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NREMT guide · updated 2026-09-29

Patient Treatment and Transport on the NREMT EMT exam

Patient Treatment and Transport is 20-24% of the NREMT EMT exam, the second-largest domain. Its seven job tasks cover managing the airway and ventilation, the cardiovascular system, musculoskeletal motion restriction, medication administration, special populations, transport, and communicating patient information.

The seven job tasks

TaskTypical content
Manage airway, ventilation and oxygenationPositioning, suction, OPA and NPA sizing, bag-valve-mask ventilation, oxygen delivery devices
Manage the cardiovascular and circulatory systemCPR quality, AED use, bleeding control, tourniquets, shock care
Manage motion restriction of the musculoskeletal systemSpinal motion restriction decisions, splinting, traction splint indications and contraindications
Administer medicationEMT-level medications and assisting with a patient's own prescribed medications
Manage interventions for special populationsPediatric, geriatric, obstetric and bariatric patients
Manage patient transportDestination choice, positioning, when to transport rapidly
Communicate pertinent patient informationRadio reports and handoff to receiving staff

Staying inside EMT scope

Every exam item is reviewed for scope of practice, so the correct answer will be something an EMT can do. Typical EMT-level medications include oxygen, oral glucose, aspirin, naloxone and epinephrine by auto-injector, along with assisting a patient with their own prescribed inhaler or nitroglycerin; your local protocols set the exact list. Answers involving IV access, advanced airways or rhythm interpretation are outside EMT scope.

For each medication, know the indication, the key contraindications, the route and what to reassess afterward. Medication questions are often about when not to give something.

Points that decide many questions

  • CPR quality: correct rate and depth, full recoil, and minimal interruptions, following current AHA guidelines.
  • Bleeding: direct pressure first; a tourniquet for life-threatening extremity bleeding that pressure does not control.
  • Ventilation beats oxygen alone when breathing is inadequate.
  • Traction splints are for isolated mid-shaft femur fractures, not for injuries near the hip, knee or ankle.
  • Transport decisions follow the patient's condition: time-sensitive problems go to the facility that can treat them.

How to study this domain

  • Pair each intervention with its trigger: which finding tells you to do this now.
  • Learn the medication list as a table of indication, contraindication, dose route and reassessment.
  • Practice short radio reports: age, sex, chief complaint, key findings, treatment, response, estimated arrival time.

Sample NREMT questions with answers

1. An EMT responds to a motor vehicle collision where a restrained driver is unresponsive with a suspected cervical spine injury. Which airway maneuver should the EMT use to open this patient's airway?

  1. Head-tilt chin-lift
  2. Jaw thrust without head extension
  3. Modified head-tilt with one hand stabilizing the occiput
  4. Neck-lift chin-lift
Show answer

B. Jaw thrust without head extension The jaw thrust without head extension is the preferred maneuver when spinal injury is suspected because it opens the airway with minimal cervical movement. Head-tilt chin-lift (A) extends the neck and is contraindicated when a cervical injury cannot be ruled out. The modified head-tilt (C) and neck-lift chin-lift (D) are not recognized BLS maneuvers and still extend the cervical spine.

2. An EMT is selecting an oropharyngeal airway (OPA) for an unresponsive adult. Which measurement correctly determines the appropriate size?

  1. From the tip of the nose to the earlobe
  2. From the corner of the mouth to the earlobe
  3. From the earlobe to the tip of the chin
  4. From the center of the forehead to the base of the chin
Show answer

B. From the corner of the mouth to the earlobe The OPA is sized by measuring from the corner of the mouth to the earlobe (or equivalently from the center of the mouth to the angle of the jaw). This ensures the flange seats at the lips and the distal tip reaches the base of the tongue without pressing on the epiglottis. Nose-to-earlobe (A) is the measurement used for a nasopharyngeal airway. Options C and D do not correspond to any standard airway-adjunct sizing technique.

3. When suctioning the oropharynx of an adult patient, the EMT should limit each suction attempt to no longer than:

  1. 5 seconds
  2. 10 seconds
  3. 15 seconds
  4. 30 seconds
Show answer

C. 15 seconds Each oropharyngeal suction attempt in an adult must not exceed 15 seconds to avoid prolonged interruption of oxygenation and the risk of hypoxia or cardiac dysrhythmia. In infants and children, 10 seconds is the limit because pediatric patients desaturate faster. Five seconds (A) is unnecessarily brief and usually insufficient to clear the airway. Thirty seconds (D) carries a significant risk of hypoxic injury. The patient should be pre-oxygenated before and after suctioning.

4. An EMT is treating a 58-year-old male who is alert and oriented with crushing substernal chest pain radiating to his left arm. He has no aspirin allergy and has not taken aspirin today. Which of the following best describes the correct aspirin administration for this patient?

  1. 81 mg enteric-coated tablet, swallowed whole with water
  2. 160–324 mg non-enteric-coated aspirin, chewed
  3. 500 mg aspirin tablet, swallowed as quickly as possible
  4. 650 mg aspirin, crushed and dissolved in water before ingestion
Show answer

B. 160–324 mg non-enteric-coated aspirin, chewed Current AHA guidelines direct EMTs to administer 160–324 mg of non-enteric-coated aspirin and instruct the patient to chew, not swallow whole, for rapid buccal absorption. Enteric-coated tablets are absorbed too slowly in the acute coronary setting. 500 mg and 650 mg both exceed the recommended range and have no additional benefit while increasing GI risk. Dissolving aspirin in water does not accelerate absorption meaningfully and is non-standard.

5. During a timed CPR quality check, an EMT counts 30 chest compressions completed in exactly 15 seconds. What is the calculated compression rate, and is it within the AHA-recommended range?

  1. 90 compressions per minute; below the recommended range of 100–120/min
  2. 100 compressions per minute; at the lower limit of the recommended range
  3. 120 compressions per minute; within the recommended range
  4. 150 compressions per minute; above the recommended range
Show answer

C. 120 compressions per minute; within the recommended range Rate = (compressions ÷ seconds) × 60 = (30 ÷ 15) × 60 = 2.0 × 60 = 120 compressions per minute. The AHA recommends 100–120/min for adult CPR; 120/min is at the upper limit and is acceptable. For comparison: 90/min would require 30 compressions in 20 s; 100/min would require 30 in 18 s; 150/min would require 30 in 12 s and is too fast.

Frequently asked questions

What percent of the NREMT is Patient Treatment and Transport?

20-24% under the 2025 EMT examination specifications.

Are IV or advanced airway questions on the NREMT EMT exam?

Items are reviewed for EMT scope of practice, so correct answers should not require ALS skills such as IV access or advanced airways.

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Sources: National Registry EMT Examination Specifications · EMT Candidate Handbook: About the Examination. Independent study material. Not affiliated with or endorsed by the National Registry.

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