NREMT EMT Course Notes

Scene size-up begins before arrival. Use dispatch information to anticipate the location, call type, possible hazards, number of patients, weather, traffic, violence risk, and resources that may be needed. Prearrival planning does not replace on-scene assessment; it prepares the EMT to slow down, look first, and avoid becoming another patient.

Primary assessment identifies and treats immediate life threats. Start with a general impression, level of consciousness, and obvious distress, then move through airway, breathing, circulation, disability, and exposure as appropriate. Do not delay life-saving actions to complete history questions or a detailed exam.

Secondary assessment fills in details after immediate life threats are addressed. Use it to understand the complaint, identify trends, and guide ongoing care during transport. It should not delay airway, breathing, circulation, severe bleeding control, or rapid transport for an unstable patient.

Severe bleeding is treated immediately. Use direct pressure first when appropriate, apply a tourniquet for life-threatening extremity bleeding that cannot be controlled quickly, and use wound packing for suitable deep wounds when trained and authorized. Reassess bleeding control often because movement can restart hemorrhage.

Splinting reduces pain and prevents further injury. Check PMS before and after splinting, expose and assess the injury, stabilize above and below the injury, and avoid unnecessary movement. If distal pulse, motor function, or sensation worsens after splinting, reassess alignment and follow protocol.

Operations begin with readiness. Check equipment before it is needed, verify oxygen and airway supplies, confirm the AED and suction work, and restock after calls. Missing equipment becomes a patient care problem only after the crew fails to find it during an emergency.