Your FREE EMR Flashcards 2026 – 250+ Cards

Emergency Medical Responder — the entry-level national EMS certification, below the EMT, providing immediate basic life support with minimal equipment until a transporting unit arrives.

EMR = entry-level BLS; EMT = transporting BLS (adds NPA, oral glucose, etc.); AEMT adds IV/IO, fluids & supraglottic airways; Paramedic adds intubation, cardiac monitoring & most IV drugs.

The National Registry of Emergency Medical Technicians (NREMT).

A computer adaptive test (CAT) of about 90–110 items, up to 1 hour 45 minutes; the test ends once it can decide your competency with confidence.

Pass/fail against a criterion-referenced cut score; there is no fixed passing percentage.

Scene Size-up & Safety, Primary Assessment (heaviest), Secondary Assessment, Patient Treatment & Transport, and Operations.

Primary Assessment — about 37–41% of the exam.

Secondary Assessment — about 4–8% of the exam.

The NHTSA document defining the four EMS levels (EMR, EMT, AEMT, Paramedic) and what each may do — the authoritative baseline for the EMR scope.

Scene safety, CPR, AED, bleeding control (pressure, packing, tourniquet), manual airway (head-tilt/jaw-thrust), OPA, suction, BVM, oxygen, naloxone, manual spinal stabilization, cervical collar, splinting, emergency childbirth.

Nasopharyngeal airway (NPA), pulse oximetry, oral glucose, aspirin, nitroglycerin, inhalers, CPAP, long backboard — these begin at the EMT level.

IV and IO access, IV fluids, and supraglottic (blind-insertion) airways — NOT in the EMR scope.

Endotracheal intubation, cardiac rhythm interpretation, manual defibrillation, and most IV medications.

The oropharyngeal airway (OPA), for an unresponsive patient with no gag reflex. The NPA is an EMT-level adjunct.

Yes — an EMR can give naloxone (intranasal or auto-injector) for an opioid overdose. Support ventilation first.

Generally no — the EMR provides immediate care and stabilizes, then hands off to a transporting (EMT/ALS) unit.

Basic life support — the non-invasive emergency care an EMR provides: CPR, AED, airway maneuvers, BVM, oxygen, bleeding control, and splinting.

Two years; renew through NCCP continuing education plus a current state EMS credential.

Complete a state-approved EMR course meeting the National EMS Education Standards, meet the state BLS skills requirement, and pass the cognitive exam.

Physician oversight of EMS care — offline (protocols/standing orders) or online (real-time orders by radio/phone).

Yes — many states expand the EMR scope beyond the national baseline, so always follow local protocol. The exam is written to the national Model.

Early recognition/activation, early CPR, and early defibrillation are the first links — and the ones an EMR, often first on scene, controls.

The EMR — frequently the first trained provider on scene, beginning care before the transporting crew arrives.

An ongoing system of reviewing and improving the quality of EMS care delivered.

The care expected of an EMR with similar training in a similar situation — the benchmark used to judge negligence.

The accurate, objective written record of an EMR's assessment and care; a legal document that supports continuity of care.

Conditions an EMR must report per state law, such as suspected child, elder, or domestic abuse.

EMRs face critical-incident stress; recognize warning signs and use healthy coping and peer/professional support.

Communicating with the patient and family with empathy, eye contact, and clear language to gain trust and information.

Use the power lift (legs, not back), keep the load close, and avoid twisting to prevent injury.

EMR → EMT → AEMT → Paramedic. Each level builds on the one below it.

Typically no — the EMR stabilizes and hands off; the EMT is the first transporting (BLS) provider.

Naloxone (IN or auto-injector) is one of the few medications in the national EMR scope — alongside oxygen.

Maintain fitness, use proper body mechanics, get rest, and manage stress to stay able to respond safely.

Off-duty good-faith aid is generally covered by Good Samaritan laws; on-duty an EMR has a duty to act.

Scope = what you're allowed to do; quality (CQI) = how well the system does it. Both shape good EMR care.

Report any blood/body-fluid exposure, follow your agency's exposure-control plan, and seek medical follow-up.

The quick pre-patient assessment: standard precautions, scene safety, mechanism of injury or nature of illness, number of patients, and the need for more resources.

Responder safety — you cannot help anyone if you become a patient.

Treating all blood and body fluids as infectious and using barriers (gloves, eye protection, mask, gown) matched to the exposure risk.

Infection-control practices applied to every patient — hand hygiene plus barriers — regardless of known infectious status.

When splashing or large fluid volumes are likely — e.g., a childbirth or major bleeding.

Stop, remove the damaged glove, perform hand hygiene, and apply a fresh glove before continuing.

The forces/energy that caused a trauma patient's injury (fall height, vehicle speed, blade path) — used to predict likely injuries.

The general type of medical problem a non-trauma patient has, gathered from the patient, family, bystanders, and scene.

MOI applies to TRAUMA patients (the forces involved); NOI applies to MEDICAL patients (the type of illness).

Your level of concern for serious, hidden injury based on the mechanism; a significant mechanism (high fall, high-speed crash) raises it.

Forces likely to cause serious injury — a high fall, ejection, high-speed crash, or rollover — warranting a higher index of suspicion and a rapid exam.

Injury from energy transferred to the body when motion stops suddenly, as in a head-on crash — even without obvious external wounds.

Stage at a safe distance and wait for law enforcement to secure the scene before approaching.

Traffic, violence, fire, electricity/downed wires, hazardous materials, unstable structures, and environmental dangers.

Recognizing extra patients or a serious situation up front lets you summon more units before being overwhelmed — it speeds definitive care.

Part of the scene size-up — determine the number of patients before committing to one, so you can request the right resources.

When the number and severity of patients exceed the resources on scene, triggering a shift to triage.

Do not approach — the vehicle and ground may be energized. Stage, keep bystanders back, and call the power company and fire/rescue.

Approach from uphill and upwind, identify the hazard from a distance, and stay clear of the danger zone.

Gear that protects the responder — gloves, eye protection, mask, gown, and, for hazards, turnout gear or specialized PPE as trained.

A patient's infectious status is usually unknown, so barriers protect the responder regardless.

Triggers a mass-casualty response and START triage.

A higher fall onto a harder surface raises the index of suspicion for serious injury (greater energy).

Consider the likely path and depth of the object (e.g., a blade through the chest) to anticipate injuries.

Begin assessing scene safety from the rig as you approach, before you step out.

A safe location where EMS waits until a hazardous scene (violence, hazmat, fire) is secured.

Hazards and patient needs must be recognized quickly to guide a safe approach and early resource calls.

Determines whether you have enough resources or must triage and call for help.

The rapid search for and treatment of immediate life threats, in the order XABC: control massive bleeding, then Airway, Breathing, Circulation.

eXsanguinating (massive) bleeding, Airway, Breathing, Circulation — treat each life threat the moment it is found.

A person can bleed to death faster than an airway problem will kill them, so massive hemorrhage is controlled first.

The immediate sick-versus-not-sick judgment from the patient's appearance, work of breathing, and skin color as you approach.

A rapid level-of-consciousness check: Alert, responds to Verbal, responds to Pain, Unresponsive.

Alert — spontaneously alert and aware of surroundings.

P — responsive to Painful stimulus only.

Deteriorating level of consciousness — the patient is getting worse.

The basic airway maneuver for an unresponsive patient with NO suspected spinal injury — tilts the head back and lifts the chin off the airway.

Opens the airway WITHOUT moving the neck — used when a spinal injury is suspected.

A rigid airway adjunct for an unresponsive patient with NO gag reflex — an EMR-level skill.

Suction for no more than about 15 seconds per attempt (less in children) to avoid hypoxia.

Rate too fast or too slow, shallow/irregular effort, accessory-muscle use, cyanosis, one- to two-word dyspnea, and altered mental status.

The device used to deliver positive-pressure ventilation to a patient breathing inadequately or not at all.

About once every 5–6 seconds (10–12/min) for a non-breathing adult with a pulse — do not over-ventilate.

Raises pressure in the chest, lowers cardiac output, and causes gastric distension and aspiration.

The carotid pulse in the neck — a large central artery that stays palpable when peripheral pulses fade.

The brachial pulse (inside the upper arm).

Fast heart rate, anxiety/restlessness, pale, cool, clammy skin, and delayed capillary refill — with near-normal blood pressure.

Falling blood pressure and a declining mental status — ominous signs that the patient is decompensating.

100–120 compressions per minute.

At least 2 inches (5 cm).

30 compressions to 2 breaths (30:2).

15 compressions to 2 breaths (15:2).

About every 2 minutes, to limit fatigue and keep compressions high-quality.

Letting the chest return fully between compressions so the heart refills — essential for effective CPR.

Analyzes the rhythm and delivers a shock to a shockable rhythm; applying an AED is a core EMR skill.

Power on, attach pads, clear the patient, let it analyze, deliver a shock if advised, then resume CPR immediately.

Occasional gasping in cardiac arrest — NOT adequate breathing; treat as arrest and begin CPR.

The sick-vs-not-sick call ending the primary assessment; a high-priority patient needs a transporting unit summoned early.

Poor general impression, airway/breathing trouble, uncontrolled bleeding, signs of shock, or an altered mental status.

Bluish skin or lips signaling inadequate oxygenation.

Sitting upright leaning forward on the arms to ease breathing — a sign of respiratory distress.

Normal rate and depth, regular rhythm, and good, equal chest rise.

A patient who is speaking/crying has an open airway and at least minimally adequate breathing.

Lets fluids drain and keeps the tongue clear of the airway in an unresponsive but adequately breathing patient.

Find and treat immediate threats to life — nothing else takes priority during it.

Responsiveness/impression → (massive bleeding) → airway → breathing → circulation.

The quick check for adequate breathing — look for chest rise, listen and feel for air movement.

A high-pitched sound on inspiration signaling upper-airway obstruction (croup, swelling, foreign body, anaphylaxis).

Keep the child calm, do NOT inspect the throat, give oxygen, and transport — agitation can worsen the airway.

Ventilate with a BVM for inadequate/absent breathing; give oxygen (cannula/NRB) for hypoxia in a patient breathing adequately.

About one-third the depth of the chest.

Usually means hypoxia — open the airway and oxygenate or ventilate.

Pauses drop blood flow; keep compressions nearly continuous and resume immediately after a shock.

Continuous chest compressions without breaths, taught for untrained or unwilling bystanders — EMRs add ventilations.

A from-the-doorway impression of a child: Appearance, Work of Breathing, and Circulation to the skin.

General impression is the overall sick/not-sick sense; AVPU is the specific level-of-consciousness rating.

1 breath every 6 seconds (about 10 per minute).

The detailed exam after life threats are addressed — a focused or rapid head-to-toe exam, vital signs, and a history.

Signs/symptoms, Allergies, Medications, Pertinent past history, Last oral intake, Events leading up.

Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Time — a pain-assessment mnemonic.

Onset.

Quality (e.g., sharp, dull, crushing).

Time.

A — Allergies.

M — Medications.

P — Pertinent past medical history.

Pulse, breathing (rate & quality), skin (color/temperature/moisture), pupils, and — where trained — a manual blood pressure.

Press a nail bed until it blanches; color should return in under 2 seconds. A delay suggests poor peripheral perfusion.

Pale, cool, clammy skin points to poor perfusion; assessing skin is a fast window on circulation.

Pupil findings reflect the brain/head; unequal or non-reactive pupils can indicate a serious head problem.

Pupils Equal And Round, Reactive to Light — a normal pupil exam.

Deformities, Contusions, Abrasions, Punctures/penetrations, Burns, Tenderness, Lacerations, Swelling — what to look for in the physical exam.

Responsive medical patient → focused exam of the relevant system; unresponsive or major-trauma patient → rapid head-to-toe exam.

Distended neck veins felt/seen during the exam — can indicate a chest or cardiac problem.

A shift of the trachea away from midline — a late sign of a tension pneumothorax.

A section of chest wall moving opposite to the rest during breathing — a flail-chest sign found on the exam.

Suggests developing poor perfusion (early shock).

Repeat the primary assessment, vitals, and interventions every 5 minutes for an unstable patient and every 15 minutes for a stable one.

The first set of vitals; later sets are compared against them to detect trends.

From family, bystanders, medical-alert tags, and the scene.

The main problem the patient (or others) report — the reason EMS was called, in the patient's own words when possible.

About 60–100 beats per minute.

About 12–20 breaths per minute.

It matches the depth of assessment to the patient's condition and mechanism.

Matters for surgery timing, diabetic emergencies, and possible aspiration.

How bad the symptom is, usually rated 0–10.

Where the pain is and where it travels (e.g., chest pain radiating to the arm).

Comparing repeated vitals against the baseline to detect improvement or deterioration.

Profuse sweating — a sign that can accompany shock, a heart attack, or hypoglycemia.

A blotchy skin pattern reflecting poor perfusion, often seen in shock.

To find distended neck veins or a deviated trachea, which point to serious chest/cardiac problems.

Checking distal Circulation, Motor, and Sensory function before and after splinting an injured limb.

Important findings the patient does NOT have (e.g., no chest pain), which help rule conditions in or out.

Direct pressure first; then a tourniquet for limb bleeding it can't control; wound packing for junctional wounds.

Firm, steady pressure directly over a bleeding wound — the first and primary method to control external bleeding.

A few inches above the wound on the limb, NOT over a joint; apply high and tight, note the time, and leave it on.

Hospital or higher-level providers — not the EMR in the field.

Firmly packing gauze (plain or hemostatic) into a deep junctional wound and holding direct pressure when a tourniquet can't reach.

Gauze treated to speed clotting; packed into a wound and held with firm direct pressure.

Place it on the forearm above the wound (a limb, not over a joint).

Keep the patient supine and warm; routine head-down (Trendelenburg) tilt is NO longer recommended for shock.

Control bleeding, maintain airway/breathing, give oxygen, keep warm and supine, and arrange rapid transport.

Unresponsive (or decreased LOC) BUT breathing adequately, has a pulse, and NO suspected spinal injury.

Inadequate breathing (ventilate/CPR instead) or a suspected spinal injury (keep aligned, manage airway in place).

Stop the burning, remove jewelry and non-stuck clothing, cover with a dry sterile dressing, keep warm — do NOT pop blisters or apply ice/ointment.

Head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, genitals 1%.

Singed nasal hair, soot in the mouth, hoarseness, or stridor — possible airway involvement; manage the airway and transport.

Seal with an occlusive (vented) dressing; if signs of a tension pneumothorax develop, burp the dressing.

Stabilize it in place — do NOT remove it; control bleeding around it and transport.

Cover protruding abdominal organs with a moist, sterile dressing — never push them back in.

Hold the head neutral with eyes forward (nose in line with the navel) for a suspected spinal injury, before and during a collar.

Supports the neck for a suspected spinal injury but does NOT fully immobilize — continue manual stabilization with it.

If moving the head toward neutral causes severe pain or resistance — hold it where found and stabilize.

An opioid antagonist an EMR can give intranasally or by auto-injector to reverse opioid respiratory depression. Support ventilation first.

Pinpoint pupils, slow or absent breathing, and a decreased level of consciousness.

Restore adequate breathing, not full alertness; over-aggressive dosing can trigger agitation and withdrawal.

Face droop, Arm drift, Speech difficulty, Time to call for help and note the last-known-well time.

Recognize with FAST, note last-known-well, support airway/breathing, check glucose if trained, and transport rapidly to a stroke center.

Crushing chest pressure radiating to the arm/jaw, dyspnea, diaphoresis, nausea — subtler in women, the elderly, and diabetics.

Keep the patient calm and at rest, give oxygen if hypoxic, monitor, and transport rapidly. (Aspirin/nitro are EMT-level.)

Give abdominal thrusts (Heimlich) above the navel until the object clears or the patient becomes unresponsive.

Lower them to the ground and begin CPR, checking the mouth for the object before giving breaths.

Alternate 5 back blows and 5 chest thrusts (not abdominal thrusts).

Support the head as it delivers, suction mouth then nose if needed, keep the newborn warm and dry, and stimulate it.

If it stays below 100 despite warming, drying, positioning, and stimulating, begin positive-pressure ventilation with a BVM.

Tilt to the LEFT side to avoid supine hypotensive syndrome (the uterus compressing the vena cava).

Immobilize a suspected fracture to reduce pain and bleeding; check distal circulation, motor, and sensation before and after.

Nasal cannula for mild need; non-rebreather (10–15 L/min) for significant hypoxia in a patient breathing adequately.

Handle gently (rough movement can trigger fibrillation), remove wet clothing, rewarm passively, and give warm humidified oxygen.

Hot skin with altered mentation — a true emergency needing rapid active cooling and transport.

Protect the patient from injury, do NOT restrain or put anything in the mouth, and protect the airway afterward.

Used only when there is immediate danger, you can't reach a critical patient, or you must access another patient.

For a chemical eye exposure, flush the eye with copious water/saline, sweeping away from the unaffected eye.

Shock from blood loss — control the bleeding, give oxygen, keep warm and supine, and transport rapidly.

Two or more adjacent ribs broken in two or more places, causing paradoxical movement — support ventilation.

Severe dyspnea, absent breath sounds on one side, distended neck veins, hypotension, and late tracheal deviation.

An occlusive (vented) dressing; burp it if a tension pneumothorax develops.

Wrap the part in moist sterile gauze, place it in a bag, keep it cool (not directly on ice), and transport it with the patient.

Have the patient sit, lean forward, and pinch the soft part of the nose; transport if severe or uncontrolled.

Rapid-onset altered mental status, sweating, fast heart rate, tremor, and weakness; check glucose where trained.

Oral glucose is an EMT-level skill in the national scope — the EMR provides supportive care and rapid transport.

A severe, multi-system allergic reaction with airway swelling, wheezing, hives, and hypotension.

Giving agency epinephrine for anaphylaxis is generally EMT-level; follow local protocol, support the airway, and transport.

CO can read a falsely normal oxygen saturation — give high-flow oxygen and remove the patient from the source.

Ensure scene safety, stay calm, set limits, and use restraints only when necessary, monitored, and per protocol — never prone.

Suffocation risk from restraining a patient face-down — avoid the prone position during restraint.

Relieve pressure with knee-chest positioning and a gloved hand keeping the presenting part off the cord; transport rapidly.

Passive rewarming — remove wet clothing, insulate, and move to a warm environment; handle gently.

Hypoxia kills; give needed oxygen and monitor — do not withhold it over an unfounded 'hypoxic drive' fear.

Splint a limb in a natural, supported position; immobilize the joints above and below the injury.

Loosening it in the field can restart life-threatening bleeding and release harmful byproducts — leave it for the hospital.

An incident whose patient numbers and severity exceed available resources — that mismatch is the defining feature.

Simple Triage And Rapid Treatment — sorts patients by Respirations, Perfusion, and Mental status into four categories.

Direct everyone who can walk to one area; they are tagged Green (Minor). Then assess the rest where they lie.

The walking wounded — can get up and move on command.

Breathing over 30/min, no radial pulse or capillary refill over 2 seconds, OR can't follow commands.

Breathing, perfusing, and following commands — but cannot walk.

No breathing even after the airway is repositioned.

Opening the airway and controlling major bleeding — you keep sorting rather than stopping to treat.

The pediatric version of START triage.

The standardized NIMS structure for organizing personnel and resources at an incident.

The contaminated danger area — entered only by trained, properly equipped responders.

The decontamination corridor between the hot and cold zones.

The safe area where EMS stages and command operates — where an untrained EMR works.

The cold zone, unless specifically trained and equipped; patients must be decontaminated before treatment/transport.

Use binoculars and reference placards/labels; approach from uphill and upwind.

Informed agreement to care from a competent adult told the condition, the proposed care, and its risks.

The assumption that an unresponsive patient or an unaccompanied minor in an emergency would consent to lifesaving care.

A competent adult may refuse care after being informed of the risks; ensure an informed refusal and document thoroughly.

A legal obligation to respond and provide care — e.g., when an EMR is on duty or dispatched on a call.

Leaving a patient you've started caring for without transferring to a provider of equal or higher training.

Handing the patient to a receiving provider of equal/higher training who takes responsibility and receives a report.

Duty, breach of duty, causation, and damages — all four must be present.

Failing to provide the standard of care, such as skipping a step local protocol clearly requires.

Protects a responder who renders reasonable, good-faith aid within their training from liability.

No — it does not protect care that goes beyond the responder's training and scope.

Protect a patient's health information; share it only with those involved in the patient's care.

A valid order (e.g., a DNR) directing the limits of care — honor it when present and valid.

Operating safely with concern for others — slow at intersections (most crashes) and wear seatbelts.

The breach of duty actually caused harm to the patient.

Implied consent allows emergency care, since a reasonable parent would consent to lifesaving treatment.

Provides a clear chain of command and resource tracking so a chaotic scene is managed safely.

Reassessing and re-tagging patients as their condition changes during an MCI.

Tag Black (Deceased/Expectant) and move on.

Tag Red (Immediate).

Do the greatest good for the greatest number — sort and treat the salvageable critical patients first.

Hazmat patients must be decontaminated before EMS treats or transports them, to protect responders and the ambulance.

Gain access, assess/stabilize, disentangle, and remove — patient care drives the process.

Document objectively and accurately on the PCR; it is a legal record supporting continuity of care.

Honor an informed refusal from a competent adult; explain the risks, document thoroughly, and offer to return.

So the receiving provider has the full assessment and treatment picture and care continues seamlessly.

Failing to respond promptly while on duty can be a breach of the duty to act.

Limited sharing is allowed for continuity of care, mandated reporting, and legal requirements.

Patient numbers and severity that overwhelm available resources — not the time of day or distance to a hospital.

Anyone who can walk to a designated area on command — assessed last.