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NREMT EMT

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Study All · NREMT EMT quick referencePrimary Assessment

Primary Assessment

Share of the exam39 to 43%
Tables4
Tested facts7
Adjunct selection and sizing
AdjunctPatientSizing
Oropharyngeal airwayApneic, unresponsive, no gag reflex, being ventilatedCorner of the mouth to the earlobe or angle of the jaw
Nasopharyngeal airwayUnconscious, uninjured, breathing adequately, or will not tolerate an oral airway; avoided with severe head or facial trauma where basilar skull fracture is suspectedTip of the nose to the earlobe
Rigid tonsil-tip (Yankauer) suctionFluid and thick secretions in the mouth, for no more than 15 seconds at a timeLike an oral airway: corner of the mouth to the earlobe
The ventilation numbers
ItemValue
Adequate breathingA regular rate around 16 with equal bilateral chest rise
Inadequate breathingFor example rate 28, shallow, diminished breath sounds: that patient needs ASSISTED VENTILATION, not more oxygen
Adult ventilationOne breath every 5 to 6 seconds (10 to 12 per minute), about 600 mL, just enough for visible chest rise, delivered slowly and gently
Effectiveness checkVisible equal chest rise and fall, and a heart rate returning to normal
Nonrebreathing mask10 to 15 L/min
Nasal cannulaUp to 6 L/min
The resuscitation numbers
ItemValue
Adult CPR100 to 120 per minute, 2 to 2.4 inches deep, 30:2
Two-rescuer paediatric ratio15:2
Infant compressionsTwo fingers just below the nipple line, about 1.5 inches
Compression fractionThe share of resuscitation time spent compressing: aim for at least 60 per cent
Lone rescuer, childAbout 2 minutes (five cycles) of CPR before leaving to call and get an AED
AED near an implanted devicePad at least 1 inch away, then proceed normally
Normal ranges
PatientHeart rateRespiratory rate
Infant90 to 180 (below 80 abnormal)
Child70 to 12020 to 30 per minute
Adult60 to 10012 to 20 per minute

Study All · NREMT EMT quick referencePatient Treatment & Transport

Patient Treatment & Transport

Share of the exam20 to 24%
Tables11
Tested facts17
Delivery complications
FindingMeaning and action
CrowningDelivery is imminent: prepare to deliver at the scene, since labour cannot be slowed or stopped
Green-tinged amniotic fluidMeconium, fetal stool: signals possible fetal distress and a risk of meconium aspiration
Nuchal cordClamp the cord in two places, cut between them ONCE, then unwrap the loops from the neck
Breech presentationSupport the body without pulling; the mother's pushing efforts deliver the head
Limb presentationCannot be delivered vaginally in the field: supportive care and immediate transport for surgical delivery
SIDS facts
ItemFact
DefinitionDeath of an infant or young child that remains unexplained even after a complete autopsy
TollAbout 3,500 infants die of SIDS annually (CDC)
Risk factorsMother younger than 20, maternal smoking during pregnancy, low birth weight
PreventionBack sleeping on a firm mattress, crib free of bumpers, blankets and toys; same room as an adult but never the same bed
Hypoglycaemia versus hyperglycaemia
FeatureHypoglycaemiaHyperglycaemia
OnsetMinutesGradual, hours to days
SkinPale, moist, clammyWarm and dry
PulseRapid and weak
BreathingDeep rapid Kussmaul respirations with a fruity breath odour
CorrectionReversed within minutes by glucoseA complex metabolic condition taking many hours to correct even in hospital
Routes and why they work
RouteWhy
SublingualThe richly vascular tissue under the tongue absorbs the drug within minutes and avoids breakdown by stomach acids
Intranasal (atomiser)The nasal mucosa is highly vascular, giving fast absorption without a needle
Auto-injectorDelivers a preset accurate intramuscular dose quickly and safely, with no drawing up from a vial
Blast injury mechanisms
TypeMechanismSignature
PrimaryThe pressure wave itselfRuptured eardrums and lungs
SecondaryFlying debris: shrapnel, glass, splintersMultiple penetrating wounds
TertiaryThe body hurled against a stationary objectImpact injuries, ground shock
Which splint for which injury
InjuryAnswer
Clavicle, scapula, AC separationSling and swathe, holding the arm against the chest wall
Femoral SHAFT fractureTraction splint
Proximal femur (hip) in a geriatric patientNO traction splint: backboard or scoop with pillows or rolled blankets supporting the limb as found
Lower leg, ankle, footNO traction splint: padded rigid, air or pillow splint including the foot up to the knee
Seizure recognition
TypePicture
Absence (petit mal)A brief staring lapse of consciousness, seconds long, no motor change, full rapid recovery
Simple partial (focal)No change in consciousness; numbness, weakness, dizziness or twitching of a limb
Complex partialAltered mental status with lip smacking, blinking, repetitive behaviour, from the temporal lobe
Typical febrileGeneralised, under 15 minutes, short or absent postictal phase
Dislocation patterns
InjuryStory and posture
PatellaTeenagers and athletes; knee moderately flexed, patella displaced laterally; splint as found
Knee, posteriorThe most common knee dislocation, from extreme hyperextension; high risk of popliteal artery injury
Hip, posteriorKnee strikes the dashboard; hip flexed, knee drawn toward the chest, thigh rotated inward over the opposite leg
Burn depth
DepthAppearance
Superficial (first degree)Red top layer only, no blisters
Partial thickness (second degree)Blisters with moist, mottled, white-to-red skin, intensely painful
Full thickness (third degree)Dry, leathery, white, brown or charred, painless in the deepest area
Croup, epiglottitis, bronchiolitis
DiseaseCausePicture
Croup (laryngotracheobronchitis)Viral, below the vocal cordsGradual onset after a cold, barking seal-like cough, stridor, low-grade fever; ages 6 months to 3 years
EpiglottitisBacterial; incidence dropped sharply since the childhood vaccineSudden onset in a well child: high fever, severe sore throat, tripod position, drooling
BronchiolitisUsually respiratory syncytial virusWheezing in the first 2 years of life, more common in boys, peaking winter and early spring
Heat emergencies
ConditionMechanismSkin and care
Heat crampsElectrolyte shift from sweatingAlert, normal temperature; rest, cool environment, water
Heat exhaustionHypovolaemia from water and electrolyte loss in sweatCold, clammy, pale skin, rapid weak pulse, temperature normal or mildly raised
Heat strokeCooling has failed; core temperature climbingCold-water immersion once core temperature reaches 104 degrees Fahrenheit or mental status is altered

Study All · NREMT EMT quick referenceScene Size-Up & Safety

Scene Size-Up & Safety

Share of the exam15 to 19%
Tables2
Tested facts2
The three zones
ZoneWhat it isEMS role
HotThe contaminated areaNone
WarmThe transition area: access control points and the decontamination corridorNone routinely: carrying large bags in is impractical, which is why care there is limited
ColdSafe, no special protective clothingTriage, treatment and transport of decontaminated patients, from a designated area
Mass casualty facts
ItemRule
DeclaringAn EMT can declare a mass casualty incident; only an elected official can declare a disaster
DurationAn MCI generally lasts no longer than a few hours; a disaster can run days to weeks
Self-sufficiencyPlan for at least 72 hours, supported by mutual aid agreements
DMATFederal Disaster Medical Assistance Teams arrive with their own equipment
FreelancingAn individual unit or responder acting outside the coordinated command structure
Casualty collection areaWhere teams triage, treat and prioritise

Study All · NREMT EMT quick referenceOperations

Operations

Share of the exam10 to 14%
Tables2
Tested facts4
Triage and command facts
ItemRule
START-style sortingAbility to walk, respiratory status, pulse status, neurologic status
Respiratory thresholdsFewer than 15 or more than 45 breaths per minute
Apneic childFive rescue breaths and recheck; if still not breathing, tag expectant
Reverse triageApneic and pulseless victims who would normally be expectant are treated first
Divisions versus groupsDivisions share a geographic area; groups share a function
Staging officerTracks arrivals and releases units
Transportation officerDistributes patients among hospitals so none is overwhelmed, tracked by the tag's unique number
Radio modes at a glance
ModeWhat it allows
SimplexPush to talk, release to listen: either direction, but only one at a time
DuplexSimultaneous two-way transmission and reception on a channel
MultiplexMore than one type of information carried at once on a single frequency

Study All · NREMT EMT quick referenceSecondary Assessment

Secondary Assessment

Share of the exam5 to 9%
Tables0
Tested facts0

No tables or tested facts in this domain yet; the guide covers it in prose. The share above is still the real exam's.

Sources this sheet is checked against

  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), patient assessment
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), mental status assessment
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), airway management, with Anatomy & Physiology for the Prehospital Provider (Jones & Bartlett)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), breathing assessment and ventilation
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), circulation and shock
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), resuscitation and assessment of trauma patients
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), paediatric assessment
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), patient assessment and shock
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), respiratory emergencies, with Pharmacology for the Prehospital Professional (Jones & Bartlett)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), medical emergencies, with Pharmacology for the Prehospital Professional (Jones & Bartlett)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), trauma and environmental emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), obstetrics and gynaecology, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), behavioural emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), soft-tissue injuries, face and neck injuries, and bleeding
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), obstetrics and neonatal care
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), paediatric emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), cardiovascular emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), toxicology and psychiatric emergencies, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), geriatric emergencies and patients with special challenges
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), respiratory emergencies, bleeding and patient assessment
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), neurologic emergencies and geriatric emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), gastrointestinal and urologic emergencies, and toxicology
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), respiratory emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), toxicology, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), endocrine and haematologic emergencies, geriatric emergencies and patients with special challenges
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), paediatric and gynaecologic emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), endocrine and haematologic emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), soft-tissue injuries, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), obstetrics and neonatal care, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), respiratory emergencies, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022) and Pathophysiology cross-reference collection
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), neurologic emergencies and geriatric emergencies, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), toxicology and gastrointestinal emergencies, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), geriatric, paediatric and psychiatric emergencies, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), principles of pharmacology, with Pharmacology for the Prehospital Professional (Jones & Bartlett)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), respiratory and immunologic emergencies, and principles of pharmacology
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), head and spine injuries and trauma overview
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), soft-tissue injuries, shock and environmental emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), orthopaedic injuries
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), environmental emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), cardiovascular emergencies, patient assessment and patients with special challenges
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), neurologic and paediatric emergencies, and airway management
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), genitourinary injuries and paediatric emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), shock
  • Pharmacology for the Prehospital Professional (Jones & Bartlett), endocrine emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), soft-tissue injuries
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), gastrointestinal and urologic emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), toxicology, with Pharmacology for the Prehospital Professional (Jones & Bartlett)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), obstetrics and paediatric emergencies, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), principles of pharmacology and endocrine emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), face and neck injuries, immunologic and environmental emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), neurologic emergencies, medical overview and medicolegal issues
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), toxicology, with Pharmacology for the Prehospital Professional (Jones & Bartlett) and National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), face and neck injuries and head injuries
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), chest injuries, orthopaedic injuries and trauma overview
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), head and spine injuries
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), geriatric emergencies, respiratory emergencies and patients with special challenges
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), psychiatric emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), gynaecologic emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), neurologic emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), cardiovascular emergencies and bleeding, with Pharmacology for the Prehospital Professional (Jones & Bartlett)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), gastrointestinal and urologic emergencies and patient assessment
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), toxicology
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), soft-tissue and orthopaedic injuries
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), cardiovascular and respiratory emergencies
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), obstetric, medical and pharmacology chapters, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), principles of pharmacology, orthopaedic injuries and patients with special challenges
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), scene size-up
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), infection control
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), workforce safety and wellness, and infectious diseases
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), infectious diseases
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), workforce safety and wellness
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), hazardous materials and scene safety
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), vehicle extrication and mass casualty incidents
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), vehicle extrication and special rescue, with patient assessment
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), medical, legal and ethical issues
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), medical, legal and ethical issues, with National Model EMS Clinical Guidelines (NASEMSO, Version 3.0, March 2022)
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), psychiatric emergencies and medical, legal and ethical issues
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), documentation and communications
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), ambulance operations and incident management
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), EMS systems and medical, legal and ethical issues
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), incident management, communications and transport operations
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), baseline vital signs
  • Emergency Care and Transportation of the Sick and Injured (AAOS / Jones & Bartlett), secondary assessment

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