NREMT EMT Exam Tomorrow?

Focus your last review on the parts of the current NREMT EMT exam that carry the most weight: assessment priorities, treatment decisions, scene safety, and high-value rules and numbers.

This is a rapid-review study page, not a replacement for your EMT course. Use it to refresh high-yield material, then rely on your current program materials, protocols, and official National Registry resources for complete preparation.

LAST-MINUTE PRIORITY

Primary Assessment alone represents roughly two-fifths of the exam. If time is short, spend disproportionate review time on recognizing immediate threats, deciding what comes first, and identifying when treatment, transport, or additional resources cannot wait.

Know the Current NREMT EMT Exam

The current National Registry EMT Certification Examination launched April 7, 2025 and is based on the 2023 BLS Practice Analysis. It uses computerized adaptive testing and focuses on the tasks an entry-level EMT performs in actual practice.

Format — Computerized adaptive test (CAT)

Questions — 70–120 total items

Time limit — 2 hours

Unscored questions — 10 unidentified pilot items

Passing standard — Entry-level competency; there is not a published fixed percent-correct passing score

Item formats — Multiple choice, multiple response, options table, build list, and drag-and-drop

Current Exam Weighting

Primary Assessment

39–43%

Patient Treatment and Transport

20–24%

Scene Size-Up and Safety

15–19%

Operations

10–14%

Secondary Assessment

5–9%

Pediatric patient-care questions are integrated throughout the exam rather than confined to a separate pediatric domain.

Free NREMT EMT Cram Sheet

Need one more fast pass through the high-value numbers, sequences, and distinctions? Keep them together with the free Readyward NREMT EMT cram sheet.

Primary Assessment: The Biggest NREMT EMT Domain

Primary Assessment represents 39–43% of the current exam. Many questions therefore come down to priorities: What threat do you recognize first? What must you assess or correct now? Does this patient need rapid treatment, rapid transport, or more resources?

Run the Primary Assessment

Form a general impression of the patient.

Assess level of consciousness.

Assess the airway.

Assess breathing.

Assess circulation.

Determine the chief complaint and identify life threats.

Obtain baseline vital signs and available diagnostic information.

Decide whether rapid treatment, rapid transport, or additional resources are needed.

WHAT COMES FIRST?

Do not let a detailed history distract you from an immediate life threat. On priority questions, first identify what can most rapidly threaten airway, breathing, circulation, or survival, then choose the intervention that addresses that problem.

Four Distinctions Worth Keeping Straight

Airway —

Is there a usable path for air to move?

Ventilation —

Is air actually moving in and out effectively?

Oxygenation —

Is enough oxygen reaching the blood and tissues?

Perfusion —

Is blood adequately circulating to the tissues?

A patient can have an open airway and still have inadequate ventilation, oxygenation, or perfusion.

CPR, Breathing & Choking: Numbers Worth Knowing

These facts are difficult to reconstruct from logic during an exam. Review the numbers until the differences between adults, children, and infants are automatic.

2025 AHA CHANGE TO REMEMBER

Current AHA guidance no longer recommends the two-finger technique for infant CPR. Use either the one-hand technique or the two-thumb encircling-hands technique.

National Registry began transitioning its examination content after the 2025 AHA guideline release. Use current AHA guidance for patient care and current course materials for examination preparation.

Adult BLS Quick Review

Compression rate

100–120/min

Compression depth

At least 2 in (5 cm); avoid excessive depth greater than 2.4 in (6 cm)

CPR without an advanced airway

30 compressions to 2 breaths

Adult with a pulse but not breathing normally

1 breath every 6 seconds

Severe choking while responsive

5 back blows followed by 5 abdominal thrusts; repeat as needed

Pediatric BLS Quick Review

Compression rate

100–120/min

Infant compression depth

At least one-third chest depth, about 1.5 in (4 cm)

Child compression depth

At least one-third chest depth, about 2 in (5 cm)

One rescuer, no advanced airway

30:2

Two rescuers, no advanced airway

15:2

Pulse present but breathing inadequate

1 breath every 2–3 seconds

Responsive infant with severe choking

5 back blows followed by 5 chest thrusts

Responsive child with severe choking

5 back blows followed by 5 abdominal thrusts

NREMT THINKING PATTERN

A clinically reasonable action may still be the wrong answer if a more immediate life threat has not been addressed first.

Patient Treatment & Transport: Treat the Threat

Patient Treatment and Transport represents 20–24% of the current exam. Focus on choosing an EMT-level intervention that addresses the immediate problem and recognizing when transport or additional care should not be delayed.

High-Yield Treatment Decisions

Inadequate ventilation —

Support ventilation. Supplemental oxygen does not replace effective ventilation.

Major external bleeding —

Control life-threatening hemorrhage promptly while continuing assessment of airway, breathing, and circulation.

Suspected opioid overdose —

Inadequate breathing is the immediate threat. Support ventilation and use naloxone when indicated and authorized.

Anaphylaxis —

Rapidly recognize airway, breathing, or circulatory compromise and use epinephrine when indicated and authorized.

Suspected hypoglycemia —

Oral glucose requires an appropriate indication and a patient who can safely take it by mouth.

Suspected stroke —

Identify the time last known well, support ABCs, perform the stroke assessment used by your program or system, and prioritize appropriate transport.

Chest pain suspicious for myocardial ischemia —

Assess ABCs, consider aspirin when indicated, and follow protocol for medication assistance and transport.

Trauma —

Address immediate threats before less urgent splinting or detailed assessment. Reassess after major interventions and during transport.

EMT Medications: Know What Problem Each One Treats

Medication authority and dosing can vary by state, system, and medical director. For last-minute NREMT review, concentrate first on indication, patient condition, and EMT-level scope rather than assuming one local protocol applies everywhere.

Aspirin

Chest pain of suspected ischemic origin when indicated

Oral glucose

Suspected hypoglycemia when the patient can safely take it orally

Naloxone

Suspected opioid overdose; continue to manage inadequate ventilation

Epinephrine auto-injector

Anaphylaxis when indicated

Inhaled bronchodilator

Dyspnea and wheezing when indicated and authorized

Nitroglycerin

At the national EMT scope-model level, assistance is with the patient’s own prescribed medication

Always follow the medication doses, contraindications, authorization rules, and protocols taught by your current EMT program and jurisdiction.

Secondary Assessment: Focus, History, Reassess

Secondary Assessment represents 5–9% of the current exam. Once immediate threats are managed, gather information that can change the treatment plan and continue watching for changes.

SAMPLE

S — Signs and symptoms
A — Allergies
M — Medications
P — Pertinent past medical history
L — Last oral intake
E — Events leading to the illness or injury

OPQRST

O — Onset
P — Provocation or palliation
Q — Quality
R — Region or radiation
S — Severity
T — Time

Do not treat the first set of findings as permanent. Repeat vital signs, repeat relevant assessment findings, and determine whether the patient is improving, worsening, or unchanged.

Scene Size-Up & Safety: Do Not Become Another Patient

Scene Size-Up and Safety represents 15–19% of the current exam. Clinical care begins only after the EMT recognizes hazards, protects responders and patients, and requests the resources the situation requires.

Use available dispatch and pre-arrival information to anticipate hazards.
Protect yourself, other responders, the patient, and the public from existing or potential hazards.
Use appropriate PPE.
Determine the number of potential patients.
Triage when multiple patients require prioritization.
Request appropriate additional resources.

SCENE-SAFETY RULE

If a hazard exceeds your training, equipment, or PPE, do not enter simply because a patient needs help. Obtain the appropriate resources and maintain responder safety.

Pediatrics: Expect It Throughout the Exam

Pediatric patient-care questions are integrated across the current NREMT EMT exam. Do not study pediatrics as an isolated chapter only; connect pediatric differences to assessment, airway, resuscitation, treatment, and transport.

Last-Minute Pediatric Reminders

Respiratory problems are an especially important cause of pediatric cardiac arrest, so inadequate ventilation and oxygenation require prompt recognition.
Pediatric CPR uses a compression rate of 100–120/min.
Compression depth is at least one-third of the chest: approximately 1.5 in (4 cm) for an infant and 2 in (5 cm) for a child.
Without an advanced airway, one-rescuer pediatric CPR uses 30:2 and two-rescuer CPR uses 15:2.
For a pediatric patient with a pulse but inadequate breathing, provide approximately 1 breath every 2–3 seconds.
Current infant CPR guidance uses the one-hand or two-thumb encircling-hands technique rather than the old two-finger technique.

Operations: Small Domain, Easy to Overlook

Operations represents 10–14% of the current EMT exam. The official blueprint emphasizes readiness, documentation, supplies, equipment, and responder well-being.

Equipment — Confirm required equipment is present and functioning.
Medications and supplies — Maintain adequate inventory for patient care.
Documentation — Accurately document assessments, care, and pertinent patient information.
Communication — Clearly transfer important patient information during transport and transfer of care.
Responder well-being — Recognize that personal safety and physical and mental readiness affect patient care.

If You Have 10 Minutes Left

□ Primary Assessment sequence
□ Airway vs. ventilation vs. oxygenation vs. perfusion
□ Adult and pediatric CPR numbers
□ Current adult, child, and infant choking sequences
□ Immediate treatment vs. transport decisions
□ Major hemorrhage priorities
□ EMT medication indications
□ SAMPLE and OPQRST
□ Scene safety, PPE, patient count, triage, and resources
□ Pediatric differences
□ Reassessment after interventions

Do not spend your final minutes trying to relearn an entire EMT textbook. Refresh the sequences, numbers, distinctions, and priority decisions you are most likely to confuse.

Make Your Last Review Count

Use the free Readyward NREMT EMT cram sheet to keep the highest-value facts together for one more focused review.

Readyward is an independent educational resource and is not affiliated with, endorsed by, or sponsored by the National Registry of Emergency Medical Technicians, Pearson VUE, the American Heart Association, NHTSA, or any state EMS authority. Exam specifications, clinical guidelines, scope of practice, and local protocols can change. Always use current official sources and the instructions of your approved EMT education program and medical director.