Computer Adaptive Testing (CAT)
Exam adjusts difficulty based on candidate's performance.
Getting Started: NREMT EMT Exam Overview
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NREMT Emergency Medical Technician (EMT) Cognitive Exam — key terms, tricks & tips
Everything from the course in one searchable place: 321 entries. Use it to review before a practice test or look up a word you forgot.
321 results · showing first 300, refine your search
Content Domains
Major subject areas covered on the exam (e.g., Trauma, Cardiology).
Getting Started: NREMT EMT Exam Overview
Cognitive Levels
How knowledge is tested: recall, application, and analysis.
Getting Started: NREMT EMT Exam Overview
Pilot Questions
Unscored questions used for future exam development.
Getting Started: NREMT EMT Exam Overview
Minimum Competency Standard
The baseline level of knowledge and skill required to pass.
Getting Started: NREMT EMT Exam Overview
95% Confidence
The statistical certainty the algorithm needs to determine pass/fail.
Getting Started: NREMT EMT Exam Overview
NREMT EMT Cognitive Exam Format
CAT: C-omputer A-dapts T-o you!
Getting Started: NREMT EMT Exam Overview
NREMT EMT Cognitive Exam Format
California EMT certification requires passing the NREMT Cognitive Exam. Be aware that while the NREMT sets the national standard, individual states may have additional requirements for licensure beyond NREMT certification. Always check the California EMS Authority (EMSA) website for the most current state-specific regulations.
Getting Started: NREMT EMT Exam Overview
NREMT EMT Cognitive Exam Format
Thinking you failed because questions got harder (it means you're doing well!)
Getting Started: NREMT EMT Exam Overview
NREMT EMT Cognitive Exam Format
Trying to count how many questions you've answered to guess if you're passing
Getting Started: NREMT EMT Exam Overview
NREMT EMT Cognitive Exam Format
Focusing only on one content area in your studies
Getting Started: NREMT EMT Exam Overview
Active Recall
Retrieving information from memory without external cues; self-testing.
Getting Started: NREMT EMT Exam Overview
Spaced Repetition
Reviewing material at increasing intervals to improve long-term retention.
Getting Started: NREMT EMT Exam Overview
Forgetting Curve
The rate at which memory of information is lost over time if not reinforced.
Getting Started: NREMT EMT Exam Overview
Study Plan
A structured schedule outlining what and when to study for an exam.
Getting Started: NREMT EMT Exam Overview
Scenario-Based Learning
Applying theoretical knowledge to realistic patient situations.
Getting Started: NREMT EMT Exam Overview
NREMT Content Areas
Official topics and skills the NREMT exam covers.
Getting Started: NREMT EMT Exam Overview
Effective Study Strategies for Exam Success
For 'Active Recall': 'Ask Yourself Constantly, Know All Lessons!'
Getting Started: NREMT EMT Exam Overview
Effective Study Strategies for Exam Success
The California EMS Authority (EMSA) requires NREMT certification for EMT licensure. Focus on NREMT guidelines as the foundation for all patient care questions.
Getting Started: NREMT EMT Exam Overview
Effective Study Strategies for Exam Success
Passive re-reading of notes or textbooks without actively engaging with the material.
Getting Started: NREMT EMT Exam Overview
Effective Study Strategies for Exam Success
Cramming all studying into a few intense sessions right before the exam.
Getting Started: NREMT EMT Exam Overview
Effective Study Strategies for Exam Success
Only focusing on memorization without understanding the 'why' behind clinical decisions.
Getting Started: NREMT EMT Exam Overview
Patent Airway
An airway that is open and clear, allowing free air passage.
Airway, Respiration & Ventilation Fundamentals
Stridor
High-pitched, harsh sound indicating upper airway obstruction.
Airway, Respiration & Ventilation Fundamentals
Gag Reflex
Protective reflex preventing foreign objects from entering the throat.
Airway, Respiration & Ventilation Fundamentals
Oropharyngeal Airway (OPA)
Device used to maintain airway in unconscious patients without gag reflex.
Airway, Respiration & Ventilation Fundamentals
Nasopharyngeal Airway (NPA)
Device used to maintain airway in conscious/semiconscious patients with gag reflex.
Airway, Respiration & Ventilation Fundamentals
Trismus
Severe jaw clenching, making oral airway insertion difficult.
Airway, Respiration & Ventilation Fundamentals
Aspiration
Inhalation of foreign material into the lungs.
Airway, Respiration & Ventilation Fundamentals
Airway Management: Assessment & Basic Interventions
OPA: No Gag? Go Ahead! NPA: Nose First, Gag Safe!
Airway, Respiration & Ventilation Fundamentals
Airway Management: Assessment & Basic Interventions
The California exam emphasizes the importance of proper measurement for both OPA and NPA, and the contraindications for each. Pay close attention to the 'no gag reflex' for OPA and 'intact gag reflex' for NPA.
Airway, Respiration & Ventilation Fundamentals
Airway Management: Assessment & Basic Interventions
Inserting an OPA in a patient with an intact gag reflex, leading to vomiting and aspiration.
Airway, Respiration & Ventilation Fundamentals
Airway Management: Assessment & Basic Interventions
Forcing an NPA, which can cause trauma and bleeding, potentially worsening the airway.
Airway, Respiration & Ventilation Fundamentals
Airway Management: Assessment & Basic Interventions
Performing a head-tilt, chin-lift on a patient with suspected cervical spine injury.
Airway, Respiration & Ventilation Fundamentals
Ventilation
Mechanical movement of air into and out of the lungs.
Airway, Respiration & Ventilation Fundamentals
Respiration
Physiological process of gas exchange (O2 and CO2).
Airway, Respiration & Ventilation Fundamentals
Alveoli
Tiny air sacs in the lungs where gas exchange occurs.
Airway, Respiration & Ventilation Fundamentals
Diaphragm
Primary muscle of respiration, separates chest and abdomen.
Airway, Respiration & Ventilation Fundamentals
External Respiration
Gas exchange between alveoli and pulmonary capillaries.
Airway, Respiration & Ventilation Fundamentals
Internal Respiration
Gas exchange between systemic capillaries and body cells.
Airway, Respiration & Ventilation Fundamentals
Partial Pressure
Pressure exerted by a single gas in a mixture of gases.
Airway, Respiration & Ventilation Fundamentals
Respiration & Ventilation Physiology and Assessment
V-M-R-G: Ventilation is Mechanical, Respiration is Gas exchange.
Airway, Respiration & Ventilation Fundamentals
Respiration & Ventilation Physiology and Assessment
The NREMT exam frequently tests the difference between ventilation and respiration. Memorize that ventilation is mechanical air movement, and respiration is gas exchange. Also, be prepared to identify accessory muscle use and abnormal breath sounds.
Airway, Respiration & Ventilation Fundamentals
Respiration & Ventilation Physiology and Assessment
Confusing ventilation with respiration; they are distinct processes.
Airway, Respiration & Ventilation Fundamentals
Respiration & Ventilation Physiology and Assessment
Failing to recognize subtle signs of respiratory distress, such as changes in mental status or accessory muscle use.
Airway, Respiration & Ventilation Fundamentals
Respiration & Ventilation Physiology and Assessment
Relying solely on pulse oximetry without a thorough clinical assessment.
Airway, Respiration & Ventilation Fundamentals
Oxygenation
Process of supplying oxygen to the body's cells and tissues.
Airway, Respiration & Ventilation Fundamentals
Hypoxia
Insufficient oxygen in the body's tissues.
Airway, Respiration & Ventilation Fundamentals
FiO2
Fraction of inspired oxygen; percentage of oxygen in inhaled air.
Airway, Respiration & Ventilation Fundamentals
Nasal Cannula
Low-flow device, 1-6 LPM, 24-44% FiO2.
Airway, Respiration & Ventilation Fundamentals
Non-Rebreather Mask
High-flow device, 10-15 LPM, up to 90% FiO2.
Airway, Respiration & Ventilation Fundamentals
Bag-Valve Mask (BVM)
Device for assisted ventilation, nearly 100% FiO2 with oxygen.
Airway, Respiration & Ventilation Fundamentals
Pulse Oximetry
Non-invasive measurement of oxygen saturation in arterial blood.
Airway, Respiration & Ventilation Fundamentals
LPM
Liters Per Minute; unit for oxygen flow rate.
Airway, Respiration & Ventilation Fundamentals
Oxygenation Principles and Delivery Devices
O-D-A-T: Oxygen Delivery, Assessment, Device, Titration. Remember to assess, then choose the right device, then titrate flow.
Airway, Respiration & Ventilation Fundamentals
Oxygenation Principles and Delivery Devices
For the NREMT, remember that oxygen is a medication. While often life-saving, be aware of specific patient populations like COPD where high-flow oxygen can be detrimental. Always prioritize patient assessment over a single SpO2 reading. Know the flow rates and approximate FiO2 for each device.
Airway, Respiration & Ventilation Fundamentals
Oxygenation Principles and Delivery Devices
Administering high-flow oxygen to a stable COPD patient without monitoring, potentially causing respiratory depression.
Airway, Respiration & Ventilation Fundamentals
Oxygenation Principles and Delivery Devices
Failing to recognize a deteriorating patient and upgrading oxygen delivery from a nasal cannula to a non-rebreather or BVM.
Airway, Respiration & Ventilation Fundamentals
Oxygenation Principles and Delivery Devices
Not checking the oxygen tank pressure before transport, leading to running out of oxygen mid-call.
Airway, Respiration & Ventilation Fundamentals
Supraglottic Airway (SGA)
Airway device that sits above the glottis.
Airway, Respiration & Ventilation Fundamentals
King LT Airway
Common type of supraglottic airway device.
Airway, Respiration & Ventilation Fundamentals
Laryngeal Mask Airway (LMA)
Another type of supraglottic airway device.
Airway, Respiration & Ventilation Fundamentals
End-Tidal CO2 (EtCO2)
Measurement of carbon dioxide at end of exhalation.
Airway, Respiration & Ventilation Fundamentals
Continuous Positive Airway Pressure (CPAP)
Non-invasive ventilatory support for breathing patients.
Airway, Respiration & Ventilation Fundamentals
Positive End-Expiratory Pressure (PEEP)
Pressure remaining in lungs at end of exhalation.
Airway, Respiration & Ventilation Fundamentals
Barotrauma
Lung injury caused by excessive pressure.
Airway, Respiration & Ventilation Fundamentals
Volutrauma
Lung injury caused by excessive volume.
Airway, Respiration & Ventilation Fundamentals
Advanced Airway Adjuncts & Ventilatory Support
For SGA confirmation, think 'LEMON': L-Look for chest rise, E-EtCO2, M-Mist in the tube, O-Observe for gastric sounds (absence), N-Note breath sounds.
Airway, Respiration & Ventilation Fundamentals
Advanced Airway Adjuncts & Ventilatory Support
For the NREMT, remember that EMTs can insert supraglottic airways (like the King LT or LMA) in many states, but always confirm your local protocols. CPAP is a common intervention for respiratory distress, especially pulmonary edema and COPD exacerbations. Focus on indications, contraindications, and proper application.
Airway, Respiration & Ventilation Fundamentals
Advanced Airway Adjuncts & Ventilatory Support
Failing to confirm SGA placement, leading to esophageal intubation.
Airway, Respiration & Ventilation Fundamentals
Advanced Airway Adjuncts & Ventilatory Support
Using CPAP on a patient who is unresponsive or unable to protect their airway.
Airway, Respiration & Ventilation Fundamentals
Advanced Airway Adjuncts & Ventilatory Support
Not troubleshooting a failing advanced airway and reverting to basic management.
Airway, Respiration & Ventilation Fundamentals
Cardiac Arrest
Cessation of effective heart function, leading to loss of consciousness.
Cardiology & Resuscitation Essentials
CPR
Cardiopulmonary Resuscitation; chest compressions and rescue breaths.
Cardiology & Resuscitation Essentials
AED
Automated External Defibrillator; delivers electric shock to heart.
Cardiology & Resuscitation Essentials
Defibrillation
Delivery of an electrical shock to reset the heart's rhythm.
Cardiology & Resuscitation Essentials
Ventricular Fibrillation (VF)
Chaotic electrical activity in the ventricles, causing no blood flow.
Cardiology & Resuscitation Essentials
Pulseless VT (pVT)
Rapid, ineffective ventricular rhythm without a palpable pulse.
Cardiology & Resuscitation Essentials
Chest Recoil
Allowing the chest to fully expand after each compression.
Cardiology & Resuscitation Essentials
Hands-Off Time
Time without chest compressions during resuscitation efforts.
Cardiology & Resuscitation Essentials
Cardiac Arrest Management: CPR and AED Use
C-A-B: Compressions, Airway, Breathing. Remember this order for resuscitation!
Cardiology & Resuscitation Essentials
Cardiac Arrest Management: CPR and AED Use
The NREMT exam frequently tests specific compression depths and rates for adults, children, and infants. Memorize these exact numbers: Adult (2+ inches), Child (~2 inches), Infant (~1.5 inches), all at 100-120 compressions per minute. Also, know the single and two-rescuer compression-to-ventilation ratios for each age group.
Cardiology & Resuscitation Essentials
Cardiac Arrest Management: CPR and AED Use
Stopping compressions for too long to check for a pulse or prepare the AED.
Cardiology & Resuscitation Essentials
Cardiac Arrest Management: CPR and AED Use
Compressing too shallow or too slowly, reducing blood flow.
Cardiology & Resuscitation Essentials
Cardiac Arrest Management: CPR and AED Use
Not allowing for full chest recoil, which impairs ventricular filling.
Cardiology & Resuscitation Essentials
Cardiac Arrest Management: CPR and AED Use
Forgetting to activate EMS early or not calling for an AED immediately.
Cardiology & Resuscitation Essentials
Myocardial Infarction (MI)
Heart attack; death of heart muscle due to blocked blood flow.
Cardiology & Resuscitation Essentials
Congestive Heart Failure (CHF)
Heart unable to pump effectively, leading to fluid backup.
Cardiology & Resuscitation Essentials
Dysrhythmia
Abnormal heart rhythm; irregular electrical activity.
Cardiology & Resuscitation Essentials
Angina Pectoris
Chest pain from temporary heart muscle ischemia.
Cardiology & Resuscitation Essentials
Diaphoresis
Excessive sweating, often associated with cardiac events.
Cardiology & Resuscitation Essentials
Orthopnea
Shortness of breath that worsens when lying flat.
Cardiology & Resuscitation Essentials
Rales (Crackles)
Wet, crackling lung sounds indicating fluid in alveoli.
Cardiology & Resuscitation Essentials
JVD
Jugular Venous Distension; bulging neck veins indicating fluid overload.
Cardiology & Resuscitation Essentials
Chest Pain, MI, CHF, and Dysrhythmias Recognition
For chest pain assessment, remember 'OPQRST': Onset, Provocation/Palliation, Quality, Radiation, Severity, Time. It helps you get the full story!
Cardiology & Resuscitation Essentials
Chest Pain, MI, CHF, and Dysrhythmias Recognition
The NREMT exam frequently tests the appropriate administration of aspirin (324 mg chewable) and assistance with nitroglycerin (0.4 mg sublingual, up to 3 doses) for suspected MI, including contraindications like recent PDE5 inhibitor use (e.g., Viagra) or hypotension. Always remember the dosage and contraindications.
Cardiology & Resuscitation Essentials
Chest Pain, MI, CHF, and Dysrhythmias Recognition
Assuming chest pain is non-cardiac without thorough assessment.
Cardiology & Resuscitation Essentials
Chest Pain, MI, CHF, and Dysrhythmias Recognition
Delaying transport for a patient with suspected MI or unstable dysrhythmia.
Cardiology & Resuscitation Essentials
Chest Pain, MI, CHF, and Dysrhythmias Recognition
Administering nitroglycerin to a hypotensive patient or one who has taken erectile dysfunction medication.
Cardiology & Resuscitation Essentials
Perfusion
Delivery of oxygen and nutrients to tissues.
Cardiology & Resuscitation Essentials
Hypovolemic Shock
Inadequate blood volume.
Cardiology & Resuscitation Essentials
Cardiogenic Shock
Heart fails as a pump.
Cardiology & Resuscitation Essentials
Obstructive Shock
Physical blockage of blood flow.
Cardiology & Resuscitation Essentials
Distributive Shock
Widespread vasodilation.
Cardiology & Resuscitation Essentials
Compensated Shock
Body's mechanisms maintain BP.
Cardiology & Resuscitation Essentials
Decompensated Shock
Compensatory mechanisms fail.
Cardiology & Resuscitation Essentials
Hypotension
Abnormally low blood pressure.
Cardiology & Resuscitation Essentials
Understanding Shock and Its Management
Remember 'HOCD' for the four types of shock: Hypovolemic, Obstructive, Cardiogenic, Distributive!
Cardiology & Resuscitation Essentials
Understanding Shock and Its Management
The NREMT exam often tests your ability to differentiate between the four types of shock based on patient presentation. Pay close attention to the underlying cause and specific signs/symptoms for each type. Remember that early recognition and intervention are key.
Cardiology & Resuscitation Essentials
Understanding Shock and Its Management
Failing to recognize early signs of compensated shock.
Cardiology & Resuscitation Essentials
Understanding Shock and Its Management
Aggressively fluid resuscitating a patient in cardiogenic shock.
Cardiology & Resuscitation Essentials
Understanding Shock and Its Management
Not addressing the underlying cause of shock (e.g., uncontrolled bleeding).
Cardiology & Resuscitation Essentials
Endotracheal Intubation
Tube placed directly into trachea for definitive airway.
Cardiology & Resuscitation Essentials
Epinephrine
Vasoconstrictor, cardiac stimulant used in cardiac arrest.
Cardiology & Resuscitation Essentials
Amiodarone
Antiarrhythmic for refractory VF/pVT.
Cardiology & Resuscitation Essentials
Return of Spontaneous Circulation (ROSC)
Return of a perfusing heart rhythm after arrest.
Cardiology & Resuscitation Essentials
Therapeutic Hypothermia
Controlled cooling to protect brain after ROSC.
Cardiology & Resuscitation Essentials
Closed-Loop Communication
Confirmation of messages between team members.
Cardiology & Resuscitation Essentials
Continuous Quality Improvement (CQI)
Ongoing review and enhancement of care processes.
Cardiology & Resuscitation Essentials
Advanced Resuscitation & Post-Arrest Care
For Post-ROSC Care: 'HOT MAP' - Hypoxia avoided, Oxygenation optimized, Temperature controlled, MAP maintained, Antiarrhythmics ready, Prepare for transport.
Cardiology & Resuscitation Essentials
Advanced Resuscitation & Post-Arrest Care
California EMTs are trained to assist with advanced airway insertion and monitor patients with advanced airways. Know the indications for epinephrine and antiarrhythmics in cardiac arrest, and the general principles of post-ROSC care.
Cardiology & Resuscitation Essentials
Advanced Resuscitation & Post-Arrest Care
Failing to confirm advanced airway placement with capnography and auscultation.
Cardiology & Resuscitation Essentials
Advanced Resuscitation & Post-Arrest Care
Delaying transport to a definitive care facility after ROSC is achieved.
Cardiology & Resuscitation Essentials
Advanced Resuscitation & Post-Arrest Care
Forgetting to debrief after a cardiac arrest, missing opportunities for team improvement.
Cardiology & Resuscitation Essentials
Hemorrhage
Excessive bleeding.
Trauma Management Principles
Direct Pressure
Applying force directly to a wound.
Trauma Management Principles
Tourniquet
Device to constrict blood flow to an extremity.
Trauma Management Principles
Abrasion
Scrape of the outer skin layer.
Trauma Management Principles
Laceration
A cut in the skin.
Trauma Management Principles
Avulsion
Flap of skin and tissue torn loose.
Trauma Management Principles
Impaled Object
Object stuck in the body tissue.
Trauma Management Principles
Shock
Inadequate tissue perfusion.
Trauma Management Principles
Bleeding Control and Soft Tissue Injuries
For bleeding control, remember 'DIRECT': Direct pressure, Elevate, Restrict (tourniquet), Ice, Call for help, Transport.
Trauma Management Principles
Bleeding Control and Soft Tissue Injuries
The NREMT exam emphasizes the importance of early and effective hemorrhage control. For severe extremity bleeding, a tourniquet is the definitive prehospital intervention if direct pressure fails. Always document the time of tourniquet application.
Trauma Management Principles
Bleeding Control and Soft Tissue Injuries
Removing a blood-soaked dressing instead of adding more on top.
Trauma Management Principles
Bleeding Control and Soft Tissue Injuries
Applying a tourniquet too loosely, which can worsen bleeding.
Trauma Management Principles
Bleeding Control and Soft Tissue Injuries
Delaying transport for a patient with suspected internal bleeding.
Trauma Management Principles
Fracture
A break in the continuity of a bone.
Trauma Management Principles
Dislocation
Displacement of a bone from its joint.
Trauma Management Principles
Sprain
Injury to a ligament, often from twisting.
Trauma Management Principles
Strain
Injury to a muscle or tendon from overstretching.
Trauma Management Principles
Crepitus
Grating sound or sensation from bone fragments.
Trauma Management Principles
Neurovascular Compromise
Impairment of nerve or blood vessel function.
Trauma Management Principles
Immobilization
Preventing movement of an injured body part.
Trauma Management Principles
In-line stabilization
Manual support to keep the spine straight.
Trauma Management Principles
Musculoskeletal & Spinal Injuries
For neurovascular checks, remember 'PMS': Pulse, Motor, Sensation. Or 'CSM': Circulation, Sensation, Motor.
Trauma Management Principles
Musculoskeletal & Spinal Injuries
For spinal immobilization, remember that the NREMT (and California protocols) emphasize a cervical collar with a backboard or vacuum mattress for suspected spinal injury. The goal is to prevent movement, not necessarily to 'fix' anything on scene. Know the indications for full spinal immobilization.
Trauma Management Principles
Musculoskeletal & Spinal Injuries
Failing to check neurovascular status before and after splinting.
Trauma Management Principles
Musculoskeletal & Spinal Injuries
Immobilizing only the injury site, not the joints above and below.
Trauma Management Principles
Musculoskeletal & Spinal Injuries
Moving a patient with suspected spinal injury without proper stabilization.
Trauma Management Principles
Flail Chest
Segment of chest wall moves paradoxically due to multiple rib fractures.
Trauma Management Principles
Tension Pneumothorax
Air enters pleural space and cannot escape, compressing lung and heart.
Trauma Management Principles
Cardiac Tamponade
Fluid in pericardial sac compresses heart, impairing filling.
Trauma Management Principles
Cullen's Sign
Periumbilical ecchymosis, indicates retroperitoneal bleeding.
Trauma Management Principles
Battle's Sign
Bruising behind the ear, sign of basilar skull fracture.
Trauma Management Principles
Peritonitis
Inflammation of the peritoneum, often from abdominal organ rupture.
Trauma Management Principles
Intracranial Pressure (ICP)
Pressure within the skull, can increase dangerously with head injury.
Trauma Management Principles
Subcutaneous Emphysema
Air trapped under the skin, feels like crackling; often from lung injury.
Trauma Management Principles
Head, Chest, and Abdominal Trauma
For life-threatening chest injuries, remember 'FATAL': Flail Chest, Airway Obstruction, Tension Pneumothorax, Aortic Injury, Lung/Heart Injury.
Trauma Management Principles
Head, Chest, and Abdominal Trauma
For head trauma, the NREMT often focuses on recognizing signs of increasing intracranial pressure (e.g., Cushing's Triad: hypertension, bradycardia, irregular respirations) and the importance of maintaining cerebral perfusion and oxygenation. Be prepared to identify subtle changes in mental status and pupillary response. For chest trauma, differentiate between a simple pneumothorax and a tension pneumothorax, and know the immediate life-saving intervention for a sucking chest wound (occlusive dressing).
Trauma Management Principles
Head, Chest, and Abdominal Trauma
Failing to recognize the significance of a mechanism of injury, even if initial signs are subtle.
Trauma Management Principles
Head, Chest, and Abdominal Trauma
Not performing a thorough and repeated assessment, missing evolving signs of deterioration.
Trauma Management Principles
Head, Chest, and Abdominal Trauma
Delaying transport to a trauma center for critical patients in favor of prolonged on-scene interventions.
Trauma Management Principles
Superficial Burn
First-degree burn; involves epidermis, redness, pain, no blisters.
Trauma Management Principles
Partial-Thickness Burn
Second-degree burn; involves epidermis & dermis, redness, pain, blisters.
Trauma Management Principles
Full-Thickness Burn
Third-degree burn; destroys all skin layers, white/waxy/charred, little pain.
Trauma Management Principles
Rule of Nines
Method to estimate body surface area (BSA) burned in adults.
Trauma Management Principles
Heatstroke
Life-threatening heat emergency with elevated temp, altered mental status.
Trauma Management Principles
Hypothermia
Core body temperature below 95°F (35°C).
Trauma Management Principles
Frostbite
Freezing of body tissues, commonly extremities.
Trauma Management Principles
Burns and Environmental Emergencies
For burn depth, remember 'SPF': S-Superficial (Sunburn), P-Partial (Painful blisters), F-Full (Feels no pain).
Trauma Management Principles
Burns and Environmental Emergencies
The NREMT exam often emphasizes the importance of stopping the burning process, proper cooling techniques, and recognizing critical burn locations. For environmental emergencies, differentiate between heat exhaustion (cool, clammy skin) and heatstroke (hot, dry or moist skin, altered mental status).
Trauma Management Principles
Burns and Environmental Emergencies
Applying ice directly to burns, which can cause further tissue damage.
Trauma Management Principles
Burns and Environmental Emergencies
Rubbing frostbitten areas, which can cause ice crystals to damage tissue.
Trauma Management Principles
Burns and Environmental Emergencies
Confusing heat exhaustion with heatstroke; heatstroke is a true emergency with altered mental status.
Trauma Management Principles
Stroke
Interruption of blood flow to part of the brain.
Medical Emergencies: Recognition & Care
Seizure
Abnormal electrical activity in the brain.
Medical Emergencies: Recognition & Care
Postictal state
Period of confusion/drowsiness after a seizure.
Medical Emergencies: Recognition & Care
Hypoglycemia
Dangerously low blood glucose levels.
Medical Emergencies: Recognition & Care
Hyperglycemia
Dangerously high blood glucose levels.
Medical Emergencies: Recognition & Care
Anaphylaxis
Severe, life-threatening allergic reaction.
Medical Emergencies: Recognition & Care
Cincinnati Prehospital Stroke Scale
Rapid assessment tool for stroke symptoms.
Medical Emergencies: Recognition & Care
Neurological, Endocrine, and Allergic Emergencies
For Stroke: FAST – Face drooping, Arm weakness, Speech difficulty, Time to call 911.
Medical Emergencies: Recognition & Care
Neurological, Endocrine, and Allergic Emergencies
The NREMT exam will test your ability to differentiate between stroke and Bell's Palsy (facial droop without other neurological deficits) and to recognize the critical time window for stroke treatment. For diabetic emergencies, always prioritize treating hypoglycemia as it is more immediately life-threatening. For anaphylaxis, know the indications, dose, and administration route for epinephrine.
Medical Emergencies: Recognition & Care
Neurological, Endocrine, and Allergic Emergencies
Not recognizing the urgency of a stroke and delaying transport.
Medical Emergencies: Recognition & Care
Neurological, Endocrine, and Allergic Emergencies
Attempting to restrain a seizing patient or putting something in their mouth.
Medical Emergencies: Recognition & Care
Neurological, Endocrine, and Allergic Emergencies
Underestimating the severity of an allergic reaction and delaying epinephrine administration.
Medical Emergencies: Recognition & Care
Poisoning
Harmful effects from a substance exposure.
Medical Emergencies: Recognition & Care
Overdose
Toxic effects from excessive substance intake.
Medical Emergencies: Recognition & Care
Activated Charcoal
Adsorbent used for some ingested poisons.
Medical Emergencies: Recognition & Care
Naloxone
Medication to reverse opioid overdose effects.
Medical Emergencies: Recognition & Care
Abdominal Quadrants
Four regions of the abdomen for assessment.
Medical Emergencies: Recognition & Care
Guarding
Involuntary tensing of abdominal muscles.
Medical Emergencies: Recognition & Care
Referred Pain
Pain felt in a part of the body other than origin.
Medical Emergencies: Recognition & Care
NPO
Nothing by mouth (Latin: nil per os).
Medical Emergencies: Recognition & Care
Poisoning, Overdose, and Abdominal Pain
For abdominal pain assessment, think 'PQRST' for Pain: Provocation, Quality, Region/Radiation, Severity, Time.
Medical Emergencies: Recognition & Care
Poisoning, Overdose, and Abdominal Pain
The NREMT exam frequently tests your understanding of specific interventions for overdose, such as the indications and contraindications for activated charcoal and naloxone. Remember that activated charcoal is generally contraindicated in patients with altered mental status or those who have ingested corrosives, caustics, or petroleum products. Naloxone is specifically for opioid overdose.
Medical Emergencies: Recognition & Care
Poisoning, Overdose, and Abdominal Pain
Inducing vomiting in a poisoned patient without medical control direction or when contraindicated.
Medical Emergencies: Recognition & Care
Poisoning, Overdose, and Abdominal Pain
Delaying transport for a patient with severe abdominal pain or suspected overdose while attempting to make a definitive diagnosis.
Medical Emergencies: Recognition & Care
Poisoning, Overdose, and Abdominal Pain
Forgetting scene safety when approaching a potential overdose or hazardous materials incident.
Medical Emergencies: Recognition & Care
Standard Precautions
Infection control for all patients.
Medical Emergencies: Recognition & Care
PPE
Equipment protecting from hazards.
Medical Emergencies: Recognition & Care
Chain of Infection
Steps for disease transmission.
Medical Emergencies: Recognition & Care
Airborne Transmission
Spread via tiny suspended particles.
Medical Emergencies: Recognition & Care
Behavioral Emergency
Abnormal behavior requiring intervention.
Medical Emergencies: Recognition & Care
De-escalation
Techniques to reduce agitation.
Medical Emergencies: Recognition & Care
Psychosis
Break from reality; hallucinations/delusions.
Medical Emergencies: Recognition & Care
Agitated Delirium
Extreme excitement, high cardiac risk.
Medical Emergencies: Recognition & Care
Infectious Diseases and Behavioral Emergencies
For PPE, remember GEMS: Gloves, Eye protection, Mask, Shield (gown).
Medical Emergencies: Recognition & Care
Infectious Diseases and Behavioral Emergencies
For infectious diseases, the NREMT often tests on the appropriate PPE for specific conditions (e.g., N95 for TB, surgical mask for flu). For behavioral emergencies, focus on scene safety, de-escalation, and ruling out medical causes. Remember that California EMTs must follow specific protocols for patient restraint.
Medical Emergencies: Recognition & Care
Infectious Diseases and Behavioral Emergencies
Not wearing appropriate PPE for the situation, especially under-dressing for suspected airborne diseases.
Medical Emergencies: Recognition & Care
Infectious Diseases and Behavioral Emergencies
Approaching an agitated patient without ensuring scene safety or backup.
Medical Emergencies: Recognition & Care
Infectious Diseases and Behavioral Emergencies
Arguing with a patient experiencing delusions or hallucinations.
Medical Emergencies: Recognition & Care
Infectious Diseases and Behavioral Emergencies
Failing to consider underlying medical causes for a behavioral emergency.
Medical Emergencies: Recognition & Care
Placenta Previa
Placenta covers cervix, causing painless vaginal bleeding.
Medical Emergencies: Recognition & Care
Abruptio Placentae
Placenta separates from uterine wall, causing painful bleeding.
Medical Emergencies: Recognition & Care
Ectopic Pregnancy
Fertilized egg implants outside uterus, often in fallopian tube.
Medical Emergencies: Recognition & Care
Pre-eclampsia
Pregnancy complication with high blood pressure and organ damage.
Medical Emergencies: Recognition & Care
Eclampsia
Severe pre-eclampsia with seizures.
Medical Emergencies: Recognition & Care
Pediatric Assessment Triangle (PAT)
Rapid, visual assessment of a child's appearance, work of breathing, and circulation.
Medical Emergencies: Recognition & Care
Polypharmacy
Simultaneous use of multiple medications, common in geriatrics.
Medical Emergencies: Recognition & Care
Prolapsed Umbilical Cord
Umbilical cord presents before the baby, risking compression.
Medical Emergencies: Recognition & Care
Gynecological, Obstetric, Pediatric, & Geriatric Emergencies
For 'PAT' (Pediatric Assessment Triangle): 'A'll 'W'ays 'C'are for kids!
Medical Emergencies: Recognition & Care
Gynecological, Obstetric, Pediatric, & Geriatric Emergencies
For obstetric emergencies, remember that California EMTs are trained to assist in normal childbirth and manage specific complications like prolapsed cord and breech presentation. The NREMT expects you to know the immediate interventions for these critical situations.
Medical Emergencies: Recognition & Care
Gynecological, Obstetric, Pediatric, & Geriatric Emergencies
Treating pediatric patients as small adults and failing to recognize their unique physiological differences.
Medical Emergencies: Recognition & Care
Gynecological, Obstetric, Pediatric, & Geriatric Emergencies
Underestimating the severity of symptoms in geriatric patients due to atypical presentations or denial of pain.
Medical Emergencies: Recognition & Care
Gynecological, Obstetric, Pediatric, & Geriatric Emergencies
Failing to maintain privacy and dignity for patients, especially in gynecological or obstetric emergencies.
Medical Emergencies: Recognition & Care
Scene Size-Up
Rapid evaluation of the scene for hazards, MOI/NOI, and resources.
EMS Operations & Professionalism
MOI/NOI
Mechanism of Injury (trauma) or Nature of Illness (medical).
EMS Operations & Professionalism
Primary Assessment
Rapid identification and management of immediate life threats.
EMS Operations & Professionalism
ABCDE
Airway, Breathing, Circulation, Disability, Exposure (trauma primary assessment).
EMS Operations & Professionalism
Secondary Assessment
Detailed head-to-toe exam, vital signs, and patient history.
EMS Operations & Professionalism
SAMPLE History
Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events.
EMS Operations & Professionalism
Ongoing Assessment
Continuous re-evaluation of the patient's condition and interventions.
EMS Operations & Professionalism
Scene Size-Up, Safety, and Patient Assessment
For primary assessment, remember 'A-B-C-D-E, Every EMT Should Do.' Airway, Breathing, Circulation, Disability, Exposure.
EMS Operations & Professionalism
Scene Size-Up, Safety, and Patient Assessment
The NREMT exam will heavily test your ability to prioritize. Remember that scene safety always comes first, followed by identifying and treating immediate life threats in the primary assessment. Look for questions that present a scenario and ask what your 'next immediate action' should be.
EMS Operations & Professionalism
Scene Size-Up, Safety, and Patient Assessment
Entering an unsafe scene without proper PPE or law enforcement clearance.
EMS Operations & Professionalism
Scene Size-Up, Safety, and Patient Assessment
Skipping steps in the primary assessment or not treating life threats immediately.
EMS Operations & Professionalism
Scene Size-Up, Safety, and Patient Assessment
Failing to perform ongoing assessments, especially after interventions or patient status changes.
EMS Operations & Professionalism
Patient Care Report (PCR)
Legal document detailing patient care and events.
EMS Operations & Professionalism
SBAR
Standardized communication for handoffs: Situation, Background, Assessment, Recommendation.
EMS Operations & Professionalism
Continuity of Care
Seamless, uninterrupted patient care across providers.
EMS Operations & Professionalism
Chief Complaint
The main reason the patient called for help.
EMS Operations & Professionalism
Interventions
Actions taken by the EMT to treat the patient.
EMS Operations & Professionalism
Medical-Legal
Pertaining to both medicine and law.
EMS Operations & Professionalism
Run Report
Another term for Patient Care Report (PCR).
EMS Operations & Professionalism
Communication, Documentation, and Transport
For PCR essentials: CHART - Chief complaint, History, Assessment, Rx (treatment), Transport.
EMS Operations & Professionalism
Communication, Documentation, and Transport
On the NREMT, expect questions about the legal implications of documentation, especially regarding refusal of care. Remember that a patient's refusal must be fully documented, including their capacity to make the decision, the risks explained, and any witnesses present.
EMS Operations & Professionalism
Communication, Documentation, and Transport
Failing to document all interventions and patient responses.
EMS Operations & Professionalism
Communication, Documentation, and Transport
Using medical jargon when communicating with patients.
EMS Operations & Professionalism
Communication, Documentation, and Transport
Delaying PCR completion, leading to forgotten details.
EMS Operations & Professionalism
Duty to Act
Legal obligation to provide care once dispatched or initiated.
EMS Operations & Professionalism
Standard of Care
Expected level of performance by a reasonably prudent EMT.
EMS Operations & Professionalism
Expressed Consent
Verbal or non-verbal agreement to treatment by a conscious patient.
EMS Operations & Professionalism
Implied Consent
Assumed consent for unconscious or incapacitated patients needing care.
EMS Operations & Professionalism
HIPAA
Federal law protecting patient health information and privacy.
EMS Operations & Professionalism
Advance Directive
Legal document outlining a patient's wishes for medical treatment.
EMS Operations & Professionalism
DNR Order
Do Not Resuscitate; a type of advance directive.
EMS Operations & Professionalism
Mandated Reporter
Legal requirement to report suspected abuse or certain crimes.
EMS Operations & Professionalism
Medical-Legal & Ethical Issues in EMS
For valid refusal, remember 'CRISP': Capacity, Risks explained, Informed, Signed, Police/Witness.
EMS Operations & Professionalism
Medical-Legal & Ethical Issues in EMS
The NREMT exam often tests your understanding of a 'competent adult' for consent and refusal. Remember that being under the influence of alcohol or drugs does not automatically make someone incompetent; they must demonstrate impaired judgment or inability to understand the consequences.
EMS Operations & Professionalism
Medical-Legal & Ethical Issues in EMS
Failing to thoroughly document a patient's refusal of care, including risks explained.
EMS Operations & Professionalism
Medical-Legal & Ethical Issues in EMS
Discussing patient information with unauthorized individuals (violating HIPAA).
EMS Operations & Professionalism
Medical-Legal & Ethical Issues in EMS
Assuming an intoxicated patient cannot refuse care without assessing their actual mental capacity.
EMS Operations & Professionalism
Mass Casualty Incident (MCI)
Incident exceeding available resources.
EMS Operations & Professionalism
Incident Command System (ICS)
Standardized, on-scene incident management.
EMS Operations & Professionalism
Triage
Sorting patients by injury severity.
EMS Operations & Professionalism
START Triage
Simple Triage And Rapid Treatment system.
EMS Operations & Professionalism
Incident Commander (IC)
Overall incident management authority.
EMS Operations & Professionalism
Span of Control
Number of subordinates a supervisor manages.
EMS Operations & Professionalism
Unified Command
Multiple agencies managing an incident.
EMS Operations & Professionalism
Mass Casualty Incidents and Incident Command
RPM: **R**espirations, **P**erfusion, **M**ental Status – the three key assessments in START triage after checking if they can walk.
EMS Operations & Professionalism
Mass Casualty Incidents and Incident Command
The NREMT exam expects EMTs to understand the basic principles of ICS and START triage, including the color codes and criteria for each category. Memorize the steps of START triage (RPM: Respirations, Perfusion, Mental Status) and the corresponding tag colors.
EMS Operations & Professionalism
Mass Casualty Incidents and Incident Command
Freelancing: Acting independently without coordinating through the ICS structure can create chaos and endanger others.
EMS Operations & Professionalism
Mass Casualty Incidents and Incident Command
Not performing systematic triage: Skipping steps or making assumptions during triage can lead to critical patients being overlooked.
EMS Operations & Professionalism
Mass Casualty Incidents and Incident Command
Using jargon or codes: In an MCI, clear text communication is vital; codes can cause confusion, especially with multiple agencies.
EMS Operations & Professionalism
Oral (PO)
Medication taken by mouth and swallowed.
Pharmacology for EMTs
Sublingual (SL)
Under the tongue for rapid absorption.
Pharmacology for EMTs
Inhaled (Inh)
Breathed into the lungs for respiratory effect.
Pharmacology for EMTs
Intranasal (IN)
Sprayed into the nostril for systemic absorption.
Pharmacology for EMTs
Intramuscular (IM)
Injected into a muscle for systemic effect.
Pharmacology for EMTs
Systemic Effect
Medication absorbed into bloodstream, affects whole body.
Pharmacology for EMTs
Local Effect
Medication acts primarily at site of application.
Pharmacology for EMTs
Medication Administration Routes and Rights
Remember the 'Six Rights' with 'P.M.D.R.T.D.': Patient, Medication, Dose, Route, Time, Documentation.
Pharmacology for EMTs
Medication Administration Routes and Rights
The NREMT exam will test your ability to apply the 'Six Rights' in various scenarios. Pay close attention to patient assessment findings that might contraindicate a specific medication or route, such as altered mental status for oral medications or hypotension for nitroglycerin.
Pharmacology for EMTs
Medication Administration Routes and Rights
Forgetting to check the expiration date of a medication.
Pharmacology for EMTs
Medication Administration Routes and Rights
Administering an oral medication to an unresponsive patient or one without a gag reflex.
Pharmacology for EMTs
Medication Administration Routes and Rights
Not reassessing the patient after medication administration to check for effects or side effects.
Pharmacology for EMTs
Pharmacodynamics
What the drug does to the body.
Pharmacology for EMTs
Pharmacokinetics
What the body does to the drug.
Pharmacology for EMTs
Absorption
Drug movement from site to bloodstream.
Pharmacology for EMTs
Distribution
Drug spread throughout the body.
Pharmacology for EMTs
Metabolism
Chemical alteration of drug (liver).
Pharmacology for EMTs
Excretion
Removal of drug from the body.
Pharmacology for EMTs
Mechanism of Action
How a drug produces its effect.
Pharmacology for EMTs
Receptor
Cellular component drug binds to.
Pharmacology for EMTs
Pharmacodynamics and Pharmacokinetics Basics
ADME: A Drug's Magical Excursion! (Absorption, Distribution, Metabolism, Excretion)
Pharmacology for EMTs
Pharmacodynamics and Pharmacokinetics Basics
NREMT candidates must understand that medication effects are a result of both pharmacodynamic (how the drug acts) and pharmacokinetic (how the body processes the drug) processes. Pay attention to questions describing drug onset, duration, and specific cellular interactions.
Pharmacology for EMTs
Pharmacodynamics and Pharmacokinetics Basics
Confusing pharmacodynamics (drug to body) with pharmacokinetics (body to drug).
Pharmacology for EMTs
Pharmacodynamics and Pharmacokinetics Basics
Underestimating the impact of administration route on drug absorption and onset.
Pharmacology for EMTs