborne precautions), hazmat PPE levels and the EMT's role
- Investigate the scene to find all potential patients: counting patients, hidden or ejected patients, mechanism of injury clues, when to consider spinal motion restriction, multiple patients with the same complaint (e.g., carbon monoxide)
- Triage patients for optimal care: mass-casualty incident definition, START (adults), JumpSTART (children), SALT, triage categories and tag colors, primary vs secondary triage, triage/treatment/transport areas
- Request appropriate resources based on known hazards and patient conditions: ALS intercept, additional ambulances, fire/rescue, law enforcement, hazmat, utilities, air medical, mutual aid, Incident Command System and NIMS roles
High-yield scene size-up and safety facts
- Before arrival, use dispatch to plan. Anticipate medical vs trauma, patient count, hazards, crew roles and the gear to carry. For an unresponsive patient, bring airway, O2, suction and AED. Dispatch can be wrong, so confirm everything on arrival.
- Nature of illness (NOI) is the medical reason for the call. Mechanism of injury (MOI) is the force that caused trauma. One patient can have both (a hypoglycemic driver who crashed).
- Safety order: self, then partner and other responders, then patient, then bystanders. Never enter an unsafe scene; stage until law enforcement or fire secures it (weapons, violence, domestic disputes, suicidal patient with a weapon).
- If a scene turns dangerous mid-care, retreat (with the patient if possible), call law enforcement and document. Leaving to stay safe is not abandonment.
- Roadway: wear a high-visibility vest, let fire apparatus block traffic, use cones and warning devices, never turn your back to traffic, and keep the loading area shielded from traffic.
- Downed power lines: assume they are live and stay well back until the utility cuts power. Occupants of a vehicle touching a line stay inside unless there is fire.
| Precaution | EMT wears | Examples / notes |
|---|---|---|
| Standard (every patient) | Gloves; add eye/face protection if splash likely; add gown for heavy splash | Suctioning, airway care, childbirth, arterial bleeding |
| Contact | Gloves + gown | MRSA, C. difficile, scabies, draining wounds |
| Droplet | Surgical mask (surgical mask on patient if tolerated) | Influenza, bacterial meningitis, pertussis |
| Airborne | Fit-tested N95 or PAPR | TB, measles, chickenpox, aerosol-generating procedures; surgical mask on the patient (or NRB if O2 needed) |
| Hand hygiene | Alcohol rub (≥60%) if hands not visibly soiled | Use soap and water if visibly soiled, or after C. difficile or norovirus (spores resist alcohol) |
The full NREMT High-Yield Cram Sheet comes with full prep.
Common scene size-up and safety traps
- Scene safety comes before patient contact, even for a child in cardiac arrest.
- Call for more resources as soon as you see multiple patients or hazards, before starting care.
- START: breathing >30/min = red even if alert; walking = green even with a painful injury.
- JumpSTART gives 5 rescue breaths to an apneic child with a pulse; START gives no rescue breaths.
- SALT separates expectant (gray) from dead (black); START lumps both as black.
- ERG green pages apply only to highlighted materials that are leaking without fire.
- Untrained EMTs never enter the hot zone; treat in the cold zone after decontamination.
- The N95 goes on the EMT; the surgical mask goes on the coughing patient.
Free NREMT scene size-up and safety practice questions
Question 1
At 0200 you are dispatched to a 'man down, bleeding from the head' in a bar parking lot. The dispatcher adds that the caller says the person who hit him is still in the area. What is the best plan as you approach?
- ARequest law enforcement and stage at a safe distance until police report the scene secure
- BHave one EMT walk to the patient while the partner stays with the ambulance
- CDrive directly to the patient, load him quickly, and leave to limit your time on scene
- DApproach with lights and siren on so the assailant leaves before you arrive
Show answer and explanation
Answer: A. The dispatch information signals a possible ongoing threat. Stage out of sight until law enforcement secures the scene.
Why not B: Splitting the crew puts one EMT alone in an unsafe scene with no backup and does nothing to remove the threat.
Why not C: A fast 'scoop and run' still puts the crew inside an unsecured scene with a possibly armed assailant nearby.
Why not D: Announcing your arrival doesn't make the scene safe. The assailant may stay or become hostile toward responders.
Remember: When dispatch information suggests violence or an assailant on scene, request law enforcement and stage at a safe distance until the scene is secured.
Question 2
You have just transferred care of a patient with known Clostridioides difficile (C. difficile) infection and profuse diarrhea. You remove your gloves, and your hands do not look soiled. Which hand hygiene method is most appropriate?
- AAlcohol-based hand rub containing at least 60% alcohol
- BAlcohol-based hand rub followed by a fresh pair of gloves
- CWashing with soap and running water
- DWiping the hands with an EPA-registered surface disinfectant wipe
Show answer and explanation
Answer: C. Soap, water and friction physically remove C. difficile spores, which alcohol does not kill.
Why not A: Alcohol rub is fine when hands are not visibly soiled for most organisms, but it does not reliably remove C. difficile spores.
Why not B: Putting on new gloves does not make up for the alcohol rub's failure to remove spores already on the hands.
Why not D: Surface disinfectant wipes are for equipment and the ambulance, not skin, and are not a substitute for proper hand hygiene.
Remember: After caring for a patient with C. difficile (or norovirus), wash with soap and water even if hands look clean, because alcohol rub does not remove spores.
Question 3
A tanker truck has overturned and is releasing a visible vapor cloud. The wind is blowing from the north toward the south. The highway slopes down from east to west, so the east side is higher. Where should you stage the ambulance?
- AUpwind to the north, on the lower ground to the west
- BDownwind to the south, on the higher ground to the east
- CDownwind to the south, on the lower ground to the west
- DUpwind to the north, on the higher ground to the east
Show answer and explanation
Answer: D. Wind from the north carries vapor south, so north is upwind. The east side is uphill, away from heavier-than-air gases and running liquids.
Why not A: North is upwind, but low ground to the west is where heavy vapors and spilled liquids will collect.
Why not B: High ground helps, but the south is where the wind will carry the vapor cloud toward the crew.
Why not C: This is the most dangerous position: it is both in the path of the vapor and where liquids and heavy gases will flow.
Remember: Approach a hazmat scene from upwind, uphill and upstream, and stay at a distance.
Question 4
A utility worker is unresponsive at the bottom of an underground vault. A coworker who climbed down to help him has also collapsed. Another coworker at the opening begs you to go in. What is your best action?
- AStay out, keep others from entering, and request fire/technical rescue with supplied air
- BTie a rope around your waist so your partner can pull you out if you get dizzy
- CLower an open oxygen cylinder into the vault, then enter once the workers improve
- DPut on an N95 respirator and climb down to pull both workers toward the opening
Show answer and explanation
Answer: A. A second collapse strongly suggests a toxic or oxygen-deficient atmosphere, so only trained rescuers with supplied air should enter.
Why not B: Toxic or oxygen-poor air can cause sudden collapse, and an untrained rope rescue rarely works. Entry requires trained rescuers with proper equipment.
Why not C: Releasing oxygen into an enclosed space creates a fire hazard. It also doesn't remove toxic gases or make entry safe.
Why not D: An N95 filters particles but supplies no oxygen and doesn't block toxic gases. You would likely become the third victim.
Remember: Never enter a confined space without training and supplied-air equipment; when would-be rescuers collapse too, assume a deadly atmosphere and call technical rescue.
Question 5
On a cold January night you are dispatched to a home for an adult with a headache. Inside, you find the caller's two children are also nauseated and dizzy, and the family says their gas furnace has been running all day. What is your best action?
- ACheck each person's SpO2 and leave anyone reading above 94%
- BMove everyone, including your crew, out of the house to fresh air and request the fire department
- COpen the windows and assess each patient inside the home
- DAssess and treat the original patient inside, then check the children
Show answer and explanation
Answer: B. Several people in one building with headache, nausea and dizziness suggests carbon monoxide. Leave the hazard and call for fire to test and ventilate.
Why not A: Pulse oximeters can read falsely normal in carbon monoxide poisoning, so a normal SpO2 does not rule it out.
Why not C: Opening windows does not make the home safe quickly or reliably. You and the patients stay exposed while you work.
Why not D: Staying inside keeps patients and crew exposed to a probable toxic gas. It also ignores the clue of multiple patients with the same complaint.
Remember: Multiple people in the same place with the same symptoms (especially headache, nausea and dizziness) means a possible toxic exposure such as carbon monoxide: get everyone out and call for fire or hazmat.
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