By: Mario Martinez @ Amateur Medicine on YouTube
Link to Channel: https://www.youtube.com/@amateurmedicine
Link to Video that goes along with this word document:
Link to NREMT-B study guide bundle:
NREMT-B Study Bundle – Amateur Medicine
Check out Amateurmedicine.com to access 500+
handpicked NREMT-B practice questions, 120+ Vital
Signs questions, as well as a GCS, APGAR, and Rule of
Nine Mastery Course (with custom PDF’s). There is also
an updated version of this study guide, along with one
that’s completely filled out.
You can download this document from Google
Doc’s, and then utilize it in a Microsoft Word
document or you can print this either one works.
Vital Signs: (0:03:01)
Blood Pressure:
Heart Rate:
SPO2:
Respiratory Rate:
Temperature:
FSBG (Finger Stick Blood Glucose):
What are some Medications an EMT-B can Administer:
(Note: This depends on your medical director, local protocol and SOG’s, do not utilize this
information utilize your department or agencies protocols/SOG’s!) (0:16:22)
1.)
2.)
3.)
4.)
5.)
6.)
7.)
8.)
9.)
What Oxygen Devices can you use?(0:30:35)
1.) _____________________ at 2-6 LPM O2
2.) _____________________ at 10-15 LPM O2
3.) _____________________ at 6-8 LPM O2
4.) _____________________ at 15 LPM O2
Airway Section: (0:37:07)
The Head tilt-chin method vs. the Jaw-Thrust method, why do we use either one?
They’re both methods to manipulate an airway to open it however…
The head tilt-chin method is utilized for patients who did not have trauma.
The jaw-thrust method is for patients who DID HAVE TRAUMA.
If you find an unconscious patient on the floor unless it was a witnessed controlled slow descent,
you MUST assume that it was traumatic, and that along with C-spine precautions you need to
utilize a jaw-thrust method!
Air has approximately how much oxygen?
It has 21 % Oxygen.
For capillary refill, basically if you squeeze a fingernail and let it go the time it takes to turn back
to its normal color is the capillary refills, you want it to be <2 seconds. Greater than 2 seconds is
a sign of inadequate perfusion and not good!
CO = SV x HR
What does that formula mean? It’s the formula for Cardiac Output = Stroke Volume x Heart
Rate. Did I ever use it after taking the National? No. Did the National ask me about the
formula? Yes. So you need to memorize it.
Minute Volume = Tidal volume x Respiratory Rate
This formula is one that I didn’t have during the National, but something you may just want to
glance over at least.
One big thing when do you use a BVM vs. a NRB (Non re-breather)? What about a nasal
cannula or a Nebulizer? Here’s the way I think of these four devices…
If a patient can control their airway, then we don’t need to ventilate for them. What are two vital
signs that we can assess to check someone’s airway? Specifically what are the two ranges for
them?
1.) SPO2 95 – 100%
2.) Respiratory Rate 12 – 20 breaths per minute
With that being said this is the ranges I personally use for airway devices. ((With some
exceptions for COPD patients))
1.) Nasal cannula: 88 – 94% SPO2, normal respiratory rate *** However if someone’s
unconscious I will never put one on a patient. ****
2.) Non-rebreather mask: 87% or lower SPO2, normal respiratory rate *** However if
someone’s unconscious I will never put one on a patient. ****
3.) Bag-valve mask: 94% SPO2 or lower with a low respiratory rate (also shallow respirations
let’s say at around 30 breaths per minute), this is generally for unconscious patients unless they
are semi conscious with a low respiratory rate (<12 breaths per minute) ((In the national this is
usually 8 breaths per minute)).
4.) Nebulizer: This is generally indicated for wheezing patients, you are looking for someone
who has asthma and is currently (but not limited to) an asthma attack.
When someone has a facial trauma with a suspected basilar skull fracture what airway device is
contraindicated?
1.) NPA (Nasopharyngeal airway device)
When suctioning how long can you suction an adult or a child? (some text will vary) Answer at
00:40:40
-​ Adult: __ seconds max
-​ Pediatric: __ seconds max
If someone has snoring respirations what can you suspect is in the way?
-​ The Tongue
What does paradoxical motion mean of the chest?
-​ This is when one side of the chest rises/falls, while the other doesn’t
What would we call this phenomenon?
-​ A flail segment, or a flail chest!
If you auscultate somebody’s lung sounds and note that there is only air moving from one side of
the chest (or at least diminished lungs sounds on one side of the chest), what should you
consider? This is generally trauma related:
-​ A pneumothorax!
If someone has cherry red skin and is at home with dizziness/lightheadedness, what respiratory
issue should you be possibly concerned about?
-​ Carbon Monoxide Poisoning!
What’s interesting about these individuals is that they have a high SPO2 reading, but since
carbon monoxide binds to their heme (iron) molecules 200 x more then oxygen roughly, they
won’t have enough oxygen, even though their SPO2 reading is in the normal range.
You NEED to know two important respiratory issues for children!
Croup: It’s caused by a VIRAL infection!!!
-​ Noted by a seal / bark like cough
Epiglottitis: It’s caused by a BACTERIAL infection!!!
-​ Noted by drooling!! As well as signs / symptoms such as a sore throat, a fever, and a
tripod position.
-​ It’s extremely important to keep these patients in a position of comfort, be extremely
careful moving or agitating these patients in any way because you can cause their
Epiglottis to close up.
Tripod Position: Think respiratory distress!! Usually when someone is sitting down leaning
forward struggling breathing. When you see this on your national alarms should be saying hey
respiratory respiratory respiratory, or at least slightly think of it.
If you see a patient with very deep and rapid respirations that are diabetic, what are these
respirations called?
-​ Kussmaul respirations
Are these patients hyperglycemic or hypoglycemic?
-​ They are hyperglycemic, for Kussmaul respirations it’s found in Diabetic Ketoacidosis
patients, (extremely high blood sugar patients).
Cardiology & Resuscitation: (0:45:44)
Tracing a drop of blood throughout the body:
*Deoxygenated blood*
Know how to trace a drop of blood from start to finish:
Blood enters the RT atrium
Goes through the Tricuspid Valve
Enters the RT Ventricle
Goes through the Pulmonary Artery
Goes to the lungs for Gas Exchange
*Oxygenated blood*
Goes through the Pulmonary Vein
Goes to the LT atrium
Goes through the Bicuspid/Mitral Valve
Enters the LT ventricle
Travels through the Aorta through Arteries and Arterioles
Then heads to Capillaries and Oxygenates Tissues while receiving CO2
*Deoxygenated Blood*
Travels through Venules and Veins
Goes to Superior and Inferior Vena Cava back to the RT atrium
Special note for tracing the blood: Be aware that for the Pulmonary artery it’s transporting
deoxygenated blood away from the heart. The Pulmonary vein transports oxygenated blood
towards the heart.
If you are transporting a patient and they go into cardiac arrest, what do you do first? Answer at
00:48:55
-​
If the AED shocks the patient, what do you immediately do next? Answer at 00:49:35
-​
Note for CPR a big factor isn’t just compressions but also the recoil of the heart to fill back up
every compression.
What are EMT-B medications you can consider for a chest pain call, of course without any
allergies to the medication or contraindications? Answer at 00:50:32
1.)
2.)
3.)
Congestive heart failure where fluid builds up in the lungs may be caused by left sided heart
failure.
Pedal Edema is where fluid builds up to the lower extremities and may be caused by right sided
heart failure.
Sympathetic Nervous System: Causes the fight or flight system, it’s generally when the body
increases its heart rate and decreases intestinal activity.
Parasympathetic Nervous System: Causes the heart rate to slow down, but increases digestion.
Also known as Rest and Digest.
What type of drugs can cause the Parasympathetic Response System?
-​ Opioids
And what EMT-B Drug can assist with reversing this? Answer at 00:52:06
-​
**We want to reverse this in times where we are concerned that the opioid may be causing a
patient to have an altered mental status, or they may slow down their breathing to the point
where they can go into respiratory failure**
For a heart beat there are four sounds S1, S2, S3, and S4.
You can explore this topic more but really just understand S1 and S2.
S1 makes the “Lub” noise (when the atrioventricular valve closes)
S2 makes the “Dub” noise (When the semilunar valve closes)
What depth do you want in compressions for an adult patient? What about a child/infant?
Adult: 2 – 3 inches depth
Child/Infant: 1/3 the depth of the chest
You want to aim for 100 – 120 compressions for minute.
CPR by yourself should be at what rate?
-​ 30:2 compressions to ventilations, (30 compressions, 2 ventilations)
If you are with your PARTNER and you have an INFANT, so 2 rescuers and an infant what rate
can you implement? Answer at 00:53:45
-​ ____ compressions to ventilations
If you’re placing the AED on a patient and they have an implanted pacemaker or defibrillator,
place the AED pads a couple inches away from the area of the implant.
If someone’s wearing a medication patch remove the patch before applying the AED.
If someone’s pulled out from a pool dry them off prior to placing the AED pads as best as
possible.
When we get a pulse back during CPR what is this called? Answer at 00:55:06
1.)
If we shock someone with the AED what’s the very next thing we do?
-​ Start CPR for 2 minutes!
Medical/Obstetrics/Gynecology: 0:55:55
There are 3 Types of Strokes:
1.) Ischemic Strokes: Clot causing a lack of oxygen to part of the brain causing a stroke
2.) Transient Ischemic Attack (TIA): Clot that dissipated by itself in less than 24 hours,
reversing stroke like symptoms on its own.
3.) Hemorrhagic Strokes: A brain bleed, while we can’t visualize what’s going on internally a
huge hallmark distinguishing this from an Ischemic stroke is that the patient will generally have
HIGH BLOOD PRESSURE!!!!! YOU NEED TO KNOW THIS!
Strokes are a neurological issue referring to damage of the brain either caused by a clot
(Ischemic/TIA), or a bleed (Hemorrhagic).
-​ You’re may see different signs and symptoms, like an altered mental status, dizziness,
numbness to an extremity(s), but the big hall marks are paralysis or weakness to one side
of the body (hemiparesis), along with weakness noted on the face.
-​ That’s why if you suspect a stroke or note any obvious weakness it’s very very important
that you complete a stroke exam!
There’s the Cincinnati stroke scale where we look for Facial droop, Arm Drift, and
Abnormalities in Speech.
There’s the FAST stroke assessment where we look at a patient's facial weakness, arm weakness,
their speech, and the time it occurred.
There’s also the VAN assessment, where we look at the patients Vision, Aphasia (difficulty
speaking), and Neglect (lost awareness of one side of the body).
For our Stroke patients we want to get them to the hospital as fast as possible, but make sure on
scene you gather when they were last seen normal and pertinent information from family
members that may be present or the patient if they’re responsive.
-​ If the stroke symptoms were less than 3 – 4.5 hours when they arrive at the ER they may
be eligible for thrombolytic drugs to break the clot, so long as a CT scan displays no
evidence of a hemorrhagic stroke. Even if they’re not eligible, bringing them to the
hospital immediately is still extremely important.
If someone is having a seizure as an EMT-B what should you do? Answer at 01:01:12
1.)
You don’t have access to sedatives! We need to stop the patient from seizing as soon as possible,
and while it may eventually stop on its own, we need to have ALS on route just in case it doesn’t
so they can administer the correct RX.
Hyperglycemia (high blood sugar) is bad. Hypoglycemia (low blood sugar) is deadly!
-​ If the patient can protect their own airway, and they are A&O x 4 (!!!!) then you can
consider administering what medication if they’re Hypoglycemic? Answer at 01:02:47
1.)
What is A&O x 4? It’s to assess if a patient is alert & oriented x 4 or generally their mental
status. We need to check at minimum four different things to assess this:
1.) Person
2.) Place
3.) Time
4.) Event
If they are not A&O x 4 or if they can’t protect their own airway but they have Hypoglycemia
what can we do as an EMT-B?
1.) Request ALS Intercept!
- If you give these patients Oral Glucose and they can’t protect their own airway/not A&O x 4,
you can potentially cause them to Aspirate (Choke) and kill them!
For the abdomen, it’s cut into 4 different sections!
1.) RUQ (Right upper quadrant)
2.) RLQ (Right lower quadrant)
3.) LUQ (Left upper quadrant)
4.) LLQ (Left lower quadrant)
- Some special considerations!! If someone has RLQ abdominal pain what should you always
suspect?
1.) Appendicitis BIG TEST QUESTION
- A huge test question, if someone has LUQ abdominal pain and should pain what abdominal
organ should you suspect?
1.) The Spleen!! THIS IS A HUGE TEST QUESTION a lot of students miss this!
Be wary when palpating the abdomen!! If someone says they have RLQ abdominal pain what
area should you palpate first?
1.) The LUQ
Why? This is because if you start at the RLQ or too close to it the patient may wince out in pain
and curl up, halting further assessment of the abdomen!
When someone is having a tearing sensation in their abdomen that radiates to their back what
should you consider that they’re experiencing? Answer at 01:08:21
-​ An ________________, you need to go code 3 to your nearest trauma facility at once if
someone describes a tearing sensation as described earlier! (they may also feel a
pulsating mass in their abdomen, but the tearing part is the main indicator).
When a patient has a STIFF NECK, fever, headache, what should you suspect they may have?
Answer at 01:09:53
1.)
If someone has hepatitis C, or some form of liver failure what should you generally be looking
for?
-​ Jaundice (yellowing of the skin or the eyes)
If somebody starts coughing up BLOODY SPUTUM what should you expect?
-​ Tuberculosis!! If you see this back away and wear proper PPE if you haven’t already!
This is very contagious!
Excited Delirium: When a patient becomes agitated, hostile, with a frenzied bizarre behavior.
These patients are diaphoretic and can potentially be FATAL!! These patients may hurt you,
others, and themselves!! If a patient presents this way what can you as an EMT-B do? Answer
at 01:11:40
-​
For heat related emergencies…
Heat Exhaustion: The patient is still able to sweat with the body trying to cool itself off.
Heat Stroke: The patient is no longer able to sweat!! An altered mental status may occur as well
along with hypotension.
-​ If someone is experiencing either of these emergencies one of the first things we want to
try to do is remove them from the exposure to the heat related source, such as bringing
them to the AC regulated ambulance/medic unit.
If you pull somebody out of a body of water / pool that was near-drowning but now they’re
“okay” and don’t want to go to the hospital what should you do?
-​ Highly highly encourage them to go!! The bacteria infection that could be developing in
their lungs can be extremely dangerous! Secondary drowning can also occur where
individuals develop pulmonary edema (fluid in the lungs), and they can die that way later
on.
For snake bites: If they are bitten in the arm keep the patients arm at a lower level then their
heart, DON’T place ice on the bite, DON’T use a tourniquet to stop the spread of venom, circle
the area effected of course this depends on the type of snake but it’s still important to do.
Some but not all tick bites can transmit rocky mountain spotted fever (causing nausea, vomiting,
headache, weakness, and paralysis 7 – 10 days after the bite) or Lyme disease (days to weeks
after the bite causing joint pain and a ring around the bite).
You need to know Gravida and Para!
Gravida: How many times a patient has been pregnant
Parity (Para): How many times a patient has given birth
For instance, if a female patient has been pregnant 3 times and has 1 child, you would say she
has 3 Gravida and 1 Parity.
You DEFINETLY need to know these terms:
Placenta Previa: Described after 20 weeks of pregnancy where the placenta is formed in an
abnormal location. The patient will present with PAINLESS BRIGHT RED VAGINAL
BLEEDING!
Abruptio Placenta: When the placenta separates itself from the uterine wall, usually found in
traumas. You would be looking for PAINFUL ABDOMEN WITH VAGINAL BLEEDING!
Ectopic Pregnancy: When the fertilized egg implants on the fallopian tubes.
Pre – eclampsia: When a female has hypertension (will vary the range to consider at
Pre-eclampsia depending on local protocols), you may see swelling of the limbs, and is pregnant,
can potentially lead to Eclampsia! Request ALS Intercept if you have a patient with this as they
can administer a medication to help with this.
Eclampsia: Same symptoms as Pre-eclampsia but the patient is seizing or had a seizure! This is
extremely dangerous! Request ALS Intercept if you have a patient with this as they can
administer a medication to help with this.
What is Meconium Staining?
-​ It’s amniotic fluid that is greenish or brownish yellow as a result of fetal defecation that
can appear over a newborns face. If this is the case, do you suction their mouth or their
nose first? Answer at 01:19:44
1.)
When a female patient is pregnant and has suspected imminent delivery with <2 minutes of
contractions what do you need to do if you’re driving to the hospital?
-​ Pull over and prepare for imminent childbirth. You’ll need your partners help.
What are some delivery emergencies that we can lead to complications?
1.) Nuchal Cord: The umbilical cord is wrapped around the baby’s neck, if there’s enough slack
we can try unwrapping the cord from the baby’s neck. If we can’t then we need to clamp and cut
the cord appropriately.
2.) Prolapsed cord: When the umbilical cord presents itself first and is being squeezed between
the vaginal wall and the child’s head. This is the ONLY time you can insert a gloved hand inside
the vagina and lift the baby’s head off the cord. (We can also try raising the mom’s pelvis
slightly to try to alleviate some pressure).
3.) Limb presentations: This is a complicated one depending on the limbs present, if we have
both legs or the buttocks present first we can potentially deliver this on the field but it’s not ideal,
this is considered a Breech Delivery. HOWEVER we CANNOT deliver a single limb
presentation with one arm or one leg presenting. You just need to transport very quickly within
reason to the appropriate hospital. Raising the mother’s pelvis again can assist with providing
you slightly more time.
The APGAR scale table near the bottom of this review, I’d highly recommend studying it
because you will get a question on the NREMT asking about it most likely. After a female
patient gives birth to a child when do you perform an APGAR exam? Answer at 01:22:47
1.)
2.)
Trauma: 01:23:46
Instead of ABC’s, we sometimes say XABC
X: Exsanguination (severe loss of blood)
A: Airway
B: Breathing
C: Circulation
For penetrating traumas never remove the impaled object, leave it in place and stabilize it.
If someone’s injured in their eye, let’s say a knife is inside of it, don't just bandage and stabilize
that eye, cover the other one too! This helps keep the affected eye from moving in the same
direction when the unaffected eye looks around. (The movie Code 3 2025 showed this really
well)
Know that traumatic injuries to the brain can sometimes take several days to develop depending
on the type of hematoma.
KNOW what is Coup-Countercoup injury of the brain!
Coup injury, the anterior injury of the brain (front)
Countercoup, the posterior injury of the brain (back)
We generally think of this when someone hits a steering wheel when driving and gets into a
crash, or more so with spidering on a windshield, indicating maybe they hit the head on the
windshield!
Know the different types of fractures!!!
But specifically know this one
Greenstick Fracture: One side of the bone is broken, the other side is not, known as a hairline
fracture.
This definitely is the biggest one in my personal opinion for EMS questions.
If someone has a closed femur fracture what can we consider to utilize? Answer at 01:28:08
-​
When can’t we use it? When someone has an open femur fracture!
When we see bright red blood spurting out of someone what do we do first?
We compress! Then we tourniquet if it doesn’t work.
Know what a pericardial tamponade / cardiac tamponade is! It’s when fluid builds up around the
heart, making it more and more difficult for the heart to pump.
Let’s talk about burns!
There are three types of burns
First Degree Burns (Superficial Burn): Think of a sunburn, displayed by red skin and pain.
Second Degree Burns (Partial Thickness Burn): Redness and specifically blistering can appear
during a second degree burn, followed with pain.
Third Degree Burns (Full Thickness Burn): The skin appears white, gray, or even leathery, and
individuals won’t feel pain directly at the area (not good).
Know what Ecchymosis means, it just means bruising.
EMS Operations: 01:32:02
Know the NFPA 704 Tetrahedron!
Blue: Health Hazard
Red: Fire Hazard
Yellow: Instability/Reactivity
White: Specific Hazard
Red, Yellow, and Blue go from 4 – 0 with 4 being the worst except for the White which has
special symbols.
Most ambulance crashes occur at: __________ Answer at 01:33:05
You should utilize what when reversing: A spotter
For a helicopter landing zone, the site needs to be at least: 100’ x 100’
Regarding Radios:
A Repeater: It receives signals from lower powered radios either mobile or portable, then sends
them out at higher strengths.
Mobile Radio: Radios mounted inside ambulances or another apparatus.
Portable Radio: Radio carried on a person
Simplex radio system: Only allows one person to transmit at a time.
Duplex radio system: Allows both users to transmit and receive at the same time, like a cell
phone.
Know these legal terms:
Battery: Placing hands on someone without consent, causing harm physically
Assault: Causing harm verbally, verbal threats or intimidation
Abandonment: Initiating care then destoning patient-provider relationship, can also be
considered if you are an EMT-B and transfer your patient to an EMR since it’s lower-level care
technically.
Negligence: Deviation from accepted standard of care, resulting in injury to your patient.
Advanced Directive: Instructions given in advance such as a DNR (Do Not Resuscitate).
Implied Consent: Consent given without being able to directly say so, which can be inferred
from a person’s actions, gestures, or inaction.
Hazmat response:
EMS should be set up in the COLD zone during a hazmat incident.
Decontamination occurs in the WARM zone.
Never enter the Hot Zone, It’s for Hazmat Technicians.
Remember to stay Uphill / Upwind.
Know the command system:
Span of Control: 3 -7 people per leader, 5 is the optimal amount of people.
Unified Command: Several agencies working independently but cooperatively.
Your safety comes first in every operation, it’s life safety, incident stabilization, and then
property conservation!
Understand START Triage!
Red: Priority 1, Critical life-threatening injuries
Yellow: Priority 2, Not life threatening but can potentially become so later on
Green: Priority 3, Walking wounded patients
Black: Priority 4, Dead or fatally injured
Extra Important Information:
Know How to Calculate a Glasgow Coma Scale! (GCS Scale) You will most likely have one
question regarding this!!
15 is considered a perfect score
3 is the lowest score possible
Fill this out to practice it!
Eye opening (4)
4: Opens spontaneously
3: Opens to voice
2: Opens to painful stimuli
1: Does not respond
Verbal Response (5)
5: A&O x 4, oriented to person, place, time, and event
4: Confused
3: Inappropriate words
2: Incomprehensible sounds
1: No response
Motor Response (6)
6: Obeys commands
5: Moves to localized pain
4: Flexes to withdraw from pain
3: Abnormal flexion
2: Abnormal extension
1: No response
Apgar Scale: This is utilized to assess a newborn’s health by evaluating five characteristics, it
can range from a 0 – 10 with a higher number being better. After an initial assessment during the
first minute of birth, you need to repeat this a second time at 5 minutes, hopefully with
improvement.
YOU WILL MOST LIKELY HAVE 1 QUESTION BASED OF THIS SCALE!!! LEARN IT!
Abbreviation
A
P
G
Term
Activity
Pulse
Grimace
0 points
Absent
Absent
Floppy
A
Appearance
Blue / Pale
R
Respiration
Absent
1 point
Flexed limbs
< 100 BPM
Minimal
response to
stimulation
Pink Body, blue
extremities
Slow and
Irregular
2 points
Active
> 100 BPM
Prompt response
to stimulation
Pink
Crying
Anatomy: We will discuss briefly some important things to note for the anatomy of a
patient.
The Anatomical Plane: You MUST understand this concept, I will show it on video of what it
looks like but basically, it’s you standing up displaying your palms on your side.
-​ This is extremely important to know because if for instance I asked what is medial/lateral
comparing your pinky and your thumb what would you say?
-​ The answer would always be the pinky is medial to the thumb! This is because in regard
to the anatomical position the pinky will always be closer to the middle of your body than
your thumb.
What about distal versus proximal though? Distal is further from the center of the body,
proximal is closer. So, with that being said is your wrist distal or proximal to your elbow?
1.) The answer is that the wrist is distal to your elbow since it’s further from the core then your
elbow.
There is an extremely low chance this will be a question but still:
What is considered the upper airway?
-​ The Nasal cavity, Oral cavity, Nasopharynx, Oropharynx, Laryngopharynx, Epiglottis,
and the Larynx.
What is considered the lower airway?
-​ The Trachea, Bronchi, Bronchioles, and the Alveoli.
Burn Patients:
What rule can we utilize to assess the surface area of burn patients?
1.) The rule of Nines
2.) The rule of Palms
- The Rule of Nines is a method used to estimate the total body surface affected by a burn. The
body is divided into sections of 9’s for adult patients as described below:
Head and Neck: 9%
Each Arm: 9% (4.5% front, 4.5% back)
Each Leg: 18% (9% front, 9% back)
Front of the Torso: 18% (9% chest, 9% abdomen)
Patients Back: 18% (9% top half, 9% bottom half)
Perineum (Genital Area): 1%
So if I said an adult patient had second degree burns on their right arm and their chest, what
percentage of body surface area was burned according to the Rule of Nines?
1.) 18%
Pediatric patients have proportionally larger heads compared to the rest of their body, which
applies to surface area and percentages for burns as described below:
Head and Neck: 18%
Each Arm: 9% (4.5% front, 4.5% back)
Each Leg: 13.5%
Front of the Torso: 18% (9% chest, 9% abdomen)
Patients Back: 18% (9% top half, 9% bottom half)
Perineum (Genital Area): 1%
(Special note, only the head/neck and the legs were different from adults. Some texts will say
the legs are 14% each to avoid confusion, but this doesn’t make sense since the overall total will
be 101% not 100%.)
The Rule of Palms can be utilized when someone has a small burn on part of their arm/leg/part of
their body. What you can do is use the patients palm length excluding their fingers or wrists and
each palm length area where a burn is will be considered 1% of their body surface area for the
burn. Generally, you will only have a test question over the Rule of Nines though.
Age Ranges:
Neonates/Newborns: Birth to 28 days old
Infants: 1 month – 1 year old
Toddlers: 1 – 3 years old
Preschoolers: 3 – 5 years old
School-age children: 6 – 12 years old
Adolescent: 13 – 18 years old
Adults: 18 years old and up
(Special note: The younger the child the higher the respiratory rate and heart rate, the lower the
average blood pressure)
Acronyms you need to know:
An acronym useful for general assessment, arguably the most useful one to learn of them all.
SAMPLE
S: Signs & Symptoms
A: Allergies
M: Medications
P: Past Medical History
L: Last Oral Intake:
E: Events
An acronym only utilized for patients experiencing pain.
OPQRST
O: Onset
P: Provocation
Q: Quality
R: Radiating
S: Severity
T: Time
An acronym referring to nerve agent poisoning.
SLUDGEM:
S: Salivation
L: Lacrimation (Excessive tearing of the eyes)
U: Urination
D: Defecation
G: GI (Gastrointestinal)
E: Emesis
M: Muscle twitching or Miosis (Constriction of pupils)
An acronym referring to nerve agent poisoning.
DUMBELLS:
D: Diarrhea
U: Urination
M: Muscle twitching or Miosis (Constriction of pupils)
B: Bronchospasm
E: Emesis
L: Lacrimation (Excessive tearing of the eyes)
S: Salivation
DCAP-BTLS:
* I don’t think you’ll need to know this for the national, but a lot of instructors like utilizing this
so here it is *
An acronym describing the type of injury a patient may have, is useful to help medical personnel
know what to look for.
D: Deformities
C: Contusions
A: Abrasions
P: Punctures / Penetrations
B: Burns
T: Tenderness
L: Lacerations
S: Swelling
Important terms to know:
Anaphylaxis: Severe life-threatening allergic reaction
Ecchymosis: Bruising
Urticaria: Hives
Diaphoresis: Sweating
Priapism: Non-aroused erection (associated normally with spinal injury)
Epistaxis: Nosebleed
Hemiparesis: One – sided weakness
Jaundice: Yellowing of the skin and/or eyes (associated with liver abnormality)
Ending of words with -itis: Meaning inflammation (an example, hepatitis, inflammation of the
liver)
Maintenance Medications:
The national isn’t going to tell you that somebody has hypertension!! They’re going to say
something like oh the patient takes Lisinopril and HCTZ.
Another example is you may not know what’s going on with the patient who has an altered
mental status but… we can see one of the medications they take is Metformin! …. So what are
we thinking then? Well, if you know your medications with no other supporting information you
can potentially have an increased suspicion of hypoglycemia! (Diabetic medication)
I have worked at a clinic for approximately 8 or so years so I have an okay understanding of
medications! I am going to give you a list of medications along with how you should memorize
them!
*************** NOTE: I AM NOT A PHYSICIAN, TRUST YOUR PHYSICIAN NOT ME.
SOME MEDICATIONS CAN HAVE MULTIPLE EFFECTS THEY ARE NOT AS SIMPLE AS
I’M DESCRIBING THIS IS ONLY TO HELP YOU STUDY AND HOW I PERSONALLY SEE
THEM *************
I AM NOT A PHYSICIAN
I AM NOT A PHYSICIAN
I think of medications in a very simple manner, and when you take the national you should to!
These medications are for high blood pressure!
Lisinopril
Amlodipine
Losartan
Labetalol
Metoprolol (can be either succinate or tartrate at the end, extremely important to know the
difference if relaying to a hospital).
So, if you see those medications on a patients list, you can infer that they have hypertension in
their past medical history, while it may be more so filler for the national, what are some
important medications we may need to be able to identify?
How about…
Diabetic medications
Metformin
Januvia
Humalog
Novolog
Novolin
Lantus
Toujeo
Blood thinners
Eliquis
Plavix
Xarelto
Erectile Dysfunction Medication
Viagra
Cialis
Sildenafil *** This was on my national ***
Tadalafil
Opioids
Hydrocodone / Norco
Tramadol
Oxycodone
Morphine
Fentanyl
Codeine
Heroin
​
Miscellaneous Note:
Know Cushing’s Triad: It’s 3 signs of intracranial pressure, often a warning sign of a brain
herniation.
1.) Hypertension
2.) Bradycardia
3.) Irregular Respirations