📋 Table of Contents
Use this to navigate directly to any topic. All 26 chapters + Master Differentiator Table are included.
Chapter Topic Key Contents
Ch 1 Patient Assessment Primary Assessment, SAMPLE/OPQRST, Vital Signs, Reassessment
Ch 2 Airway Management Distress vs. Failure, Adjuncts, O₂ Devices, Lung Zones, Pulse Oximetry
Ch 3 BLS & CPR CPR Parameters, Age Groups, 5H/5T, Cardiac Rhythms, Post-ROSC
Ch 4 Cardiovascular Angina, MI, CHF, Tamponade, Blood Flow, Conduction System
Ch 5 Respiratory Croup, Epiglottitis, Asthma, COPD, Anaphylaxis, PE, CO Poisoning
Ch 6 EMT Medications 6 Rights, Drug Reference Table, Medication Check
Ch 7 Neurological Stroke/TIA, Seizures, Status Epilepticus, Syncope, Delirium
Ch 8 Endocrine & Diabetes Hypoglycemia, Hyperglycemia, DKA, HHNS
Ch 9 Shock Hypovolemic, Neurogenic, Septic, Cardiogenic, Anaphylactic, Obstructive
Ch 10 Toxicology Toxidrome Table, Opioids, Cholinergic, Anticholinergic, Alcohol/DTs
Ch 11 GI & GU Abdominal Quadrants, GI Bleeds, Appendicitis, Cholecystitis, AAA
Ch 12 Behavioral Health Acute Psychosis, Excited Delirium, Suicide Risk, PTSD
Ch 13 Obstetrics & Neonatal Preeclampsia, Eclampsia, Abruption vs. Previa, Delivery, APGAR
Ch 14 Pediatrics & Geriatrics PAT, Age Groups, Atypical Geriatric Presentations
Ch 15 Head, Spine & Trauma Epidural vs. Subdural, Cushing's Triad, Penetrating Trauma, Fractures, SCI
Syndromes
Ch 16 Environmental Heat/Cold, Hypothermia, DCS vs. Air Embolism, Lightning, Envenomation
Ch 17 Medical Legal & Ethics Consent, Negligence, DNR, HIPAA, Good Samaritan
Ch 18 EMS Operations START Triage, JumpSTART, MCI, ICS, Air Medical, HAZMAT
Ch 19 Infection Control PPE Levels, CISM, Stress Types, DABDA
Ch 20 Face, Neck & Eye Eye Burns, Epistaxis, Neck Trauma, Dental Injuries
Ch 21 Medical Illnesses Influenza, HIV, Hepatitis, Meningitis, TB, MRSA, COVID, Ebola
Ch 22 Special Challenges ASD, Down Syndrome, LVAD, Tracheostomy, Cerebral Palsy
Ch 23 Medication Orders Standing Orders, Off-line vs Online Direction, Two-Provider Check Steps
Ch 24 Burns Rule of Nines, Burn Depth, Critical Burns, Chemical/Electrical
Ch 25 Spinal Motion Restriction SMR Criteria, Spinal Cord Injury Signs, Neurogenic Shock
Ch 26 Pediatric Vitals Age Vitals Table, PAT Triangle, Anatomical Differences
Final Master NREMT 25 High-Yield Side-by-Side Comparisons
Differentiator
, EMT Ultimate Study Guide
UCLA Center for Prehospital Care · NREMT Exam Prep
All Sources Consolidated: Study Grids + Lecture Slides (Sessions 1–17) + Master Review Guide
March 2026
📋 Study Grids PDF 🎓 Lecture Slides 1–17 📖 Master Review Guide
Condition grids filled in — Signs, Instructor emphasis, case studies, Detailed comparison tables,
Treatment, Definitions for all topics mnemonics, clinical pearls from all formulas, MCI, EMS Operations,
sessions special population atypical
presentations
HOW TO USE THIS GUIDE
🔍
▸ Bold questions = Q&A format from your original study guide style
⚡
Purple box on every condition = KEY DIFFERENTIATOR for that condition
🟡
Gold box = NREMT TIP from your Master Review Guide
Teal box = mnemonic to memorize
Grid tables = condition-by-condition reference with differentiators built in
🩺 Chapter 1: Patient Assessment
Primary Assessment — Steps in Order
Step Assessment Key Action
1. General Age, sex, level of distress, Scan for life threats — uncontrolled bleeding FIRST
Impression overall appearance
2. LOC AVPU + Alert & Oriented ×4 Any patient NOT fully A&O ×4 = altered LOC
(Person/Place/Time/Event)
3. Airway Open and patent? Medical: head-tilt chin-lift | Trauma: jaw thrust
4. Breathing Rate, rhythm, depth, effort — Treat as you find: O₂ for distress, BVM for failure
Lung sounds
5. Circulation Pulse rate/rhythm/quality — Skin Control bleeding; treat for shock if needed
signs — Cap refill
6. Decision Load & Go vs. Stay & Play Life threats = Load & Go immediately
⚡ NREMT TIP: Treat life threats AS YOU FIND THEM — don't finish assessment before intervening.
Vital Signs — Normal Ranges
Vital Sign Adult Normal Pediatric Notes Key Clinical Point
Pulse Rate 60–100 bpm See Ch 24 full Tachycardia = FIRST sign of shock. Rate +
table. Newborn: Rhythm + Quality
, Vital Sign Adult Normal Pediatric Notes Key Clinical Point
85–205 | Infant:
100–190 | Child:
60–140
Respirations 12–20 bpm See Ch 24 full <12 or >20 = abnormal. Rate + Rhythm + Depth +
table. Newborn: Effort
30–60 | Toddler:
24–40 | Child: 18–
30
SpO₂ 94–100% Same <94% = hypoxia. COPD target: 88–92%.
Unreliable in CO poisoning
Blood Glucose 80–120 mg/dL Same <60 = hypoglycemia (treat). >400 = DKA range
Blood Pressure SBP 110–130 Peds SBP = Hypotension is a LATE sign of shock in adults —
mmHg 70+(2×age) don't wait for it
GCS 15 = normal Infant: use modified <8 = severe TBI/intubation threshold. TREND it
GCS — direction matters
Pupils PERRL Same Pinpoint = opioids/cholinergics | Dilated =
sympathomimetics/anticholinergics | Unequal =
TBI
Skin Pink, warm, dry Same Pale/cool/clammy = shock | Hot/dry = heat stroke
| Cyanotic = hypoxia
Cap Refill <2 seconds Most reliable in In peds, cap refill is MORE reliable than BP for
children perfusion assessment
SAMPLE & OPQRST
SAM OPQ
Meaning Meaning
PLE RST
S Signs & Symptoms (chief complaint) O Onset — gradual or sudden?
A Allergies — what happens with exposure? P Provocation/Palliation — what makes it worse
or better?
M Medications — Rx, OTC, recreational Q Quality — describe the pain
P Past Medical History R Radiation — does it move anywhere?
L Last Oral Intake S Severity — 1–10 scale
E Events Leading Up T Time — how long has this been happening?
Reassessment Intervals
• Unstable patients: every 5 minutes
• Stable patients: every 15 minutes
• Each reassessment: repeat primary assessment, vitals, chief complaint, recheck all interventions
⚡ NREMT TIP: If it's not documented, it didn't happen. Document everything — refusals, patient statements,
bystander info, all interventions and patient responses.
, 🌬️ Chapter 2: Airway Management
▸ How do you differentiate respiratory distress from failure?
• Distress: ALERT, tachypnea, labored, accessory muscles, SpO₂ may still be >94% → give O₂
• Failure: ALTERED/cyanotic/rate <10 or >30/poor chest rise → BVM immediately
🔍 KEY DIFFERENTIATOR: The mental status is THE differentiator. ALERT + struggling = distress (O₂). ALTERED
or cyanotic = failure (BVM). Never give O₂ when BVM is needed.
⚡ NREMT TIP: Confirm BVM effectiveness: visible chest rise + improving color + SpO₂ trending up.
Respiratory Distress vs. Failure — Comparison
Finding Respiratory Distress Respiratory Failure
Mental Status Alert, anxious Confused, lethargic, unresponsive
Speech 2–3 word dyspnea Unable to speak
Rate Tachypnea <10 or >30; gasping; agonal
Chest Rise Present Poor or absent
SpO₂ May still be >94% Dropping despite O₂
Skin Diaphoretic, flushed Cyanotic
Treatment O₂ — NC (1–6 LPM) or NRB (10–15 BVM @ 15 LPM with O₂
LPM)
Airway Adjuncts
Device Indication Contraindication Size Key Note
OPA Unconscious, NO gag Gag reflex present — Corner of Insert rotated 90–180°, then
reflex will cause vomiting mouth → seat
corner of
jaw
NPA Conscious OR Suspected basilar skull Nares → Lubricate, bevel toward
unconscious WITH gag fracture earlobe septum, stop if resistance
reflex
iGel Sustained Gag reflex, caustic By No rotation needed — curved
unconsciousness, ingestion size/weight design seats above glottis
cardiac arrest
CPAP Awake, spontaneously Apnea, decreased LOC, Adult/peds NOT a ventilation device —
breathing patient with vomiting sizes patient must breathe on their
CHF/COPD own
🔍 KEY DIFFERENTIATOR: CPAP is not a ventilation device. If the patient stops breathing while on CPAP →
switch to BVM immediately.
O₂ Delivery Devices
Device Flow Rate Approx. FiO₂ When to Use
Nasal Cannula (NC) 1–6 LPM 24–44% Mild distress; COPD (titrate to SpO₂ 88–92%)
Non-Rebreather Mask 10–15 LPM ~90% Moderate-severe distress; any shock; CO
(NRB) poisoning
BVM 15 LPM ~100% with Respiratory failure; cardiac arrest; rate <10 or
Use this to navigate directly to any topic. All 26 chapters + Master Differentiator Table are included.
Chapter Topic Key Contents
Ch 1 Patient Assessment Primary Assessment, SAMPLE/OPQRST, Vital Signs, Reassessment
Ch 2 Airway Management Distress vs. Failure, Adjuncts, O₂ Devices, Lung Zones, Pulse Oximetry
Ch 3 BLS & CPR CPR Parameters, Age Groups, 5H/5T, Cardiac Rhythms, Post-ROSC
Ch 4 Cardiovascular Angina, MI, CHF, Tamponade, Blood Flow, Conduction System
Ch 5 Respiratory Croup, Epiglottitis, Asthma, COPD, Anaphylaxis, PE, CO Poisoning
Ch 6 EMT Medications 6 Rights, Drug Reference Table, Medication Check
Ch 7 Neurological Stroke/TIA, Seizures, Status Epilepticus, Syncope, Delirium
Ch 8 Endocrine & Diabetes Hypoglycemia, Hyperglycemia, DKA, HHNS
Ch 9 Shock Hypovolemic, Neurogenic, Septic, Cardiogenic, Anaphylactic, Obstructive
Ch 10 Toxicology Toxidrome Table, Opioids, Cholinergic, Anticholinergic, Alcohol/DTs
Ch 11 GI & GU Abdominal Quadrants, GI Bleeds, Appendicitis, Cholecystitis, AAA
Ch 12 Behavioral Health Acute Psychosis, Excited Delirium, Suicide Risk, PTSD
Ch 13 Obstetrics & Neonatal Preeclampsia, Eclampsia, Abruption vs. Previa, Delivery, APGAR
Ch 14 Pediatrics & Geriatrics PAT, Age Groups, Atypical Geriatric Presentations
Ch 15 Head, Spine & Trauma Epidural vs. Subdural, Cushing's Triad, Penetrating Trauma, Fractures, SCI
Syndromes
Ch 16 Environmental Heat/Cold, Hypothermia, DCS vs. Air Embolism, Lightning, Envenomation
Ch 17 Medical Legal & Ethics Consent, Negligence, DNR, HIPAA, Good Samaritan
Ch 18 EMS Operations START Triage, JumpSTART, MCI, ICS, Air Medical, HAZMAT
Ch 19 Infection Control PPE Levels, CISM, Stress Types, DABDA
Ch 20 Face, Neck & Eye Eye Burns, Epistaxis, Neck Trauma, Dental Injuries
Ch 21 Medical Illnesses Influenza, HIV, Hepatitis, Meningitis, TB, MRSA, COVID, Ebola
Ch 22 Special Challenges ASD, Down Syndrome, LVAD, Tracheostomy, Cerebral Palsy
Ch 23 Medication Orders Standing Orders, Off-line vs Online Direction, Two-Provider Check Steps
Ch 24 Burns Rule of Nines, Burn Depth, Critical Burns, Chemical/Electrical
Ch 25 Spinal Motion Restriction SMR Criteria, Spinal Cord Injury Signs, Neurogenic Shock
Ch 26 Pediatric Vitals Age Vitals Table, PAT Triangle, Anatomical Differences
Final Master NREMT 25 High-Yield Side-by-Side Comparisons
Differentiator
, EMT Ultimate Study Guide
UCLA Center for Prehospital Care · NREMT Exam Prep
All Sources Consolidated: Study Grids + Lecture Slides (Sessions 1–17) + Master Review Guide
March 2026
📋 Study Grids PDF 🎓 Lecture Slides 1–17 📖 Master Review Guide
Condition grids filled in — Signs, Instructor emphasis, case studies, Detailed comparison tables,
Treatment, Definitions for all topics mnemonics, clinical pearls from all formulas, MCI, EMS Operations,
sessions special population atypical
presentations
HOW TO USE THIS GUIDE
🔍
▸ Bold questions = Q&A format from your original study guide style
⚡
Purple box on every condition = KEY DIFFERENTIATOR for that condition
🟡
Gold box = NREMT TIP from your Master Review Guide
Teal box = mnemonic to memorize
Grid tables = condition-by-condition reference with differentiators built in
🩺 Chapter 1: Patient Assessment
Primary Assessment — Steps in Order
Step Assessment Key Action
1. General Age, sex, level of distress, Scan for life threats — uncontrolled bleeding FIRST
Impression overall appearance
2. LOC AVPU + Alert & Oriented ×4 Any patient NOT fully A&O ×4 = altered LOC
(Person/Place/Time/Event)
3. Airway Open and patent? Medical: head-tilt chin-lift | Trauma: jaw thrust
4. Breathing Rate, rhythm, depth, effort — Treat as you find: O₂ for distress, BVM for failure
Lung sounds
5. Circulation Pulse rate/rhythm/quality — Skin Control bleeding; treat for shock if needed
signs — Cap refill
6. Decision Load & Go vs. Stay & Play Life threats = Load & Go immediately
⚡ NREMT TIP: Treat life threats AS YOU FIND THEM — don't finish assessment before intervening.
Vital Signs — Normal Ranges
Vital Sign Adult Normal Pediatric Notes Key Clinical Point
Pulse Rate 60–100 bpm See Ch 24 full Tachycardia = FIRST sign of shock. Rate +
table. Newborn: Rhythm + Quality
, Vital Sign Adult Normal Pediatric Notes Key Clinical Point
85–205 | Infant:
100–190 | Child:
60–140
Respirations 12–20 bpm See Ch 24 full <12 or >20 = abnormal. Rate + Rhythm + Depth +
table. Newborn: Effort
30–60 | Toddler:
24–40 | Child: 18–
30
SpO₂ 94–100% Same <94% = hypoxia. COPD target: 88–92%.
Unreliable in CO poisoning
Blood Glucose 80–120 mg/dL Same <60 = hypoglycemia (treat). >400 = DKA range
Blood Pressure SBP 110–130 Peds SBP = Hypotension is a LATE sign of shock in adults —
mmHg 70+(2×age) don't wait for it
GCS 15 = normal Infant: use modified <8 = severe TBI/intubation threshold. TREND it
GCS — direction matters
Pupils PERRL Same Pinpoint = opioids/cholinergics | Dilated =
sympathomimetics/anticholinergics | Unequal =
TBI
Skin Pink, warm, dry Same Pale/cool/clammy = shock | Hot/dry = heat stroke
| Cyanotic = hypoxia
Cap Refill <2 seconds Most reliable in In peds, cap refill is MORE reliable than BP for
children perfusion assessment
SAMPLE & OPQRST
SAM OPQ
Meaning Meaning
PLE RST
S Signs & Symptoms (chief complaint) O Onset — gradual or sudden?
A Allergies — what happens with exposure? P Provocation/Palliation — what makes it worse
or better?
M Medications — Rx, OTC, recreational Q Quality — describe the pain
P Past Medical History R Radiation — does it move anywhere?
L Last Oral Intake S Severity — 1–10 scale
E Events Leading Up T Time — how long has this been happening?
Reassessment Intervals
• Unstable patients: every 5 minutes
• Stable patients: every 15 minutes
• Each reassessment: repeat primary assessment, vitals, chief complaint, recheck all interventions
⚡ NREMT TIP: If it's not documented, it didn't happen. Document everything — refusals, patient statements,
bystander info, all interventions and patient responses.
, 🌬️ Chapter 2: Airway Management
▸ How do you differentiate respiratory distress from failure?
• Distress: ALERT, tachypnea, labored, accessory muscles, SpO₂ may still be >94% → give O₂
• Failure: ALTERED/cyanotic/rate <10 or >30/poor chest rise → BVM immediately
🔍 KEY DIFFERENTIATOR: The mental status is THE differentiator. ALERT + struggling = distress (O₂). ALTERED
or cyanotic = failure (BVM). Never give O₂ when BVM is needed.
⚡ NREMT TIP: Confirm BVM effectiveness: visible chest rise + improving color + SpO₂ trending up.
Respiratory Distress vs. Failure — Comparison
Finding Respiratory Distress Respiratory Failure
Mental Status Alert, anxious Confused, lethargic, unresponsive
Speech 2–3 word dyspnea Unable to speak
Rate Tachypnea <10 or >30; gasping; agonal
Chest Rise Present Poor or absent
SpO₂ May still be >94% Dropping despite O₂
Skin Diaphoretic, flushed Cyanotic
Treatment O₂ — NC (1–6 LPM) or NRB (10–15 BVM @ 15 LPM with O₂
LPM)
Airway Adjuncts
Device Indication Contraindication Size Key Note
OPA Unconscious, NO gag Gag reflex present — Corner of Insert rotated 90–180°, then
reflex will cause vomiting mouth → seat
corner of
jaw
NPA Conscious OR Suspected basilar skull Nares → Lubricate, bevel toward
unconscious WITH gag fracture earlobe septum, stop if resistance
reflex
iGel Sustained Gag reflex, caustic By No rotation needed — curved
unconsciousness, ingestion size/weight design seats above glottis
cardiac arrest
CPAP Awake, spontaneously Apnea, decreased LOC, Adult/peds NOT a ventilation device —
breathing patient with vomiting sizes patient must breathe on their
CHF/COPD own
🔍 KEY DIFFERENTIATOR: CPAP is not a ventilation device. If the patient stops breathing while on CPAP →
switch to BVM immediately.
O₂ Delivery Devices
Device Flow Rate Approx. FiO₂ When to Use
Nasal Cannula (NC) 1–6 LPM 24–44% Mild distress; COPD (titrate to SpO₂ 88–92%)
Non-Rebreather Mask 10–15 LPM ~90% Moderate-severe distress; any shock; CO
(NRB) poisoning
BVM 15 LPM ~100% with Respiratory failure; cardiac arrest; rate <10 or
