Free EMT/NREMT Exam Flashcards

ABCDE organizes assessment: Airway, Breathing, Circulation, Disability, and Exposure. Treat life threats as you find them and reassess; do not finish the mnemonic before acting. Adult cardiac arrest requires prompt CPR beginning with compressions, while critical bleeding needs immediate control under the applicable protocol. Protect privacy and warmth during exposure; team tasks may occur simultaneously.

A = alert, V = responds to voice, P = responds to pressure/painful stimulus, U = unresponsive. AVPU is a rapid, less detailed assessment than the Glasgow Coma Scale. Alert does not by itself prove orientation: assess confusion and the underlying cause, and document changes. Some clinical assessment systems explicitly add C for new confusion (ACVPU).

Record eye opening (1-4), verbal response (1-5), and motor response (1-6), with the actual observed responses. If all components are testable, totals range from 3 to 15: E2 + V4 + M6 = 12. Mark an untestable component NT and explain why; do not invent a total. A low or falling score prompts urgent airway/ventilation assessment and escalation within EMT scope, not automatic intubation based on a score alone.

S = Signs/Symptoms, A = Allergies, M = Medications, P = Past medical history, L = Last oral intake, E = Events leading to the incident. Collected during secondary assessment from patient or bystanders.

O = Onset (what were you doing?), P = Provocation/Palliation (what makes it better/worse?), Q = Quality (sharp, dull, crushing?), R = Radiation (does it move?), S = Severity (1-10 scale), T = Time (when did it start?).

For a calm, resting adult, typical pulse is 60-100/min and respiratory rate 12-20/min. AHA normal blood pressure is below 120 mmHg systolic AND below 80 mmHg diastolic; a normal pressure does not rule out shock. Average temperature is about 37°C (98.6°F), varying by person, time, activity, and measurement. Interpret SpO2 with breathing and perfusion: poor circulation, pigmentation, temperature, and nail polish can affect accuracy. Record pupil size, equality, and reaction; compare trends and the clinical picture.

Without suspected cervical injury, use head tilt-chin lift for an unresponsive adult. With head/neck trauma, trained rescuers first use a jaw thrust without head extension. If jaw thrust and an appropriate airway adjunct cannot open the airway, use head tilt-chin lift: oxygenation and ventilation take priority. Limit spinal movement manually as feasible; suspected injury must not leave the airway obstructed.

Airway opening technique for patients WITH suspected spinal injury. Place fingers behind the angle of the mandible and push jaw forward. Maintains neutral C-spine alignment. Preferred in trauma patients.

Rigid airway adjunct inserted into the mouth. Sizing: corner of mouth to earlobe or angle of jaw. Insert upside-down, rotate 180° (adults). Used ONLY in unresponsive patients with NO gag reflex. Prevents tongue from blocking airway.

Flexible rubber airway inserted through the nostril. Sizing: tip of nose to earlobe. Lubricate with water-soluble lubricant. Can be used in patients WITH a gag reflex. Contraindicated in suspected basilar skull fracture.

Manual ventilation device. Deliver over 1 second per breath. Adult: 500-600 mL per breath. Rate: 10-12 breaths/min (adults), 12-20 (peds). Connect to high-flow O2 at 15 L/min. Two-person technique preferred for proper seal.

Oropharyngeal: rigid (Yankauer) catheter, suction no longer than 15 seconds. Measure catheter like OPA. Do not insert past base of tongue. Logroll patient and suction if vomiting. Pre-oxygenate before suctioning.

Spectrum of conditions from unstable angina to STEMI. Symptoms: chest pain/pressure, dyspnea, diaphoresis, nausea, radiation to arm/jaw. EMT treatment: oxygen if SpO2 <94%, aspirin 324 mg (chewed), nitroglycerin (if prescribed), rapid transport.

1) Early recognition and activation of EMS, 2) Early CPR, 3) Early defibrillation, 4) Early advanced cardiac life support, 5) Post-cardiac arrest care, 6) Recovery. Each link must be strong for best patient outcome.

Rate: 100-120 compressions/min. Depth: at least 2 inches (5 cm) but no more than 2.4 inches. Full chest recoil between compressions. Minimize interruptions (<10 seconds). Ratio: 30:2 (compressions to ventilations). Switch compressors every 2 minutes.

Power on, attach pads (right clavicle, left axilla). Analyze rhythm—ensure no one is touching patient. Shockable rhythms: V-fib, pulseless V-tach. Deliver shock if advised, immediately resume CPR for 2 minutes. Reanalyze after each cycle.

Early: anxiety, restlessness, tachycardia, pale/cool/clammy skin. Late: hypotension, altered mental status, weak/thready pulse, cyanosis, delayed capillary refill (>2 sec). Treat cause, position supine, keep warm, high-flow O2, rapid transport.

1) Direct pressure (most effective for external bleeding), 2) Tourniquet (extremity, life-threatening bleeding—apply high and tight), 3) Hemostatic agents, 4) Wound packing. Do NOT remove dressings once applied; add more on top.

Arterial: bright red, spurting, pulsatile—most dangerous. Venous: dark red, steady flow. Capillary: oozing, slow—usually self-limiting. Arterial bleeding is life-threatening and requires immediate tourniquet or direct pressure.

Indicated for mechanism of injury with suspected spinal trauma: falls >3 feet, diving injuries, MVA, penetrating trauma near spine. Manual stabilization, apply cervical collar, secure to long backboard. Maintain neutral alignment.

Simple: air in pleural space, lung partially collapses. Tension: air accumulates with no exit, compresses heart/great vessels—life-threatening. Signs of tension: tracheal deviation, JVD, absent breath sounds, hypotension. Treat: needle decompression (ALS).

Head: 9%. Each arm: 9%. Chest: 18%. Back: 18%. Each leg: 18%. Groin: 1%. Patient's palm = ~1% BSA. Critical burns: >25% BSA, face/airway/hands/feet/genitalia, circumferential, chemical/electrical, with inhalation injury.

Two or more adjacent ribs fractured in two or more places, creating a free-floating segment. Paradoxical movement: segment moves inward during inspiration, outward during expiration. Treat with positive pressure ventilation and stabilize the segment.

Three tests: (1) Facial droop—have patient smile, (2) Arm drift—extend both arms, eyes closed, (3) Speech—repeat a phrase clearly. Any ONE abnormality = 72% probability of stroke. Note time of symptom onset (critical for treatment decisions).

Hypoglycemia (BGL <60): rapid onset, cool/clammy skin, altered mental status, seizures. Treat: oral glucose if conscious. Hyperglycemia (BGL >300): gradual onset, warm/dry skin, Kussmaul breathing, fruity breath odor. Both need rapid transport.

Severe allergic reaction causing airway swelling, bronchospasm, and vasodilation. Signs: hives, wheezing, stridor, hypotension, tachycardia, facial swelling. Treatment: epinephrine auto-injector (0.3 mg adult IM, lateral thigh), high-flow O2, rapid transport.

During seizure: protect from injury, do NOT restrain or place anything in mouth, time the seizure. Post-ictal: maintain airway (recovery position), suction if needed, high-flow O2. Status epilepticus: seizure >5 min or repeated without regaining consciousness—emergency.

Asthma: reversible airway constriction, wheezing, younger patients, triggered by allergens/exercise. COPD: chronic, irreversible airway disease (emphysema/chronic bronchitis), older patients, smoking history. Both: bronchodilator (assist prescribed MDI), O2, position of comfort.

Scene safety first (hazmat?). Identify substance if possible. Contact Poison Control (1-800-222-1222). Assess ABCs, monitor vital signs. Naloxone (Narcan) for opioid overdose: 2 mg IN or IM. Do NOT induce vomiting. Bring containers/medications to hospital.

EMTs can administer: oral glucose (hypoglycemia), aspirin (ACS), epinephrine auto-injector (anaphylaxis), naloxone (opioid OD), albuterol via nebulizer (some states). Can ASSIST with: nitroglycerin, metered-dose inhalers (patient's prescribed medications).

Vasodilator for chest pain. Dose: 0.4 mg sublingual, may repeat every 5 min up to 3 doses. Contraindications: SBP <100 mmHg, head injury, ED medications (sildenafil) in last 24-48 hours, right ventricular infarction. Side effects: headache, hypotension.

For severe allergic reaction/anaphylaxis. Adult: 0.3 mg (EpiPen). Pediatric: 0.15 mg (EpiPen Jr, for <30 kg). Inject into lateral mid-thigh through clothing if needed. Hold for 10 seconds. May repeat in 5-15 minutes. Side effects: tachycardia, anxiety.

Rapid visual assessment from the doorway: (1) Appearance—tone, interactiveness, consolability, look/gaze, speech/cry (TICLS), (2) Work of Breathing—nasal flaring, retractions, positioning, (3) Circulation to Skin—pallor, mottling, cyanosis.

Compression depth: 1/3 AP diameter (infant: 1.5 inches, child: 2 inches). Rate: 100-120/min. Ratio: 30:2 (single rescuer), 15:2 (2 healthcare providers). Infant technique: heel of one hand or two-thumb encircling (two-finger eliminated in 2025). Most pediatric arrests are respiratory in origin.

Croup: viral, gradual onset, barking/seal-like cough, low-grade fever, steeple sign on X-ray, ages 6mo-3yr. Epiglottitis: bacterial (H. influenzae), rapid onset, drooling, tripod position, high fever, thumb sign on X-ray, do NOT examine throat—airway emergency.

Support head as it delivers, check for nuchal cord (slip over head or clamp/cut), suction mouth then nose, deliver anterior shoulder (gentle downward traction), then posterior shoulder. Dry and stimulate newborn. Clamp cord at 6 inches and 9 inches from baby.

Assess at 1 and 5 minutes after birth. Appearance (color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), Respirations. Each scored 0-2. Total 7-10: normal. 4-6: moderately depressed. 0-3: severely depressed, needs aggressive resuscitation.

Simple Triage And Rapid Treatment. Walk? → Minor (Green). Breathing? No → reposition airway → still no → Expectant (Black). Respiratory rate >30? → Immediate (Red). Radial pulse absent or CRT >2s? → Immediate (Red). Follows commands? No → Immediate (Red). Yes → Delayed (Yellow).

Standardized management for emergencies. Key roles: Incident Commander (overall authority), Operations (tactical), Planning (strategy), Logistics (resources/supplies), Finance/Admin (costs). Unified command for multi-agency incidents. Span of control: 3-7 (optimal 5).

EMR (Emergency Medical Responder): basic first aid, CPR, AED. EMT (Emergency Medical Technician): BLS, airway management, medications. AEMT: IV, some medications. Paramedic: ALS, intubation, cardiac monitoring, IV medications, surgical airways.

Expressed: competent adult verbally or in writing agrees to treatment. Implied: assumed for unconscious or incapacitated patients (life-threatening situations). Minors: consent from parent/guardian except for emancipated minors or emergencies (implied consent applies).

Mild (90-95°F): shivering, confusion—passive rewarming (blankets, warm environment). Moderate (82-90°F): loss of shivering, decreased LOC—active rewarming (warm packs to core). Severe (<82°F): unresponsive, V-fib risk—handle gently, no rough movements, limit to one defibrillation if <86°F.

Heat exhaustion: heavy sweating, cool/moist skin, normal/slightly elevated temp, weakness, nausea. Treat: cool environment, fluids. Heat stroke: NO sweating, hot/dry/red skin, temp >104°F, altered mental status—LIFE THREATENING. Treat: rapid cooling, ice packs to neck/axillae/groin.

Assume cervical spine injury (diving, unknown mechanism). Begin rescue breathing ASAP (even in water if trained). CPR on firm surface. Focus on ventilation (drowning is primarily a respiratory emergency). Suction as needed. All submersion patients require hospital evaluation.

Ensure scene safety (request law enforcement if needed). Use calm, non-threatening approach. Maintain safe distance. Do NOT make sudden movements. Never leave patient alone. Assess for medical causes (hypoglycemia, hypoxia, head injury). Document thoroughly.

Potentially fatal condition: extreme agitation, paranoia, superhuman strength, hyperthermia, imperviousness to pain. Often associated with stimulant use or psychiatric crisis. High risk for sudden cardiac arrest. Request ALS, prepare for chemical sedation, continuous monitoring.

Health Insurance Portability and Accountability Act protects patient health information (PHI). EMTs may share PHI only for treatment, payment, or healthcare operations. Minimum necessary standard applies. Violations can result in fines up to $250,000 and imprisonment.

Must prove all four: (1) Duty to act—EMT had an obligation, (2) Breach of duty—deviated from standard of care, (3) Causation—breach caused the injury, (4) Damages—patient suffered actual harm. Absence of any element = no negligence.

Legal document directing EMS not to perform CPR/resuscitation. Must be verified as valid (signed by physician, current). If validity is uncertain, begin resuscitation. DNR applies to cardiac arrest only—still treat other conditions. Follow local protocols.

EMTs are mandated reporters for: suspected child abuse/neglect, elder abuse, domestic violence (varies by state), gunshot wounds, stab wounds, animal bites, certain infectious diseases. Report to appropriate authorities. Document objectively—do not accuse.