Primary Assessment
39-43%of exam
Treatment + Transport
20-24%of exam
CPRAEDBleedingSplintingMedications
Scene Size-Up
15-19%of exam
BSIPPEMOINOIResources
Operations
10-14%of exam
DocumentationCommunicationLegalTriageHazmat
Secondary Assessment
5-9%of exam
Quick Facts
- Exam
- EMT
- Body
- NREMT
- Format
- CAT
- Questions
- 70-120
- Time
- 2 hr
- Pass
- 950/1500
- Fee
- $104
- Launch
- Apr 7 2025
Primary vs Secondary
Primary
- Life threats
- ABC
- Transport priority
Secondary
- Details
- Focused exam
- History
Threats before details
Airway Picker
- No spine concern→Head-tilt(Open airway)
- Spine concern→Jaw-thrust(Manual control)
- Unresponsive no gag→OPA(Measure mouth-ear)
- Gag present→NPA(Measure nose-ear)
- Secretions/vomit→Suction(Clear airway)
- Poor ventilation→BVM(Ventilate)
Primary ABC
- Impression
- Sick/not sick
- AVPU
- Mental status
- Airway
- Open/patent
- Breathing
- Rate/quality
- Circulation
- Pulse/bleeding/skin
- Priority
- Transport decision
- Vitals
- Baseline data
OPA vs NPA
OPA
- No gag
- Unresponsive
- Mouth to ear
NPA
- Gag tolerated
- Nose route
- Avoid facial trauma
No gag vs gag
Priority Picker
- Unsafe scene→Wait/stage(Responder safety)
- Massive bleeding→Control bleed(Immediate threat)
- No pulse→CPR/AED(CAB)
- Airway blocked→Open/suction(First ABC)
- Shock signs→Rapid transport(Perfusion)
- Stable complaint→Secondary(Focused exam)
Airway + Oxygen
- Head-tilt
- No spine concern
- Jaw-thrust
- Spine concern
- OPA
- Unresponsive no gag
- NPA
- Tolerates gag
- Suction
- Clear fluids
- NRB
- High oxygen
- NC
- Low oxygen
- BVM
- Ventilatory support
Vital Signs
- Pulse
- Rate/quality
- Respirations
- Rate/effort
- BP
- Perfusion clue
- Skin
- Color/temp/moisture
- Pupils
- Neuro clue
- SpO2
- Oxygen saturation
- Glucose
- AMS clue
Cardiac Arrest
CAB: compressions before airway.
CompressionsAirwayBreathingAED
Compensated vs Decompensated
Compensated
- Fast pulse
- Cool skin
- BP maintained
Decompensated
- Falling BP
- Late shock
- Critical
Holding vs failing
Transport Picker
- Major trauma→Trauma center(High priority)
- Stroke signs→Stroke center(Time window)
- STEMI suspected→PCI center(Cardiac)
- OB crowning→Prepare delivery(Stay/assist)
- Unstable airway→Closest ER(Immediate care)
- MCI scene→Triage plan(Distribute patients)
Cardiac + CPR
- CAB
- Arrest sequence
- CPR rate
- 100-120/min
- Adult depth
- 2-2.4 inches
- Ratio
- 30:2 adult
- AED
- Early defibrillation
- Aspirin
- Chest pain
- Nitro assist
- Prescribed only
Shock + Bleeding
- Shock
- Poor perfusion
- Compensated
- BP maintained
- Decompensated
- BP falling
- Direct pressure
- First bleeding step
- Tourniquet
- Severe extremity
- Hemostatic
- Junctional bleeding
- Supine
- Shock position
Trauma Care
- DCAP-BTLS
- Trauma signs
- Spine motion
- Manual stabilization
- Flail chest
- Paradoxical motion
- Sucking wound
- Occlusive dressing
- Evisceration
- Moist sterile cover
- Impaled object
- Stabilize in place
- Burns
- Stop burning
Medical Emergencies
- Asthma/COPD
- Breathing difficulty
- Anaphylaxis
- Epinephrine assist
- Hypoglycemia
- Oral glucose
- Stroke
- Time critical
- Seizure
- Protect airway
- Overdose
- Ventilate first
- OB delivery
- Support crowning
MOI vs NOI
MOI
- Trauma clue
- Forces
- Injury prediction
NOI
- Medical clue
- Complaint pattern
- Illness cause
Injury vs illness
Scene Size-Up
- BSI
- Body substance isolation
- PPE
- Responder protection
- Safety
- Hazards first
- MOI
- Trauma mechanism
- NOI
- Medical nature
- Patients
- Count victims
- Resources
- Request early
START
RPM: respirations, perfusion, mental status.
RespirationsPerfusionMental statusMove walking
Consent vs Refusal
Consent
- Permission
- Express/implied
- Treat allowed
Refusal
- Capacity required
- Explain risks
- Document thoroughly
Accept vs decline
Operations + Legal
- Consent
- Permission to treat
- Implied consent
- Unconscious patient
- Refusal
- Document capacity
- Abandonment
- Improper transfer
- Negligence
- Duty breach harm
- PCR
- Care record
- START
- MCI triage
SAMPLE
Symptoms, Allergies, Meds, Past, Last, Events.
SymptomsAllergiesMedsPastLastEvents
Signs vs Symptoms
Signs
- You observe
- Measurable
- Objective
Symptoms
- Patient reports
- Subjective
- Complaint
Seen vs said
Secondary History
- SAMPLE
- History frame
- Signs
- Observable findings
- Symptoms
- Patient complaints
- Allergies
- Reaction risks
- Meds
- Current drugs
- OPQRST
- Pain assessment
- GCS
- Neuro score
OPQRST
Onset to time tells pain story.
OnsetProvokesQualityRadiationSeverityTime
Common Traps
Safety first
Scene unsafe ≠ Do not enter
Spine airway
Spine concern ≠ Use jaw-thrust
Oxygen vs ventilation
Oxygen supports ≠ BVM ventilates
Shock timing
Anxiety early ≠ Hypotension late
Refusal risk
Capacity matters ≠ Document risks
Secondary timing
After primary ≠ Not before ABCs
Last Minute
- 1.Scene safety before patient contact
- 2.Primary assessment is largest domain
- 3.Airway before detailed history
- 4.Jaw-thrust for spine concern
- 5.NRB gives high oxygen
- 6.BVM fixes poor ventilation
- 7.Direct pressure before tourniquet
- 8.Hypotension is late shock
- 9.SAMPLE collects history
- 10.Document refusals carefully
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