Skill sheet
Patient assessment.
The one station every EMS student sweats. Follow the order, verbalize every step, and don't forget vitals.
Medical
Medical patient
- BSI / scene safety.
- MOI / NOI, number of patients, additional resources, C-spine consideration.
- General impression, AVPU, chief complaint.
- Airway — patent? Interventions (suction, OPA/NPA).
- Breathing — rate, quality, O₂ therapy as indicated.
- Circulation — pulse, skin, major bleeding, cap refill.
- Transport decision (rapid vs on-scene continued assessment).
- History of present illness — OPQRST.
- SAMPLE history.
- Focused secondary assessment based on complaint.
- Baseline vitals (BP, pulse, respirations, SpO₂).
- Field impression + interventions.
- Reassessment: repeat primary, vitals, interventions.
Trauma
Trauma patient
- BSI / scene safety.
- MOI, number of patients, additional resources, C-spine.
- General impression, LOC, chief complaint.
- Airway with C-spine control.
- Breathing — assess & treat immediate threats (tension pneumo, open chest wound, flail).
- Circulation — control major hemorrhage, assess perfusion, shock management.
- Rapid trauma exam (head-to-toe, DCAP-BTLS).
- Baseline vitals + SAMPLE history.
- Transport decision — load-and-go for critical trauma.
- Detailed exam en route as time allows.
- Reassessment: primary, vitals, interventions.
Critical fail criteria
- Failure to take or verbalize BSI precautions.
- Failure to determine scene safety.
- Failure to voice or provide high-concentration oxygen when indicated.
- Failure to assess or provide adequate ventilation.
- Failure to control major hemorrhage.
- Failure to identify or manage a life threat in the primary survey.
- Failure to differentiate a load-and-go from a stay-and-play patient.
- Performing any assessment out of the required order without correction.
- Exiting the station before completing patient care.
Say-it-out-loud script
Examiners score what they hear. Narrate every step: "BSI in place, scene is safe, one patient, no additional resources. General impression: middle-aged male, alert, in obvious distress…" If you touch the patient before saying it, you didn't do it.
FAQ
How long do I get for the Patient Assessment station?
The NREMT no longer administers standardized psychomotor exams centrally, but state and program stations typically allow 15 minutes for medical and 10 minutes for trauma. Confirm with your testing site.
What's the number one reason students fail this station?
Not verbalizing BSI/scene safety at the very start, and forgetting to state a general impression before touching the patient.
Do I have to reassess vitals to pass?
Yes. You must obtain a full baseline set (BP, pulse, respirations) and reassess vitals at least once — every 5 min for stable, every 5 min or sooner for unstable.
When do I transport?
For unstable patients, initiate transport as soon as the primary survey and critical interventions are complete. Verbalize a transport decision — don't do the whole exam on scene.
Drill scenarios with rationales
Patient assessment questions dominate the NREMT cognitive exam too.