SANTA CLARA COUNTY EMS PARAMEDIC
PROTOCOL PATIENT CARE PROCEDURES
COMPREHENSIVE FINAL REVIEW EXAMINATION
2026 PRACTICE QUESTIONS WITH ANSWERS AND
RATIONALES COMPLETE | ACCURATE |
GUARANTEED
EXAMINATION TITLE: Santa Clara County EMS Paramedic Protocol Patient
Care Procedures — Final Review Examination 2026
DOMAINS COVERED:
• Domain 1: Variance Reporting — Policy 108 (Questions 1-40)
• Domain 2: Communications and Ringdown Procedures (Questions 41-
70)
• Domain 3: MCI and Multi-Patient Incident Management (Questions 71-
90)
• Domain 4: Policies, Procedures, and Accreditation (Questions 91-120)
• Domain 5: Patient Care Protocols and Clinical Decision-Making
(Questions 121-160)
• Domain 6: Hospital Designations, Destination Protocols, and Transport
(Questions 161-200)
DOMAIN 1: VARIANCE REPORTING — POLICY 108
Questions 1-40
Question 1:
Under Santa Clara County EMS Policy 108, what constitutes a Level A
variance?
,A) Any incident where responders went above and beyond normal
expectations
B) Any deviation from protocol that does not result in patient harm
C) Any incident that results in a threat to public safety, patient,
bystander, or responder harm
D) Any equipment failure without patient impact
Rationale: Policy 108 defines Level A variances as incidents that result in a
threat to public safety, patient, bystander, or responder harm.
Question 2:
What is the maximum time allowed to report a Level A variance?
A) 5 business days
B) 7 calendar days
C) 24 hours
D) 72 hours
Rationale: Level A variances must be reported immediately to the EMS Duty
Chief, and the EMS System Variance Report (Form #903) must be submitted
within 24 hours.
Question 3:
Who must be notified immediately for a Level A variance?
A) The hospital receiving the patient
B) The EMS Duty Chief via County Communications
C) The medical director
D) The patient's family
Rationale: Level A variances must be reported immediately to the EMS Duty
Chief via County Communications.
Question 4:
What is the definition of a Level B variance?
,A) Any incident that results in patient harm
B) Any incident that does not result in patient harm but is a deviation
from EMS agency policies, procedures, and protocols
C) Any incident where outstanding care was provided
D) Any incident involving equipment failure
Rationale: Level B variances are incidents that do not result in patient harm
but represent a deviation from EMS agency policies, procedures, and
protocols.
Question 5:
How long do you have to report a Level B variance?
A) 24 hours
B) 3 business days
C) 5 business days
D) 7 calendar days
Rationale: Level B variances must be reported within five (5) business days
using EMS Form #903.
Question 6:
What form is used to file any variance report in Santa Clara County?
A) EMS Incident Report Form #501
B) EMS System Variance Report Form #903
C) EMS Patient Care Report Form #700
D) EMS Quality Improvement Form #108
Rationale: The EMS System Variance Report Form #903 is used to file all
variance reports.
Question 7:
What must be included when submitting a System Variance Report Form
#903?
, A) Only the narrative of the incident
B) Dispatch information, PCR, and statements from others involved in
the incident
C) Only the patient's name and date of birth
D) Only the treating paramedic's name
Rationale: In addition to Form #903, copies of dispatch records, the patient
care record (PCR), and statements from those involved must be submitted.
Question 8:
What constitutes a Level C variance?
A) Any incident involving a medication error
B) Any incident resulting in patient harm
C) Incidents where responders provided outstanding care and went
above and beyond normal expectations
D) Any deviation from protocol without patient harm
Rationale: Level C variances are incidents where responders provided
outstanding care and went above and beyond normal expectations.
Question 9:
How long do you have to report a Level C variance?
A) 24 hours
B) 5 business days
C) 7 days
D) 10 business days
Rationale: Level C variances should be reported within 7 days to the EMS
Agency.
Question 10:
Which policy addresses variance reporting in Santa Clara County?
A) Policy 109
B) Policy 108
PROTOCOL PATIENT CARE PROCEDURES
COMPREHENSIVE FINAL REVIEW EXAMINATION
2026 PRACTICE QUESTIONS WITH ANSWERS AND
RATIONALES COMPLETE | ACCURATE |
GUARANTEED
EXAMINATION TITLE: Santa Clara County EMS Paramedic Protocol Patient
Care Procedures — Final Review Examination 2026
DOMAINS COVERED:
• Domain 1: Variance Reporting — Policy 108 (Questions 1-40)
• Domain 2: Communications and Ringdown Procedures (Questions 41-
70)
• Domain 3: MCI and Multi-Patient Incident Management (Questions 71-
90)
• Domain 4: Policies, Procedures, and Accreditation (Questions 91-120)
• Domain 5: Patient Care Protocols and Clinical Decision-Making
(Questions 121-160)
• Domain 6: Hospital Designations, Destination Protocols, and Transport
(Questions 161-200)
DOMAIN 1: VARIANCE REPORTING — POLICY 108
Questions 1-40
Question 1:
Under Santa Clara County EMS Policy 108, what constitutes a Level A
variance?
,A) Any incident where responders went above and beyond normal
expectations
B) Any deviation from protocol that does not result in patient harm
C) Any incident that results in a threat to public safety, patient,
bystander, or responder harm
D) Any equipment failure without patient impact
Rationale: Policy 108 defines Level A variances as incidents that result in a
threat to public safety, patient, bystander, or responder harm.
Question 2:
What is the maximum time allowed to report a Level A variance?
A) 5 business days
B) 7 calendar days
C) 24 hours
D) 72 hours
Rationale: Level A variances must be reported immediately to the EMS Duty
Chief, and the EMS System Variance Report (Form #903) must be submitted
within 24 hours.
Question 3:
Who must be notified immediately for a Level A variance?
A) The hospital receiving the patient
B) The EMS Duty Chief via County Communications
C) The medical director
D) The patient's family
Rationale: Level A variances must be reported immediately to the EMS Duty
Chief via County Communications.
Question 4:
What is the definition of a Level B variance?
,A) Any incident that results in patient harm
B) Any incident that does not result in patient harm but is a deviation
from EMS agency policies, procedures, and protocols
C) Any incident where outstanding care was provided
D) Any incident involving equipment failure
Rationale: Level B variances are incidents that do not result in patient harm
but represent a deviation from EMS agency policies, procedures, and
protocols.
Question 5:
How long do you have to report a Level B variance?
A) 24 hours
B) 3 business days
C) 5 business days
D) 7 calendar days
Rationale: Level B variances must be reported within five (5) business days
using EMS Form #903.
Question 6:
What form is used to file any variance report in Santa Clara County?
A) EMS Incident Report Form #501
B) EMS System Variance Report Form #903
C) EMS Patient Care Report Form #700
D) EMS Quality Improvement Form #108
Rationale: The EMS System Variance Report Form #903 is used to file all
variance reports.
Question 7:
What must be included when submitting a System Variance Report Form
#903?
, A) Only the narrative of the incident
B) Dispatch information, PCR, and statements from others involved in
the incident
C) Only the patient's name and date of birth
D) Only the treating paramedic's name
Rationale: In addition to Form #903, copies of dispatch records, the patient
care record (PCR), and statements from those involved must be submitted.
Question 8:
What constitutes a Level C variance?
A) Any incident involving a medication error
B) Any incident resulting in patient harm
C) Incidents where responders provided outstanding care and went
above and beyond normal expectations
D) Any deviation from protocol without patient harm
Rationale: Level C variances are incidents where responders provided
outstanding care and went above and beyond normal expectations.
Question 9:
How long do you have to report a Level C variance?
A) 24 hours
B) 5 business days
C) 7 days
D) 10 business days
Rationale: Level C variances should be reported within 7 days to the EMS
Agency.
Question 10:
Which policy addresses variance reporting in Santa Clara County?
A) Policy 109
B) Policy 108
