NREMT EMR cheat sheet

Normal adult respiratory rate is 12 to 20 breaths per minute; a rate below 8 or above 28 with other signs of distress indicates inadequate breathing.

Head-tilt, chin-lift opens the airway in an unresponsive patient with no suspected spinal trauma; jaw-thrust is used when spinal injury is suspected.

An oropharyngeal airway is measured from the corner of the mouth to the earlobe and is used only in unresponsive patients with no gag reflex.

A nasopharyngeal airway is measured from the nostril to the earlobe and is avoided when a basilar skull fracture is suspected.

Suctioning is limited to 15 seconds in an adult, 10 seconds in a child, and 5 seconds in an infant.

Nasal cannula at 1 to 6 L/min delivers about 24 to 44 percent oxygen; a nonrebreather at 10 to 15 L/min delivers up to about 90 percent.

Bag-valve-mask ventilation uses 15 L/min oxygen at 10 to 12 breaths per minute for adults and 12 to 20 for children and infants, with visible chest rise.

Pulse oximetry below 94 percent indicates hypoxemia; readings are unreliable with poor perfusion, carbon monoxide poisoning, or dark nail polish.

Adult CPR: compressions at 100 to 120 per minute, at least 2 inches (5 cm) deep and no more than 2.4 inches, with full chest recoil.

Compression-to-ventilation ratio is 30:2 for adults and for children or infants with a single rescuer; it is 15:2 for children and infants with two rescuers.

Infant compression depth is about 1.5 inches (4 cm) or one third of the chest depth; child depth is about 2 inches (5 cm).

A carotid pulse is checked for no more than 10 seconds; if the rescuer is unsure whether a pulse is present, compressions begin.

An AED is applied as soon as it arrives; pads go below the right clavicle and on the left lower ribs, and everyone must be clear during analysis and shock.

In suspected cardiac chest pain, aspirin 324 mg chewed is given when there is no allergy and no active bleeding, per protocol.

Nitroglycerin is withheld when systolic blood pressure is below 100 mmHg, with head injury, or after recent erectile-dysfunction medication.

Cardiac arrest in children most often results from respiratory failure or shock rather than from a primary heart rhythm problem.

Major external bleeding is controlled with direct pressure first; a tourniquet is applied 2 to 3 inches above the wound, not over a joint, with the time recorded.

Signs of shock include pale, cool, clammy skin, a rapid weak pulse, rapid shallow breathing, and restlessness or altered mental status.

Shock treatment: control bleeding, maintain the airway, give oxygen, keep the patient warm, and transport rapidly.

Rule of Nines (adult): head 9 percent, each arm 9 percent, anterior trunk 18 percent, posterior trunk 18 percent, each leg 18 percent, genitalia 1 percent.

The patient's palm equals about 1 percent of body surface area.

An impaled object is stabilized in place with bulky dressings and is never removed in the field.

An amputated part is wrapped in sterile gauze, sealed in a plastic bag, and placed on ice without direct contact.

Clear or blood-tinged fluid from the nose or ears after head trauma suggests a cerebrospinal fluid leak and is not packed or suctioned.

The Cincinnati Prehospital Stroke Scale tests facial droop, arm drift, and speech; any one abnormal finding suggests stroke.

Time last known well determines eligibility for fibrinolytics, generally within 3 to 4.5 hours of symptom onset.

Hypoglycemia has rapid onset with sweating, tremor, and confusion; hyperglycemia develops over days with polyuria and thirst.

Oral glucose is given only to a conscious patient who can swallow and has an intact gag reflex.

Anaphylaxis epinephrine auto-injector dose is 0.3 mg for adults and 0.15 mg for children, injected into the lateral thigh.

During a seizure, protect the patient from injury, do not restrain or put anything in the mouth, and note the duration; over 5 minutes is status epilepticus.

AEIOU-TIPS lists causes of altered mental status: alcohol, epilepsy and endocrine, insulin, overdose, uremia, trauma, infection, poisoning, and stroke or seizure.

A patient with asthma or COPD is positioned upright and assisted with their own prescribed inhaler per protocol.

After about 20 weeks of pregnancy, a supine patient may develop supine hypotensive syndrome from compression of the inferior vena cava; the uterus is displaced left or the patient is placed on the left side.

Normal newborn heart rate is above 100; if below 100 or apneic, ventilate with a bag-valve-mask at 40 to 60 breaths per minute.

Newborn care sequence: dry, warm, position, stimulate, then assess breathing and heart rate.

In a prolapsed cord, the patient is placed knee-chest or Trendelenburg, the presenting part is elevated off the cord, and the cord is kept moist.

Postpartum hemorrhage is blood loss over 500 mL after delivery and is treated with uterine fundal massage, oxygen, and rapid transport.

Preeclampsia is hypertension with headache, visual disturbance, or swelling; seizures indicate eclampsia.

Ectopic pregnancy presents with sudden sharp lower abdominal pain, a missed period, and signs of shock.

Standard precautions treat all blood and body fluids as infectious; gloves are the minimum, with eye protection and a mask when a splash is likely.

START triage sorts patients by respirations, perfusion, and mental status into immediate, delayed, minor, and deceased categories.

Consent may be expressed, implied for an unresponsive patient, or given by a parent or guardian for a minor.

A verbal radio report includes unit identification, patient age and sex, chief complaint, vital signs, treatment given, and estimated time of arrival.

Hazmat scenes have a hot zone (contaminated), a warm zone (decontamination corridor), and a cold zone (safe treatment area); untrained responders do not enter.

Lifting technique keeps the back straight, uses the leg muscles, and holds the load close to the body.

Patient care reports are objective, accurate, and completed at the time of the call.