NREMT EMT - Emergency Medical Technicians Exam

Even in high-acuity situations, NREMT standards require EMTs to perform a scene size-up before patient contact. Scene size-up includes ensuring scene safety, determining the mechanism of injury, identifying hazards, and assessing the need for additional resources. Entering a scene without confirming safety places the EMT at risk and can result in additional victims.

Although the patient is unresponsive and apneic, EMTs must first confirm the scene is safe to enter. Only after scene safety is established should patient care begin.

Option B is incorrect because CPR cannot be initiated until the EMT has safely accessed the patient.

Option C is incorrect because airway maneuvers are performed after scene safety and patient access are confirmed.

Option D is incorrect because spinal stabilization occurs after initial access and assessment.

NREMT emphasizes: rescuer safety always comes first, even in life-threatening emergencies.

Comprehensive and Detailed Explanation From Exact Extract:

Pertinent negatives are findings that are not present, but would be clinically relevant if they were. For example:

“No neck or back pain” helps rule out spinal injury

“No loss of consciousness” informs head trauma assessment

Statements about behavior or initial refusal (B, E) may be documented under patient behavior or refusal, but they are not pertinent negatives. Positive findings like abdominal tenderness are pertinent positives.

Comprehensive and Detailed Explanation (Based on NREMT standards):

For unresponsive children, NREMT guidelines recommend checking central pulses to determine circulation.

Option B (Carotid) is correct and is the preferred pulse site for children over 1 year old.

Option C (Femoral) is also acceptable as a central pulse, especially if the carotid pulse is difficult to locate.

Option A is a peripheral pulse and unreliable in shock.

Option D is used for infants under 1 year.

Option E is not used for pulse assessment.

Accurate pulse assessment guides CPR decisions and must be completed within 10 seconds.

Comprehensive and Detailed Explanation From Exact Extract:

The START (Simple Triage and Rapid Treatment) system classifies patients based on ability to walk, respirations, perfusion, and mental status. A patient with an open fracture who can breathe adequately, has a pulse, and follows commands is categorized as “Delayed”.

Immediate (Red) is reserved for those who cannot walk and have life-threatening conditions, such as compromised airway or severe bleeding.

NREMT distinguishes mild versus severe airway obstruction primarily by the patient’s ability to move air. In a mild obstruction, the patient can cough forcefully, speak, and exchange air. A severe obstruction occurs when airflow is critically impaired.

Option A (Ineffective cough) is the key indicator that a mild obstruction has progressed to a severe one. An ineffective or silent cough means the patient can no longer generate enough airflow to clear the obstruction, placing them at imminent risk of hypoxia and cardiac arrest.

Option B is a late sign of hypoxia but does not define severity of obstruction.

Option C is not specific to airway obstruction severity.

Option D indicates a mild obstruction, not severe.

NREMT teaches that once a cough becomes ineffective, immediate airway intervention is required.

Comprehensive and Detailed Explanation From Exact Extract:

Dehydration signs in infants include:

Poor skin turgor (elasticity)

Sunken fontanelles (indicative of fluid loss)

Delayed capillary refill (>2 seconds)

Flushed skin is more common in fever or heat illness, not dehydration. Hypotension, not hypertension, is associated with dehydration in late stages.

The foundation of effective multiple-casualty incident (MCI) management is the Incident Command System (ICS). NREMT teaches that ICS provides clear leadership, communication, accountability, and coordination of resources.

Option D is correct because ICS allows for scalable management, efficient delegation, and integration of multiple agencies.

Option B is important but is a component of ICS, not the core principle.

Option C is a tactical step that occurs within the command structure.

Option A misunderstands ICS, as command is established based on arrival, not rank alone.

NREMT stresses that without ICS, MCIs become chaotic and unsafe, regardless of clinical skill.