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NREMT Cognitive Exam Prep
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What are emergency moves? ✔✔These are used when the scene is dangerous and the patient must be
moved before providing patient care. Types of emergency moves include the armpit-forearm drag,
shirt drag, and blanket drag.




What is an urgent move? ✔✔Used when the patient has potentially life-threatening injuries or
illness and must be moved quickly for evaluation and transport.

Rapid extrication: an urgent move used for patients in a motor vehicle; it requires multiple rescuers
and a long backboard. The patient is rotated onto a backboard with manual cervical spine precautions
and removed from the vehicle.




What are non-urgent moves? ✔✔Used when there are no hazards and no life-threatening
conditions are apparent.

Types of non-urgent moves include direct ground lift, extremity lift, direct carry method, and draw
sheet method.




What is the log roll technique? ✔✔Commonly used to place a patient on a backboard or assess
the posterior.

Can be done while maintaining manual cervical spine precautions.

,Should have at least three trained personnel. The person controlling manual cervical spine protection
should direct the log roll.




What are special considerations for bariatric patients? ✔✔Obese patients pose additional
challenges and risks to providers during lifting and movement.

Some EMS systems have special bariatric ambulances with specialized equipment, automated lifting
systems, and wider stretchers capable of a greater weight capacity.




What is supine hypotensive syndrome? ✔✔Patients in the later stages of pregnancy should not be
placed supine due to the risk of supine hypotensive syndrome. Place the pregnant patient on her
left side. If patient has potential cervical spine trauma, tilt backboard to the left about 20 degrees.




When can patients be restrained? ✔✔In general, patients may be forcibly restrained if they pose
a significant, immediate threat to you, your partner, or others.

Restraining a patient against his will is a last resort.

Anticipate and plan. Request law enforcement assistance. Contact medical direction when possible.

Guidelines for restraining a patient:

-Get additional help whenever possible; at least 4 people is recommended.

-Use the minimum amount of force necessary to protect yourself, the patient and others.

-Secure patient supine, with backboard if available. DO NOT secure the patient in a prone position.

-Use soft, padded restraints.

-Monitor the patient's level of consciousness, airway, and distal circulation continuously.

-Thoroughly document the reason for restraining the patient, the method of restraint, the duration
of restraint, and frequent reassessment of the patient while restrained.

,What is the use of force doctrine? ✔✔The EMT must act reasonably to prevent harm to a patient being
forcibly restrained. The use of force must be protective, not punitive.




What is scope of practice? ✔✔Scope of practice outlines the actions a provider is legally allowed
to perform based on his or her license or certification level.

Scope of practice is tied to the licensure or certification, not the individual's knowledge or experience.

Each state determines the scope of practice for its EMS providers.




What is standard of care? ✔✔Standard of care is the degree of care a reasonable person with
similar training would provide in a similar situation.

Standard of care requires EMTs to competently perform the indicated assessment and treatment
within their scope of practice.




What are sources that help establish standard of care? ✔✔National EMS Education Standards

State protocols and guidelines

Medical direction

EMS agency's policies and procedures

Reputable textbooks

Care considered acceptable by similarly trained providers in the same community.




What is informed consent? ✔✔Informed consent is required from all patients who are alert
and competent.

-Patient must be informed of your carer plan and associated risks of accepting or refusing care
and transport.

, -Patient must be informed of, and understand, all information that would impact a reasonable person's
decision to accept or refuse care and transport.




What is expressed consent? ✔✔Expressed consent also requires that the patient be alert and
competent to give expressed consent. Expressed consent can be given verbally or nonverbally.

-Expressed consent is similar to informed consent, but not usually as in-depth as informed consent.

-Expressed consent is often used to obtain consent for more basic assessments or procedures.




What is implied consent? ✔✔Implied consent allows assumption of consent for emergency care from an
unresponsive or incompetent patient.

-Patients might be incompetent for many reasons, such as alcohol, drugs, head injury,
hypoxia, hypoglycemia, or mental incompetency.

-Implied consent can be used to treat a patient who initially refused care but later loses consciousness
or becomes otherwise incapacitated.




What is minor consent? ✔✔Minors are not competent to accept or refuse care.

-Consent is required from a parent or legal guardian. Implied consent can be used when unable to reach
a parent or guardian and treatment is needed.

-Minor consent is not required for emancipated minors. Criteria for emancipation varies but usually
includes minors who are married or pregnant, already a parent, a member of the armed forces,
financially independent, or emancipated by the courts.




What is involuntary consent? ✔✔Involuntary consent is used for mentally incompetent adults or
those in custody of law enforcement. Consent must be obtained from the entity with the appropriate
legal authority.

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