If you did well through EMT school and studied well, you should have an idea which group you fall into. Candidates who fail may have done well on most of the EMT-B exam, but have done very poorly on a specific area or areas of content.
If the algorithm determines early a candidate can not pass a required area of content it may end the test around 70 questions. The good news is if a candidate fails, the National Registry of EMT will indicate how well they did on the various content areas.
EMT-B Cognitive Exam Content
The cognitive portion of the NREMT exam for the EMT-B is constructed to administer test questions from 5 areas of content. These content categories are EMS Operations, Trauma, Cardiology and Resuscitation, Airway; Respiration and Ventilation, and Medical/ Obstetrics/ Gynecology.
For all of these areas of content, any patient care questions will be 85% elderly and adult and 15% pediatric.
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The goal of the National Registry of EMT exam is to determine if candidates can apply their book learning and course knowledge to real life field experience and patient care. The EMT test is designed to create situations and tasks that an entry-level EMS professional will need to respond to.
Wrong answers on the EMT test may reflect wrong choices in the field that lead to incorrect assessment or treatments of patients in the field.
The EMT-B Cognitive Exam content is organized using a test plan which is approved by the National Registry of EMT Board.
The test plan is basically a blue-print that communicates with the computer testing software and tells it how to build each candidate’s exam.
According to the test plan each Basic EMT test will focus:
10% – 14% of the NREMT exam is EMS Operations.
Trauma will be the focus of 14% – 18% of the EMT test.
20% – 24% of the EMT test is Cardiology and Resuscitation.
Airway; Respiration & Ventilation is 18% – 22% of the NREMT exam.
Medical: Obstetrics & Gynecology is 27% – 31% of the NREMT exam.
These areas of content cover Emergency Medical Services (EMS) care and the standard for passing is to provide safe and effective entry-level emergency medical care.
Before taking the NREMT exam follow this link to 10 Expert Tips for passing the National Registry of EMT cognitive exam. Follow the guide to be better prepared on your test day.
NREMT Psychomotor Exam
The National Registry of EMT Psychomotor Exam for the EMT-B demonstrates that a candidate is competent in a range of emergency medical skills. The candidate should speak to their instructor in EMT school about this portion of the NREMT exam because it can be completed during the final stages of an EMT course.
If the EMT test for psychomotor skills is not done at the educational institution of the EMT school, the instructor should be able to inform the candidate of where to go for testing.
The NREMT psychomotor exam is not administered by the National Registry of EMT. If an EMT school doesn’t give a candidate information about testing, they can always contact their state’s Local EMS office for testing information.
Unlike the cognitive EMT test which is written, the psychomotor NREMT exam is a hands on exam with stations the candidate will visit and perform at. Each skill is timed and during the psychomotor EMT test the candidate must verbalize what they are doing and the instructor may ask questions that will require a verbal answer or action.
To get better prepared check out these 7 Expert Tips for passing the psychomotor exam.
The best way to study for the psychomotor EMT test is with hands on practice using the National Registry of EMT skill sheets.
These NREMT skill sheets are similar to the skill sheets used in EMT school and should be familiar to candidates. Here are 10 examples of skills that candidates will need to become competent in for the EMT-B NREMT psychomotor exam. (These skills are from the 2016 NREMT skill sheets):
1. Long Bone Immobilization: Candidate needs to:
A. Verbalize or actually use Personal Protective Equipment (PPE)
B. Direct application of manual stabilization of the injury
C. Assess distal Motor, Sensory, and Circulatory functions in the injured extremity and the examiner should verbalize that they are present and normal
D. Measure and Apply the splint
E. Immobilize the joint above and the joint below the injury site.
F. Secure the entire injured extremity and immobilize the hand/foot in the position of function.
G. Reassess distal Motor, Sensory, and Circulatory functions in the injured extremity and the examiner will verbalize that they are present and normal.
2. Joint Immobilization: Candidate should:
A. Use or verbalize the use of Personal Protective Equipment (PPE)
B. Direct application of manual stabilization of the injury
C. Assess distal Circulatory, Motor, and Sensory functions in the injured extremity and the examiner should state that they are present and normal.
D. Select the correct splinting material and immobilize the site of the injury.
E. Immobilize the bone above and the bone below the injury site.
F. Secure the entire injured extremity.
G. Reassess distal Circulatory, Motor, and Sensory functions in the injured extremity. (Examiner will most likely state that these functions are present and normal.)
3. Bleeding Control/ Shock Management:
A. Verbalize or take the appropriate PPE precautions
B. Apply direct pressure to the wound (the examiner will verbalize that the patient continues bleeding)
C. Apply tourniquet (Examiner will notify the candidate that the patient is showing signs and symptoms of hypo-perfusion)
D. Properly position the patient
E. Administer high concentration oxygen
F. Begin steps to prevent heat loss in patient
G. Indicate the need for immediate transport.
4. Oxygen Administration by Non-Rebreather Mask:
A. Verbalize or take the appropriate PPE precautions
B. Get the appropriate equipment needed
C. Crack the oxygen tank valve and assemble the regulator to the oxygen tank
D. Open the oxygen tank valve and check the oxygen tank pressure
E. Check for leaks and attach the non-rebreather mask to the correct port of the regulator
F. Turn on the oxygen flow in order to fill the reservoir bag and adjust the regulator to oxygen flow rate of at least 10L/ Minute
G. Adjust mask to patient’s face and adjust so that it fits snugly.
5. Cardiac Arrest Management / AED:
A. Verbalize or take the appropriate PPE precautions
B. Determine the scene and situation is safe
C. Check patient responsiveness and direct assistant to get the automated external defibrillator (AED)
D. Request additional EMS assistance
E. Check pulse and breathing simultaneously (Examiner will indicate the patient is unresponsive, apneic and pulseless)
F. Begin immediate chest compressions with adequate depth and rate (Allow the chest to recoil completely)
G. Perform high-quality 1 Rescuer Adult CPR for 2 minutes:
a. Correct depth and rate
b. Compression to ventilation ratio is correct
c. Allow chest to recoil completely
d. Adequate volume for each breath
e. Minimal interruptions of no more than 10 seconds throughout CPR.
NOTE: After 2 minutes or around 5 cycles of CPR the candidate should assess the patient and a second rescuer will resume compressions while the candidate operates the AED.
H. Turn power on to AED
I. Follow AED prompts and correctly attach the AED to the patients
J. Stop CPR and make sure all rescuers are clear of the patient during rhythm analysis
K. Ensure everyone is clear of patient and deliver shock from AED
L. Immediately direct rescuer to resume chest compressions.
6. Spinal Immobilization (Seated Patient):
A. Take or verbalize appropriate PPE precautions
B. Instruct assistant to place and maintain head in the neutral, in-line position
C. Instruct assistant to maintain manually stabilizing the head
D. Reassess circulatory, motor, and sensory functions in each extremity
E. Apply appropriate size extrication collar
F. Position the immobilization device behind the patient and secure the device to the patient’s torso
G. Evaluate torso fixation and adjust as needed
H. Evaluate and pad behind the patient’s head as needed and secure the patient’s head to the device
I. Verbalize moving the patient to a long backboard and reassess circulatory, motor, and sensory functions in each extremity.
