NREMT Skillset

This skill is based fully upon material take from the CDC recommendations for EMS personnel[1] and reflects up to date COVID-19 compliant instructions[2] for the donning and doffing of a full set of PPE including respiratory, eye and hand protection with a full isolation gown. For most prehospital patient encounters the isolation gown is not required, but you should be familiar with its use.

Using the PENMAN mnemonic helps the first responder approach every incident in a safe, methodical and organized way. The goals are to ensure the responder and response team(s) are safe, and that they remember to request appropriate additional resources to stabilize and mitigate the incident in a timely manner. Reviewing the elements of PENMAN is done continually from the start of the dispatch throughout the incident until the patient(s) is/are transported to the hospital.

The purpose of the Primary Assessment/Survey is to identify and treat life threatening conditions. The Primary Assessment/Survey should be performed rapidly and methodically. If massive hemorrhage is present it must be controlled first. Manage or direct the management of potentially life threatening issues as they are encountered.

Vital Signs (VS) include the measurement of pulse, respiratory rate, blood pressure, and temperature. These numbers provide critical information (hence the name "vital") about a patient's state of health. Vital signs are included in this California-based EMT program as mastery of this skill is required for several of the higher level skills tested for California Registration.

The SAMPLE history is a structured way for medical responders to gather key patient information: Signs/Symptoms, Allergies, Medications, Pertinent history, Last oral intake, and Events leading to the incident to understand the patient’s condition and guide treatment.

Cardiopulmonary Resuscitation (CPR) is a series of immediate actions to take to restore the flow of oxygenated blood to a person's brain and organs when they suffer Sudden Cardiac Arrest (SCA). If the flow of oxygenated blood to the brain is not restored within a few minutes the victim could die or suffer irreversible brain damage.

Training in Lifting and Moving Patients is included in this California-based EMT program as it is required in higher level scenario-based skills verification for California Registration.[1] Although it may seem like a simple and potentially redundant skill to teach as everyone lifts things in their daily life, this is in fact one of the most important skills for any healthcare worker to master as back injuries due to lifting are some of the most common injuries found in EMS workers.

Airway Management is the first step in the competent care of the compromised patient. Hypoxia, or lack of oxygen, can cause neurological damage within minutes, and airway management is one of the most urgent interventions the EMT can perform in the prehospital setting.

The Sager Traction Splint Application provides a detailed guide for EMTs on when and how to use a unipolar (Sager) traction splint for femur fractures, covering indications, contraindications, step-by-step application, documentation, and pain management tips, emphasizing safe technique, neurovascular checks, and patient comfort during immobilization and transport.

The Seated Spinal Immobilization (KED) pageexplains how to safely immobilize and extricate a seated patient with a suspected spinal injury—typically after a vehicle collision—using a Kendrick Extraction Device (KED).

This skill page covers long backboard immobilization for the supine patient.

The Hemorrhage Control procedure teaches emergency responders how to stop life-threatening bleeding using direct pressure, tourniquets, and wound packing. It emphasizes acting immediately—since uncontrolled bleeding is a leading preventable cause of death—and explains when to use each method, how to apply commercial or improvised tourniquets, and how to pack deep or junctional wounds safely.

Long Bone Splinting covers the step-by-step procedures EMTs use to stabilize fractures and prevent further injury during patient transport. It explains how to immobilize upper and lower limb fractures, including wrist, arm, femur, and tibia/fibula breaks, using materials like cardboard, air, or SAM splints.

Joint Immobilization teaches EMTs how to stabilize suspected joint injuries in the field to prevent further damage and reduce pain, emphasizing pre-/post-immobilization checks of circulation, sensation, and motor (CSM) and generally securing the joint in the position found. It covers upper and lower extremity care—using sling & swathe for shoulder/upper-arm support, A-frame splints for elbow/knee angles, and padding/rigid supports for ankles/hips—plus when to consider reduction per local protocol. The guide stresses patient comfort, continuous reassessment, and clear documentation of findings and interventions.

Penetrating chest trauma most frequently involves mechanisms such as stabbing and gunshot wounds (GSW), although there are a variety of ways the chest can be penetrated in industrial accidents. Penetrating chest trauma frequently creates serious or fatal injury because of injuries to the lungs and large vascular structures (including the heart) that are housed within the chest cavity. You should have a high index of suspicion that there may be C-spine involvement in any trauma involving the chest, and take appropriate precautions during treatment.

Trauma Patient Assessment outlines how EMTs conduct a secondary assessment for trauma patients after life-threatening conditions are stabilized. It guides responders through the SAMPLE history (Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events) and a head-to-toe physical exam using DCAP-BTLS (Deformities, Contusions, Abrasions, Penetrations, Burns, Tenderness, Lacerations, Swelling). The procedure includes detailed inspection and palpation of the head, neck, chest, abdomen, pelvis, extremities, and back, emphasizing maintaining airway and C-spine precautions, identifying hidden bleeding, and reassessing vital signs frequently.

The Patient Care Report (PCR), also called a Prehospital Care Report, is the legal document used by first responders to record all aspects of the care a patient receives from initial dispatch to handoff in the hospital.

This module introduces the two key phases of patient handoff in prehospital care—the Ring Down and the Full Handoff. Learners will practice concise, structured communication to ensure continuity and safety during transitions of care. The module emphasizes clarity, accuracy, and professionalism when relaying patient information to receiving providers, both over radio and in person. By the end of the module, learners will be able to deliver an organized, complete handoff using structured tools such as SBAR, MIST, or I-PASS.

This module introduces EMT learners to key setup and support procedures used in Advanced Life Support operations under the supervision of a Paramedic or nurse. It covers the preparation and assembly of an endotracheal (ET) tube, setup and monitoring of intravenous (IV) fluids, and placement of EKG leads for cardiac monitoring. Learners will develop the ability to support airway management, maintain IV fluid systems safely, and accurately place 4-lead and 12-lead EKG electrodes to assist in cardiac assessment. Emphasis is placed on aseptic technique, patient safety, and effective teamwork in ALS environments.

This module introduces learners to the principles, indications, and safe application of Continuous Positive Airway Pressure (CPAP) in the prehospital setting. CPAP is a non-invasive ventilation technique used to support patients in respiratory distress, including those with COPD, pulmonary edema, pneumonia, or near-drowning. Learners will gain hands-on experience assembling CPAP equipment, applying the device to patients, adjusting settings for comfort and efficacy, and monitoring patient response. The module emphasizes understanding CPAP’s physiological effects, recognizing contraindications, and documenting care accurately.

Learn to obtain and interpret point-of-care blood glucose in the field. This module covers meter calibration/quality checks, safe capillary sampling (finger-stick and alternates), interpretation of results in context (hypo- vs hyperglycemia), immediate EMT-level interventions, and clear PCR documentation.

This module trains learners to recognize and manage opioid overdoses using intranasal naloxone (Narcan). EMTs will learn how to identify the signs of opioid toxicity, perform medication safety checks, and administer naloxone safely while maintaining airway and breathing support. The module emphasizes patient monitoring, reassessment, and effective documentation to ensure continuity of care.

This module trains EMTs to recognize, prepare for, and assist in emergency childbirth when delivery occurs before reaching a medical facility. Learners will practice assessing labor progression, managing a safe and sterile delivery, caring for both mother and newborn, and identifying emergencies that require rapid transport. The session emphasizes calm, structured teamwork and maintaining maternal and neonatal safety in dynamic environments.

This module trains EMTs to recognize, prepare for, and assist in emergency childbirth when delivery occurs before reaching a medical facility. Learners will practice assessing labor progression, managing a safe and sterile delivery, caring for both mother and newborn, and identifying emergencies that require rapid transport. The session emphasizes calm, structured teamwork and maintaining maternal and neonatal safety in dynamic environments.

This module introduces EMTs to the principles and application of mass casualty triage using the START (Simple Triage and Rapid Treatment) and JumpSTART systems for adults and pediatric patients. Learners will practice rapid assessment, prioritization, and classification of patients based on respiratory effort, perfusion, and mental status during large-scale emergencies. The focus is on performing quick, consistent triage decisions that maximize survival while maintaining rescuer safety and situational awareness.

This module teaches EMTs how to recognize and treat severe allergic reactions and anaphylaxis using an epinephrine auto-injector. Learners will practice safe, accurate medication administration using the “Five Rights,” understand when epinephrine is indicated, and learn to monitor patients for both improvement and potential side effects. The module emphasizes rapid recognition, confident intervention, and thorough patient monitoring during life-threatening allergic emergencies.

This module trains EMTs in the systematic evaluation of non-trauma medical patients through structured assessment, history taking, and physical examination. Learners will use standardized mnemonics (PENMAN, SAMPLE, OPQRST, AEIOU-TIPS, and PASTE) to identify life-threatening conditions, gather critical history, and determine the priority and mode of transport. The emphasis is on developing diagnostic reasoning through consistent, thorough, and adaptable patient assessment practices.

This training module is intended for use by Foothill College EMT students to train to administer COVID-19 vaccine under the supervision of EMS Faculty in volunteer vaccination clinics. Authorization for EMTs, Paramedics and EMS students in a EMT or Paramedic training program to draw up and administer vaccine via IM injection is subject to Medical Direction and Authorization on a county by county basis.