EMT Training - Become an Emergency Medical Technician

National Registry Paramedic


Professional Partner – During the IOOH scenario the National Registry paramedic candidate will be partnered with a licensed paramedic. Don’t overlook or undervalue your partner.


The professional partner is not there to trick or trip up the candidate and the will perform skills properly in real-time.


The candidate can perform skills themselves or delegate the skill to the professional partner. However, if the candidate decides to perform the skill, they must do the skill according to current passing skill standards.


The profession partner is an asset for multiple reasons. The first reason is you can delegate the majority of skill tasks to the professional partner. The exception to this is, at some point in the scenario one intervention delegated to your partner may fail.


This means they want the candidate to perform the skill during the testing scenario. (Usually the skill will be to start an IV, push a med, Intubate a patient, etc.) If the professional partner infiltrates an IV, it means the proctor wants to see you start an IV during the testing process.


The second reason to consider the professional partner an asset is because you are being evaluated on how well you communicate and function as a team leader. The only way to evaluate the candidate role as a team leader is with interactions between the candidate and the professional partner.


Communicate with the professional partner and feel free to consult with them about treatment plans. They are trained not to guide you or give away too much, but they aren’t forbidden from talking to you about your treatments.


Reason number three is possibly the most important reason your professional paramedic partner is an asset. They are not there to trick you, in fact their role is like your partner in the field. This means they are working under a license within the rules and laws of a paramedic.


For this reason, the professional partner will “challenge” the candidate to prevent them from making a mistake.


This is great news for any candidate who is paying attention. The professional partner won’t come right out and say “stop, don’t do that” but they will subtly challenge the candidate up to two times in an attempt to draw your attention to the mistake.


An example of some professional partner challenges are:


“are you sure that’s the dose you want to give?”
“confirming that you are going to defibrillate a patient with a pulse?”
“Is there another treatment option?”


If the National Registry paramedic candidate asks for inappropriate or harmful actions, the professional partner will voice a challenge. The partner will challenge the candidate twice and ultimately will not perform any harmful action – just like any paramedic in the field.


For this reason, the paramedic candidate should take notice anytime the professional paramedic voices an opinion or asks a question during the IOOH scenario.


Another thing to keep in mind is that the instructor may ask for feedback from the professional partner after the testing after is complete.


Quick Tip: If your professional partner makes a suggestion don’t ignore it.


Patient Care – The National Registry paramedic candidate will be responsible for patient assessments and deciding patient diagnosis and patient interventions.


The paramedic candidate needs to interact with the patient just like they would in the field because they are being evaluated on effective communication and maintaining professionalism throughout the entire call. Don’t just communicate with the professional partner and proctor during the call.


Instructors want to see the candidate interacting with the patient while doing a proper assessment. This is true even if the patient stand in is a mannequin. The candidate is expected to communicate with the mannequin as if it is a real life patient, which means explaining what you’re doing, what you’re looking for, and what interventions you are taking.


Don’t treat the patient like a prop in a test scenario, treat them with kindness and compassion like you would treat a patient in the field.


Transport – Once the National Registry paramedic candidate indicates the patient is ready for transport, they will need to verbalize how they plan to move the patient to the ambulance.


The paramedic candidate isn’t required to lift or move the patient to a stretcher at all during the exam, but they do need to verbalize exactly what kind of device they will use, how they will navigate stairs, hazards, etc.


After the candidate successfully tells the proctor how to get the patient in the ambulance, the transport phase will begin.


The candidate will need to verbalize to the proctor and professional partner how they want to transport (emergent or non-emergent) and where they want to transport (Ex: closest hospital ED with a surgical unit).


At this point the candidate loses the professional partner because they are now seated in a position for driving the ambulance.


From this point on, all care will be done by the candidate in the ambulance setting – with the patient strapped into a stretcher and the candidate seated in the ambulance for safety.


The National Registry paramedic candidate should continue to monitor and evaluate the patient’s condition during transport. Interventions and treatments should be reassessed and any status changes should be managed.


It’s possible that a patient’s condition may improve, deteriorate, or remain static during transport because the integrated out of hospital scenario is meant to mirror real life.


The candidate should keep in mind that patient status changes during transport do not reflect the quality of care or the candidate’s performance.


During transport, the candidate will need to call in report to the receiving facility about the patient. Be prepared to report information like chief complaint, interventions, current patient condition, and ETA to the facility.

Useful Information – IOOH Scenario


• National Registry Paramedic candidate will be provided with a fully stocked first in bag during the scenario.

• National Registry Paramedic candidate will have a cardiac monitor defibrillator or a simulator that is realistic and functional during the scenario.

• Non electronic tools are ok to use during testing – ACLS pocket reference, med dose chart/ med guide, and pocket protocols ok to use.

• National Registry Paramedic candidate should expect an obstacle of some sort to happen during the scenario testing. (IV infiltration, dog barking, patient is located on third floor, snowy steps, disruptive family member etc…). Consider what the goal of the obstacle is and find the solution.

Examples: A barking dog is probably referring to a goal of scene safety. Solution: ask resident if dog is loose or caged and lock it in another room. The goal of IV infiltration is to see candidate perform the skill. Solution: Candidate should start an IV.

• National Registry Paramedic candidate should remember to verbalize reassessing patient as indicated. This is especially important if you have not had an obstacle thrown at you yet. It’s likely to pop up during a reassessment.

• National Registry Paramedic candidate can benefit from paying attention to everything that is placed on scene and listening to all the information the proctor gives you.


Check out this video from the National Registry of EMT for information on Critical Fails during the OOHI scenario.


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