We overheard Dan Limmer, our Chief Pass-ologist, talking to a student during his office hours on EMTReview.com. The student had two days until he took the NREMT exam and asked Dan what he thought he should study. Many of you are headed to the NREMT this month after completing your EMT class. We thought you might like to know what Dan said.
Here are Dan Limmer’s last minute things to study you should know:
CPR guidelines – You must know these!
- Check the pulse for no more than 10 seconds. If there is no pulse, begin with compressions.
- Push hard and fast. Don’t stop.
- Know the compression rate (100-120/min) and depth of 2 – 2.4” (5 to 6cm).
- Defibrillate as soon as the defibrillator is available but do not delay CPR while it is being prepared.
- CPR is primarily done at 30:2 except 2-rescuers CPR for infants and children which is 15:2.
[NOTE] The AHA summary of guidelines can be found here
Respiratory Distress vs Respiratory Failure – you must know the difference. Failure requires you to ventilate the patient while the distress doesn’t. Patients in failure aren’t breathing enough on their own to stay alive. How do you identify respiratory failure? Look for several things including a reduced mental status, respiratory rates outside the norm (very high or low) and/or some indication of a reduced depth of breathing. Usually words like “shallow” or “gasping” on an exam indicate failure—especially with an altered mental status.
Oxygenation – You’re not going to be giving a lot of oxygen except in critical patients and severe traumas. For most patients—and especially for cardiac and stroke patients—you’ll provide oxygen according to pulse oximetry readings. If the patient isn’t in severe distress and their saturation is above 94%, they probably won’t get oxygen. If their sats slip below 94%, a cannula will do nicely to bring it back up to around 94%. More info
Obstetrics and Neonatal Resuscitation – People either seem to get a lot of these or just a few—and rarely in between. It is good to remember some important things.
- If a neonate has a pulse below 100, you will ventilate them.
- If they have a pulse below 60, you will perform compressions.
- Suction isn’t used routinely for delivery anymore unless the baby is in distress.
- Ventilate a neonate at a rate of 40-60/minute.
- A mom’s feeling of having to move her bowels or needing to push may indicate imminent delivery.
Rule of 9s – You can’t guarantee that there will be a burn question on the exam, but there certainly could be. And this is a no-brainer. Arms are 9. Legs are 18. Each side of the torso is 18. The head is 9 and the genitalia is 1%. It is that easy. In young peds, consider the legs 14% and the head 18%. Read the question carefully to determine exactly what part of what body part is burned.
Don’t forget to take your time and read the question carefully—without reading into it. Watch step by step video of how to read an NREMT question.
Last minute study shouldn’t be frantic. It will just add to your stress. If you are in the 24 – 48-hour window before the NREMT, strategically study the day before the exam, get some sleep and head to the testing center refreshed. Don’t cram the day of the exam or in the parking lot of the test center. At that point, you know all you are going to know.
EMT Review’s sole purpose is to help you pass the NREMT. Additional information about passing the NREMT may be found at:
- 3 things necessary to pass the NREMT
- 4 steps for evaluating an NREMT question
- 5 thoughts that will fail you on the NREMT
Best to you for NREMT success!