Jeff is reclaiming his unique digital identity with a sense of clarity.

EMR/CPR links

I am not currently employed as an EMR because of some personal issues with the profession. However, I am still licensed at this point and time and may try to take on employment in this field at some point in the future…

I had this page set to password protected, but now it’s not since I feel that the info on this page may be useful to other folks than just myself. Enjoy it (for now – may go password protected again later at some point. If I do password will likely be something silly stupid easy to access like “emr”).
Yes, I did pass my nremt emr test a few weeks back, and am currently training for my new job…. info below helped me get to this point.

I’m currently enrolled in an Emergency Medical Responder class so have started collecting a variety of links related to the first responders and cpr. Below are some of the best ones I’ve come across. Hopefully they will help you as they have helped me my brothers and sisters in the many emergency medical systems of this great world of ours… Come back here often (book mark the page if you like) as I plan to add a LOT more links over time and also organize them in to various categories eventually… (for now, newer stuff will be added to the top of the list below for simplicity’s sake)

Also, pay attention to my Twitter Feed as sometimes I post EMS related stuff there (which feeds it over in to Facebook too through a third party)  instead of posting it all right here…



Here is an in-depth guide to road safety for parents – This guide has advice categorized by age group; from picking the right car seat for a newborn through to how parents can encourage their teen not to text and drive.

============ – EMR basic skill sheets – EMT basic skill sheets – Advanced EMT Skill Sheets






LAB RAT. Left Atrium Bicuspid (mitral), Right Atrium Tricuspid.

“Toilet Paper My A..” Tricuspid, Pulmonary, Mitral (Bicuspid), Aortic

RaT in an Rv
LaMB in Las vegas

Right atrium
Tricuspid valve
Right ventricle

Left atrium
Mitral (bicuspid valve)
Left ventricle

Superior and inferior vena cavae
Right atrium
Tricuspid valve
Right ventricle
Pulmonic valve
Pulmonary artery (the ONLY major artery to carry deoxygenated blood)
Pulmonary arteries (small), arterioles, capillaries, venules, and small veins
Pulmonary vein (the ONLY major vein to carry oxygenated blood)
Left atrium
Biscuspid (mitral) valve
Left ventricle
Aortic valve
Superior and inferior vena cavae

=================================================== – site with a lot of links on it that seem useful!… going to have to check em out since there’s a bunch listed.

I took the test with 2 other people, one of which I had the class with, and the other of which had the class before mine but had problems getting her state testing done since she was trying for the emt level originally but on that she didn’t have time to do the ambulance hours required. She actually lives in the fire station we did the test in as she volunteers there as firefighter in exchange for housing from the county to be there. Now to ace that blasted computer based written test soon! 🙂

I signed up for LCready web app from Limmer Creative. I’ve got about 3 other paid for apps from google play so far, as well as a bunch of the freebie apps. I plan to work my way through each app as much as possible between now and the time that I have to take the real test, whenever that may be.
below uses cbs for circulation.. Instead PBS is better, just like on tv, PBS is always better than regular tv stations since it has sesame street and other educational shoes…

PBS-S under C under circulation in ABCs (abcdef)
PSYCHOMOTOR EMR test is at 2:30 this afternoon… BSMAC ->GACCAT->OPQRSTI->SAMPLE->FVFIT-PRBELLS-GOC. BSI, is scene safe, moi or noi (mechanism of injury or nature of illness), additional resources needed? (call ALS ambulance for backup, is this the only patient?) C-spine consideration (do always consider it, but only use it if needed… pass it off to the pretend firefighter if he’s available as additional resource)———>General impression, AVPU, chief complaint, ABCDEF(A-irway with cspine-OPA!!!-open airway/oxygen administration, OPA-oropharangeal airway insertion, Adequate ventillation…,–>B-reathing-BOAL-Breathe Oxygen, Airway, Lung Sounds–>C-Circulation-PBS-S-with bleeding control -pulse,bleeding control, skin color/temp/condition (yellow jaundice,blue cyanosis – lack of air, red-hot/fever, pink-normal, pale-shock, diaphoretic-sweaty, wet-really sweaty, dry, etc. S-SHOCK->mainly trauma… put on a blankie as blanket conserves heat, even/especially if patient has been burned… D-Distended Abdomen, Elvis the Pelvis/E-xpose, Femurs with Neuro exam, )), transport decision based on gcs (glascow coma scale) score. Examine all 4 Extremities ———->OPQRSTI-onset – what brought on this problem/when, provocation – what do you do that makes this feel worse/better/explain, quality – in your own words describe exactly what you are feeling and be as detailed as you can be, radiation – does the pain or problem radiate anywhere or stay put, please point to exactly where it hurts and where it seems to radiate to/from, severity – on a scale of 0-10 with ten being worse pain possible how would you rate your pain level at this time, on the same scale how would you rate the pain level when this first began, and when was that time that it first began, time – exactly how long has this been going on? Has it happened before? SAMPLE – signs/symptoms, allergies (medical, environmental, food), Medications – dosages and explain what these prescriptions are for?Past history of present illness? Last oral intake, events leading up to this situation.More M-Do you take any illegal drugs, please explain what/how much… I a medical professional, not a cop. I just want to help you but need to know exactly what is going on with you… Focused questions, Vitals -PRBELLS-goc-(GOC NOT NECESSARY, BUT MIGHT HELP)PULSE, RESPIRATORY RATE, BLOOD PRESSURE, EYES -PEARLY RACOON -PUPILS EQUAL AND REACTIVE TO LIGHT RACCOON EYES?/EARS – BLOODY, CLEAR CEREBRAL SPINAL FLUID LEAKS?, BATTLE SCARS?, LUNG SOUNDS… LEVEL OF CONSCIOUSNESS (AVPU AGAIN), SKIN COLOR/TEMP/CONDITION… two sets of vitals is good baseline +another if possible before ambulance…GOC-glucose test, Oximeter test, Capillary Refill time test… reassess, reassess, reassess… Transport and give verbal handoff report.
since below isn’t scrolling… a copy of the table is at



B S M A C –> G A C C A T O P Q R S T I –> S A M P L E –> V F I T
S C O D E V H O B r N R U A E I N I L E A A V I O N R
I E I D S N P I M C a S O A D V M T G L D S S E T C T A
E OF T I R F L E s T O I A R R S R C T L S R S
A N N PAIN N AIRWAY with Cspine r T O Y N E I S A N R
E I L O AND -OPen and Adequate O ONE-TEN I Y N O PULSE H I
CALL ALS L – insert OPA (oropharyngeal airway) c S T AND DRUGS T EYES I S
-CBS-S (like the tv station BUT PLURAL) +BACKBOARD
—Circulation (pulse) +LOGROLL
—Bleeding Control (dressing and wrap) +DRESSING…
——-direct pressure, pressure point, tourniquet +WATER, ETC.
—Shock Control
— pms in all 4
Pulse, Motor Function, Sensation



===========================================’s%20Guide.pdf :

PATIENT ASSESSMENT – TRAUMA ………………………………………………………………………. 33 points
PATIENT ASSESSMENT – MEDICAL ……………………………………………………………………… 33 points
CARDIAC ARREST MANAGEMENT/AED ………………………………………………………………. 14 points
SPINAL IMMOBILIZATION (SUPINE PATIENT) …………………………………………………… 11 points
LONE BONE IMMOBILIZATION……………………………………………………………………. 8 points
JOINT IMMOBILIZATION………………………………………………………………………………7 points
NOTE: Failure must be noted for any skill where minimum points were not realized. In addition,
failure must be noted for any skill where the examiner has checked one of the “Critical
Criteria” statements and documented the performance as required.




” If the face is red, raise the head; if the face is pale, raise the tail (feet).”

Alaska’s EMT stuff online:



The US Library of Medicine: good information about diseases and disorders. Also drugs and herbal supplements. Be aware that some drugs are known by US brand name so always look up the generic name.
English for Chinese Medicine, Dentistry, Medicine ,Medical Engineering and Nursing. Excellent resource for medical prefixes and suffixes and a pronunciation guide.
Good for the body systems
Physiotherapy terms A-M
Physiotherapy terms N-Z

Medical terms

Body systems

Several anatomy and physiology reference books

Online activities with body systems
Evidence of Best Practice site. Fact Sheets.

Nursing Diagnosis, Nursing Interventions. Note: mainly used in US hospitals
Nursing Procedures (this is a US site): includes videos of procedures
Center for Disease Control and Prevention

information about healthcare

information about healthcare
Medical glossary
understanding pathology tests

converting US to SI units
a glossary of medical terms
Videos on current topics in health
Health topic




THERE ARE A TON OF YOUTUBE VIDEOS RELATED TO NREMT, various assessments, etc. I might try to link to some of them in here someday, or maybe do a specific blog entry on some of them and compare/contrast some of them. What I’ve been doing lately is just taking info in this blog post, such as the acrynyms bsmac-gaccat-vfit (vfit but I can remember vfit easier) and a print out of the nremt emr skill assessment sheets and looking at the videos in youtube as I go through the sheets to memorize every stinking little thing on there in the order that I can, taking what I see in each video as being done the best way and trying to internalize that in to my own style of how I’m gonna do this stuff when I get to take the practical/psychomotor test myself.  For instance, some of the youtube videos are showing folks just verbalizing taking the vitals while others are showing them actually taking them. It’s probably a good idea to actually take them, assuming you don’t go over your time limit for that station in doing so… and take them at least twice… so you have a baseline and something to compare them with later when you do the verbal handoff report to incoming ems at the end of the scenario.  The focused physical exam is something we didn’t do a lot of hands on in my emr class so that’s one aspect of the videos I’m really trying to study a lot as well as the general overview of what exactly happens in what order, etc. There is a LOT to this thing even though each station is around 10 minutes or so in length in real time…

While doing all of this I’m also downloading some of the various powerpoints in the search things listed below to give myself some different ways of reviewing the same  info or more detailed info covering the same stuff we studied in class that may be in the book we studied, etc.  I’m a bit an information addict/junkie… I can’t completely explain it but when approaching big stuff like this that I’m going to be tested on I try to learn AS MUCH AS HUMANLY POSSIBLE using both stuff inside and outside of classes, etc. My thought is that the more times that I see the same information presented in a different way the more that it’ll absorb in to my brain on a subconscious level… It kinda keeps me from getting bored and burned out if I see the same information 20 times but 12 of those are on different backgrounds or different sources, etc.  This is something I learned about myself back in college… I used to work in a library for my work study program back then. Something I’d do a lot (which I probably shouldn’t have done due to privacy issues, etc. but did anyways) was check books out to myself after others brought them in to check in… that way I’d get a huge stack of books all with related information on them and I could quickly speed read them to find the stuff I really wanted to study in there and have a few different resources to that one topic right on hand. I remember fondly carrying literally over 30 books from the library across the street to my dorm room a time or two, carrying them in a huge laundry bag.  Call me a nerd if you want, but my level of education is amazing and I got a hell of a lot more out of my college experience in doing this type of stuff than most of the drunk frat guys did that lived next door to where I lived most of the times I was up there at various dorm rooms and apartments at college, lol. (got a lot of lulz out of those frat boyz from time to time when I wanted to study or go to class or work at 7 am the morning after some of their parties when I called the cops on their loud asses over and over and over again, hee hee hee. 🙂  If you are setting up frat parties, make sure to put up sound proof walls outside of your party rooms…. Also walk around the block when you are blasting music to get an idea  of who all can hear your stuff.  If apartments are in that range, make darn sure you invite the folks in those apartments to your parties if you don’t like to see sirens coming and raiding you for noise ordinance violations.  If you can, make your frat house be surrounded by an area that is about the size of a football field on each side… and put fancy long twisty driveways and sidewalks leading up to it.  That type of setup is way better for your image and the type of people you bring in to your frat than some slummed up joint sitting next to the cheap ass housing…



We strive to live to be 120….

We Want to live to be 80….

We are Lucky to live to be 70….

(adult pulse rate is on average 70, adult bp rate is on average 120/80)


  • 2008-01-30: A checklist for first tasks on scene of a motor vehicle collision.
  • Environmental hazards
  • Number of patients
  • Additional resources
  • Mechanism of injury
  • Extrication?
  • 2008-01-30: A different checklist for first tasks at an MVC.
  • Personal Protective Equipment
  • Equipment needed
  • Number of injured
  • Mechanism of injury
  • Additional resources needed
  • Need for immobilization?
  • 2010-11-07: A checklist for handover of a trauma patient.
  • Mechanism of Injury – describe it
  • Injuries – describe them
  • Signs – vital signs, abnormal s/s
  • Treatment – what have you done?
  • 2010-11-07: Elements of a Patient Contact/Care Report or Patient Report Form
  • Chief complaint
  • History – recent & relevant long term
  • Assessment – your conclusions
  • Treatment – include patient reactions
  • Transport – note changes en route
  • 2012-02-23: The elements of a radio ringdown/passdown to a hospital.
  • Start with Agency and Unit Number. ex. “St. Anthony’s, This is South Kitsap Aid 17Adam.”
  • When the hospital answers up, begin your report with age and sex. ex. “I have a 23-year-old female.” Then,
  • Mechanism. “Fall,” “MVC/MVA,” “Possible MI,” etc.
  • Chief Complaint. “Complaining of…”
  • Vital Signs. “Vital signs are…”
  • Injuries. List all known injuries with severity of major ones.
  • Treatment. What have you done to treat these conditions?
  • ETA. “Our ETA is 10 minutes. Do you have any questions?”

  • This is the general order for treating a patient.
  • Subjective information (What is the patient telling you?)
  • Objective information (What are your observations and tools telling you?)
  • Assessment of the patient (What do you think is happening?)
  • Plan of action (What are you going to do about it?)
  • 2008-01-30: This is a summary of a patient contact, from start to finish.
  • Chief Complaint
  • History
  • Examination
  • Assessment
  • Treatment
  • Evaluation (Did the treatment help?)
  • Disposition (What was the final outcome?)
  • The ABC’s are the critical steps in the Initial Assessment of a patient.
  • Airway
  • Breathing
  • Circulation
  • Deformity
  • Expose
  • Farenheit (temperature)
  • EKG, Pulse Oximetry, Vital signs
  • Head to toe exam
  • Interventions, Inspect back
  • SAMPLE is the acronym covering the details we need to get about any patient.
  • Signs & Symptoms
  • Allergies
  • Medications
  • Past pertinent history
  • Last oral intake, liquid & solid
  • Events leading to the incident
  • 2012-02-23: The vital signs to take.
  • Pulse
  • Respiration
  • Blood Pressure
  • Eyes (PERRLA)
  • LoC (AVPU)
  • Skin Signs (Color, Appearance, Temperature)
  • 2012-02-23: Added L, M, and N to the start of the list.
  • This is the list the mnemonic for evaluating a medical patient.
  • Location (this event)
  • Medical History
  • New (Is this event a new one, or has it gone on a while?)
  • Onset (this event)
  • Provoke, Palpation
  • Quality
  • Radiates (Does it spread out?)
  • Severity
  • Time (history)
  • This is an alternate mnemonic for evaluating a patient with difficulty breathing.
  • Provoke, Progression
  • Associated Chest Pain
  • Sputum, color & amount
  • Time, Trauma
  • Medications
  • Exertion, Exercise
  • Diagnosis by physician
  • This is the mnemonic to establish level of responsiveness.
  • Alert
  • Verbal (Instructions are mostly followed. Answers are delayed or inappropriate.)
  • Pain (Sternal rub. Thumb web pinch.)
  • Unresponsive (Ain’t gettin’ nuttin’…)
  • This mnemonic is used when evaluating extremities.
  • Color
  • Motor
  • Sensory
  • Temperature
  • Pulse
  • 2008-01-30: Thanks to many contributions, I can now say that this mnemonic outlines the information needed following a seizure.
  • Focus (What part of the body?)
  • Activity (Tonic? Clonic? One but not both?)
  • Color (Cyanotic?)
  • Time (How long was the episode? How much time between episodes?)
  • Somnolence (Postictal state?) or Secondary trauma (Was the seizure caused by trauma? Did the patient suffer trauma as a result of the episode?)
  • These are the symptoms of excessive stimulation of body functions due to organophosphate poisoning.
  • Salivation (Drool)
  • Lacrimation (Tears)
  • Urination (Piss)
  • Defecation (Poop)
  • Gastric juices (Heartburn)
  • Emesis (Vomiting)
  • 2008-01-30: I can’t believe I never included this list for evaluating the eyes during a field exam!
  • Pupils are
  • Equal,
  • Round, and
  • Reactive to
  • Light
  • Accomodation
  • 2008-01-30: START is an acronym for a copyrighted system for triage. RPM is the list of specific actions taken in this system.
  • Simple
  • Triage
  • And
  • Rapid
  • Transport
  • &
  • Respirations
  • Perfusion
  • Mentation
  • 2010-11-07: Key parts of an ALS intervention.
  • Vital Signs
  • Oxygen
  • Monitor
  • IV
  • Treatment/Transport
  • 2010-11-07: Elements of the Cincinnati Stroke Scale.
  • Facial droop
  • Aarm drift
  • Speech abnormality
  • Time of onset or Time last observed negative test result
  • This is an alternative to OPQRST.
  • Character – What does it feel like?
  • Onset
  • Location
  • Duration
  • Exacerbation
  • Radiation
  • Relief

  • This is a list of some common drugs. 2008-01-30: Possibly a list of commonly abused drugs?
  • Percodan/Percocet
  • Codeine
  • Morphine
  • Methadone
  • Heroin
  • Lomotil
  • Darvon
  • Demerol
  • The five drugs that may be adminstered by endotracheal tube.
  • Narcan (naloxone)
  • Atropine
  • Versed (midazolam) (May be Valium (diazepam) in some areas.)
  • Epinephrine
  • Lidocaine
  • The seven types of shock.
  • Cardiogenic
  • Hemmorhagic
  • Anaphalactic
  • Septic
  • Hypovolemic
  • Psychogenic
  • Neurogenic
  • 2008-01-30: An alternative list of eight types of shock.
  • Cardiogenic
  • Hemmorhagic
  • Anaphalactic
  • Metabolic
  • Psychogenic
  • Septic
  • Respiratory
  • Neurogenic
  • 2010-11-07: Safety in medication/drug administration. Particularly IVs
  • Drug – correct one
  • Integrity – packaging intact
  • Color
  • Concentration
  • Clarity
  • Expiration

============== – Blog that lists many resources and acronyms used by EMTs.

PMS is used to assess a patient’s extremities and is often abbreviated as “PMSx4″ if everything is intact on all four extremities.

P Pulse
M Motor
S Sensation


START is used to categorize a patient’s priority status before moving them to the triage area.The initial assessment to categorize a patient by color is done by using ARPM and should not exceed 30 seconds.

S Simple
T Triage
A And
R Rapid
T Transport
A Ambulate

  • Ability to walk: Green
R Respirations

  • Respirations are greater than 30: Red
  • Respirations are shallow or inadequate and require positive pressure ventilation (PPV): Red
  • No respiratory effort and airway is open: Black
  • Respirations are less than 30: Move on to perfusion
P Perfusion

  • Capillary refill is greater than 2 seconds or no radial pulse: Red
  • Capillary refill is less than 2 seconds and a radial pulse is present: Move on to mental status
M Mental status

  • Obeys commands: Yellow
  • Does not obey commands or is unresponsive: Red

Color Categories

Red: Immediate care and transport required (Priority 1).

Yellow: Delayed care and transport (Priority 2).

Green: Only minor injuries (Priority 3).

Black: Deceased or fatal injuries (Priority 4).


PERL is used to assess a patient’s eyes and the pupil size is recorded in millimeters.

P Pupils
E Equal
R And reactive
L To light


PRBELLS is used to obtain vital signs when conducting patient assessments.

P Pulse
R Respirations
B Blood pressure
E Eyes (see PERL)
L Level of consciousness (LOC) (see AVPU)
L Lung sounds
S Skin

NOTE: I LIKE TO ADD G.O.C.  to the end of PRBELLS… G for glucose, O for Oximeter reading… C for Capillary refill time.


AEIOU TIPS is used to assess patients with an altered mental status (AMS) or an altered level of consciousness (ALOC).

A Alcohol
E Epilepsy
I Insulin
O Overdose
U Underdose
T Trauma
I Infection
P Pyschosis
S Stroke


APGAR is used to assess newborns.

A Appearance

  • Extremities and core are pink: 2 points
  • Blue hands and feet with a pink core (acrocyanosis): 1 point
  • Entire body is cyanotic or pale: 0 points
P Pulse

  • Heart rate is greater than 100: 2 points
  • Heart rate is less than 100: 1 points
  • Pulseless: 0 points
G Grimace

  • Tactile stimulation causes the baby to cough, sneeze or cry: 2 points
  • Tactile stimulation produces only a facial grimace: 1 point
  • Tactile stimulation results in no activity: 0 points
A Activity

  • Actively moving around: 2 points
  • Some flexion without active movement: 1 point
  • Limp without any movement: 0 points
R Respirations

  • Full and effective respirations with a strong cry: 2 points
  • Slow or irregular respirations with a weak cry: 1 point
  • Apneic: 0 points

Total Score

7-10 Points: The newborn is active and requires only routine care.

4-6 Points: The newborn will require additional stimulation and oxygen therapy.

0-3 Points: The newborn is not perfusing adequately and assisted ventilations with a bag-valve-mask (BVM) and CPR may be required.

APGAR scores should be completed at 1 minute and 5 minutes after delivery.

DCAP BTLS is used to assess trauma patients.

D Deformities
C Contusions
A Abrasions
P Punctures and penetrations
B Burns
T Tenderness
L Lacerations
S Swelling


ABC is used for the primary survey/resuscitation section of patient assessments.

A Airway

  • Determine if the airway is patent by looking, listening, and feeling
B Breathing

  • Check the quality of breathing by assessing the rate and tidal volume
C Circulation

  • Determine the rate, quality and rhythm of the pulse
  • Assess the skin color, temperature, moisture and capillary refill

My instructor likes to add to this… see in other parts of this blog… airway with c-spine, breathing, circulation with bleeding control, distended abdomen, Elvis the pelvis/Expose, Femurs with Neuro Exam.


BRIM CARB is used to assess trauma patients.

B Breathing
R Response
I Eyes
M Motor or movement
C Chest
A Abdomen
R Refill or capillary refill
B Blood pressure


AVPU is used for the primary survey/resuscitation section of patient assessments.

A Alert and oriented

  • The patient is alert and oriented to person, place, time and event. This is often abbreviated as A/Ox4.
V Verbal

  • The patient responds to verbal stimuli.
P Pain

  • The patient responds to painful stimuli with a purposeful or nonpurposeful movement.
U Unresponsive

  • The patient does not respond to any stimuli.


OPQRST is used for the history taking section of patient assessments.

O Onset

  • What was the patient doing when the signs and symptoms first occurred? Was the onset sudden or gradual?
P Provocation / Palliation

  • Is there anything that makes the symptom better or worse?
Q Quality

  • Description of what the patient is feeling. For example, the pain can be described as dull, sharp, crushing, aching, tearing, throbbing, etc.
R Region / Radiation

  • Where is the pain located and does it move to another part of the body?
S Severity

  • How severe is the symptom based on a scale of 1 to 10?
T Time

  • When did the signs and symptoms first occur?


SAMPLE is used for the history taking section of patient assessments.

S Signs and symptoms
A Allergies
M Medications
P Past medical history or pertinent history
L Last oral intake
E Events leading to incident


For respiratory emergencies, PASTE can be used in lieu of OPQRST for the history taking section of patient assessments.

P Provoking factors
A Associated pain
S Sputum (color) / Speech
T Time of onset / Temperatue
E Exacerbation


PENMAN is used for the scene size-up section of patient assessments.

P Personal protective equipment (PPE)
E Environmental hazards
N Number of patients
M Mechanism of injury (MOI) or nature of illness (NOI)
A Additional resources
N Need for extrication or c-spine precautions


SLUDGEM is used to assess patients with an overdose or poisoning emergency.

S Salivation
L Lacrimation (secretion of tears)
U Urination
D Defecation
G Gastroenteritis (GI irritation)
E Emesis
M Miosis (pupil constriction)


DUMBBELLS is used to assess patients with an overdose or poisoning emergency.

D Defecation
U Urination
M Miosis (pupil constriction)
B Bronchospasm
B Bradycardia
E Emesis
L Lacrimation (secretion of tears)
L Lethargy
S Salivation


B-smac – Bsi, Scene safe, Mechanism, additional units, C-spine

GACCAT – General imperssion, Avpu, Chief complaint, ABCs, Transport
OPQRST – Onset, Provocation, Quality, Radiation, Severity, Time

SAMPLE – Signs and Symptoms, Allergies, Medications, Past Medical History, Last Oral Intake, Events
F-VIT – Focused, Vitals, interventions, transport



CHART – Chief Complaint, History, Assessment (ABCs), Rx – Treatment (interventions), Transport


DR. ABC – Danger, Responsiveness, Airway, Breathing, Circulation,


ABCDEF – Airway with Cspine, Breathing, Circulation with Bleeding Control, Distended Abdomen, Elvis the Pelvis, Femurs with Neuro Exam






BS-MAC or B-Smac

  • Bsi
  • Scene Safe?
    • from :
      • Check THESE THREE THINGS when you first encounter the patient – Always introduce yourself to the patient using your name and while you’re doing this, feel their radial pulse with your fingers. This tells you three immediately important things that will drive the rest of your care: The status of their Airway, Breathing, and Circulation. You’ll feel the rate and quality of their pulse; feel their skin temperature, moisture, and condition; and be able to assess their work of breathing when they answer you back from your introduction. If any of these things are compromised… the patient is probably sick and in need of intervention.
  • Mechanism of Injury if Trauma OR Nature of Illness if Medical?
  • Additional Resources needed?
  • Cervical Spine Considerations?


  • General Impression?
  • Avpu? (simplified version of GCS – Glasgow Coma Scale)
    • LOC – Level of Consciousness on AVPU scale:
      • Alert: The patient is fully awake (although not necessarily oriented). This patient will have spontaneously open eyes, will respond to voice (although may be confused) and will have bodily motor function. (15 on GCS)
      • Verbal/Voice: The patient makes some kind of response when you talk to them, which could be in any of the three component measures of eyes, voice or motor – e.g. patient’s eyes open on being asked “Are you OK?”. The response could be as little as a grunt, moan, or slight move of a limb when prompted by the voice of the rescuer. (12 on GCS)
      • Pain:  The patient makes a response on any of the three component measures on the application of pain stimulus, such as a central pain stimulus like a sternal rub or a peripheral stimulus such as squeezing the fingers. A patient with some level of consciousness (a fully conscious patient would not require a pain stimulus) may respond by using their voice, moving their eyes, or moving part of their body (including abnormal posturing). (8 on GCS)
      • Unresponsive: Sometimes seen noted as ‘Unconscious‘, this outcome is recorded if the patient does not give any eye, voice or motor response to voice or pain. (3 on GCS)


  • Signs and Symptoms?
    • Onset?
      • When did this problem start?
    • Provocation?
      • What caused this problem to start?
    • Quality
      • In your own words, how would you describe this pain?
    • Radiation?
      • Does the pain travel anywhere?  Please be as specific as possible, and point to the where it goes if you need to help explain it.
    • Severity?
      • On a scale of 0-10 with zero being no pain and 10 being the worst pain you could possibly feel in your entire lifetime, how would you rate your pain at this time?
      • On that same scale of 0-10 how would you rate your pain at the time that it began?  When exactly was it that this pain began?
      • Is the pain level the same in all areas or is it worse in some locations?
    • Time
      • How long has this problem been going on?
    • Interventions
      • What have you done about this problem up to this point in time?
        • Has what you done helped?
        • Has what you done made the situation worse or more painful?
  • Allergies?
    • Are you allergic to anything?
      • What medicines are you allergic to?
      • What environmental things are you allergic to?
      • What foods are you allergic too?
      • How symptoms do you develop with these allergies?
  • Medications?
    • What prescription medications do you take on a regular basis?
      • What are the dosages on each of those medications?
    • Are you taking any medications other than those prescribed by a doctor?
      • What are those medications?
      • What are the dosages on each of those medications that you are taking?
    • Do you drink alcohol on a regular basis??…
      • How much do you drink? How much have you ingested recently?
    • Do you take any over the counter medications?
      • What are those medicines and how often do you take them?
    • Do you take any illegal drugs?
      • What do you take and how often?
        • When was the last time you took that?
  • Past Medical History?
    • History of Present Illness
      • Has anything like this happened before?  Can you describe what happened in the past and when?
  • Last Oral Intake?
    • When was the last time you had anything to eat or drink?
      • What was it that you had to eat?
        • When did you eat it?
      • What was it that you had to drink?
        • When did you drink it?
  • Events?
    • What was going on prior to or leading up to the problem that you are having?
      • Please be as specific as possible.


  • Vitals
    • Breathing/Respiratory Rate (RR)
      •  count chest rise and fall 30 seconds x 2
      • According to the book I had in my EMR class:
        • 12 – 20 per minute is normal RR for adults
        • 30-50 per minute is normal RR for Newborns (infant)
        • 25-40 per minute is normal RR for 0-5 months (infant)
        • 20-30 per minute is normal RR for 6 months – 5 years old (infant->toddler->preschool)
        • 15-30 per minute is normal RR for ages 6-10 year old (school age)
        • 12 – 20 per minute is normal RR for adults
      • According to
        • normal Respiratory Rate for newborn up to 42 days old is 40-60
        • normal respiratory rate for Toddler 2 year old is 24
        • normal respiratory rate for adolescent 15 year old is 12
    • Pulse
      • Palpate artery with index and middle fingers. Count 30 seconds x 2
      • According to the Book that I had in class:
        • 60 – 80 per minute is normal pulse for adults (70 average)
        • (120?) 140-160 per minute is normal pulse for newborn
        • 90-140 is normal pulse for 0-5 month old (infant)
        • 80-140 is normal pulse for 6-12 month old (infant)
        • 80-130 is normal pulse for 1-3 year old (toddler)
        • 80-120 is normal pulse for 3-5 year old (preschool)
        • 70-110 is normal pulse for 6-10 year old (school age)
        • 60-105 is normal pulse for 11-14 year old (adolescent)
        • 70 is normal pulse for ages 20-40 (early adult)
      • According to
        • 80-200 is normal pulse for newborn up to 42 days old
        • 80-180 is normal pulse for infant 6 months old
        • 80-180 is normal pulse for toddler 2 year old
        • 60-160 is normal pulse for school age 7 year old
        • 60-160 is normal pulse for adolescent 15 year old
    • Skin
      • Color
        • Look at Palm, Sole, Tongue, Mucous Membranes (nostrils, lips, mouth, eyelids)
        • distal or proximal discolorations, or overall colors…
          • Blue – cyanosis
          • Red – Erythema – Fever, skin infections, inflammation
          • Pink – normal
          • Yellow – Jaundice – Liver Problems potentially
      • Temperature
        • Use back of hand without glove preferably? (do this at intro)
      • Condition
        • Dry or Wet or Flushed
        • Diaphoretic is sweating
        • Hypohidrosis is lack of sweating
      • Capillary Refill Time
        • 2 seconds or quicker is goal – capillary refill time is most useful for children, but is useful for anyone somewhat.
    • Pupils
      • Observe size and reaction to Penlight
        • PEARL is goal
          • Pupils
          • Equal
          • and
          • Reactive
          • to
          • Light
    • Blood Pressure
      • According to
        • normal BP for 12 hour old baby should be 50 – 70 systolic / 25-45 diastolic
        • normal BP for 96 hour old baby should be 60- 90 systolic/20-60 diastolic
        • normal BP for 7 day old is 74+-22 mmHg Systolic
        • normal BP for 42 day old is 96+-20 mmHg Systolic
        • normal BP for infant 6 month old is 87-105 Systolic/  53-66 Diastolic
        • normal BP for Toddler 2 year old is 95-105 Systolic/53-66 Diastolic
        • normal BP for School Age 7 year old is 97-112 Systolic/ 57-71 Diastolic
        • normal BP for Adolescent 15 year old is 112-128 Systolic/66-80 Diastolic
    • Pulse Oximetry – Use Pulse Ox
  • Focused History & PHYSICAL 
    • assess head
      • inspects and palpates scalp and ears
      • assess eyes
      • assess facial areas including oral and nasal areas
      • assesses back of head and side
        • “battle scars” behind ears, etc.
      • From
        • Head – Check the scalp for cuts, bruises, swellings, and other signs of injury. Examine the skull for deformities, depressions, and other signs of injury. Inspect the eyelids/eyes for impaled objects or other injury. Determine pupil size, equality, and reactions to light. Note the color of the inner of the inner surface of the eyelids. Look for blood, clear fluids, or bloody fluids in the nose and ears. Examine the mouth for airway obstructions, blood, and any odd odors.
        • Head
          • Is headache present
          • Are the pupils are the pinpoint, dilated, asymmetrical in size
          • Are the conjunctiva injected, draining,
          • Does the patient complain of eye pain, photophobia or blurring of vision
          • Is salivation, drooling, and/or rhinorrhea present
          • Is nasal flaring present
          • Note skin color – i.e. is the patient cyanotic
          • Note the smell of the patients breath
          • Is the patients throat sore, red
    • assess neck
      • inspects and palpates the neck
      • assesses for Jugular Vein Distension (JVD)
      • assesses for tracheal deviation (trachea moves to left or right due to various reasons such as hemothorax, etc.)
      • From
        • Neck – Examine the patient for point tenderness or deformity of the cervical spine. Any tenderness or deformity should be an indication of a possible spine injury. If the patient’s C-spine has not been immobilized immobilize now prior to moving on with the rest of the exam. Check to see if the patient is a neck breather, check for tracheal deviation
        • Neck
          • Is stridor present
          • Are the muscles in the neck “pulling”
    • assess chest
      • inspects chest
      • palpates chest
      • auscultates chest
      • From
        • Chest – Examine the chest for cuts, bruises, penetrations, and impaled objects. Check for fractures. Note chest movements a look for equal expansion.
        • Chest/Lungs
          • Note the presence of increased work of breathing i.e. retractions, increased rate
          • Note the presence of stridor
          • Note the presence of wheezing, rhonchi, rales, decreased breath sounds
          • Note the presence of central cyanosis
          • Does the patient complain of burning in the chest or chest pain
    • assess abdomen
      • assess abdoment and pelvis
      • verbalize assessment of genetalia/perineum as needed for nremt testing
      • From :
        •  Abdomen – Examine the abdomen for cuts bruises, penetrations, and impaled objects. Feel the abdomen for tenderness. Gently press on the abdomen with the palm side of the fingers, noting any areas that are rigid, swollen, or painful. Note if the pain is in one spot or generalized. Check by quadrants and document any problems in a specific quadrant.
        • Abdomen
          • Is the abdomen painful, tense, distended or rigid?
          • Does the patient have cramping, vomiting or diarrhea
    • assess pelvis
      • From :
        • Pelvis – Feel the pelvis for injuries and possible fractures. After checking the lower back, slide your hands from the small of the back to the lateral wings of the pelvis. Press in and down at the same time noting the presence of pain and/ or deformity
        • Pelvis
          • Check for incontinence of urine or feces
    • assess extremities
      • inspects and palpates all 4 extremities
      • check east extremity for:
        • motor function (can you wiggle your toes, can you move your fingers)
        • sensation (can you feel this… can you feel this…)
        • distal circulation (radial pulses, pulses on top of feet, etc.)
      • from
        • Lower Extremities – Examine for deformities, swellings, bleedings, discolorations, bone protrusions and obvious fractures. Check for a distal pulse. The most useful is the posterior tibial pulse which is felt behind the medial ankle. If a patient is wearing boots and has indications of a crush injury do not remove them. Check the feet for motor function and sensation.Upper Extremities – Examine for deformities, swellings, bleedings, discolorations, bone protrusions and obvious fractures. Check for the radial pulse (wrist). In children check for capillary refill. Check for motor function and strength.
    • assess posterior
      • assesses thorax
      • assesses lumbar
      • From :
        • Lower Back – Feel for point tenderness, deformity, and other signs of injury
    • assess genitals (verbalized in nremt testing, not physically done in the test):
      • from
        • Genital Region – Look for wetness caused by incontinence or bleeding or impaled objects. In male patients check for priapism (persistent erection of the penis). This is an important indication of spinal injury
    • manages secondary injuries and wounds
    • from :
      • Focused Physical Exam – Responsive Medical PatientThe focused physical exam of the responsive medical patient is usually brief. The most important information is obtained through the patient history and the taking of vital signs. Focus the exam on the body part that the patient has the complaint about.
      • Heart/Circulation
        • Note the presence of irregular, fast or slow heart rhythms
        • Note the presence of diminished or absent peripheral pulse
        • Note the presence of prolonged capillary refill in children
        • Note the color and temperature of the distal extremities
      • Neurological
        • What is the patient’s mental status? Is he (she) seizing?
        • Is the patient dizzy?
        • Did syncope occur? (fainting)
        • Was there sudden collapse
        • Does he (she) have muscle twitching?


        • Is the skin painful, burning numb or tingly
        • Is the skin erythematous
        • Are there vesicles, bullae
        • Is there necrosis
  • Interventions
  • Transport


Secondary Assessment/Reassessment questions to go in to or in to more detailed in the focused history:



  • Alcohol/Drugs?
  • Electrolyte Imbalance (vomit/heat, etc.)
  • Insulin Imbalance?
  • Oxygen Level?
  • Uremia (Kidneys)


  • Trauma?… Temp Changes?… Tumor?
  • Infection?
  • Poison?… Psychological?
  • Seizure?… Shock?… Stroke?… Syncope (fainting)?…




more crazy acronyms and stuff:

“Safety First” … Table of Contents

SAFETY    Use your BSI – Biological Safety

              F is for Fire – Scene Safety

I                 I is for Incident: MOI/NOI        

R                Determine the numbeR of patients

S                Send for help

T                Trauma to the C-spine?

G                General impression of the patient

E                Estimate LOAs

T                Threats to you or your patient?

1°A             1° Airway

1°B             1° Breathing

1°C             1° Circulation

1°D             1° Decision

2°A             2° Airway

2°B             2° Breathing

2°C             2° Circulation

2°D             2° Decision


AAA – American Ambulance Association AACN – Advanced Automatic Collision Notification AAP – American Academy of Pediatrics AAR – After Action Report ACEP – American College of Emergency Physicians ACLS – Advanced Cardiac Life Support ACS – American College of Surgeons ADA – Americans with Disabilities Act AED – Automated External Defibrillator AEMER – Alliance for Emergency Medical Education and Research AEMSC – Atlantic EMS Council AEMT- Advanced Emergency Medical Technician AHA – American Heart Association AHRQ – Agency for Healthcare Research and Quality ALS – Advanced Life Support AMI – Acute Myocardial Infarction ANSI – American National Standards Institute APA – Administrative Process Act APCO – Associated PublicSafety Communications Officers APLS – Advanced Pediatric Life Support ARES – Amateur Radio Emergency Service ASPR – Office of the Assistant Secretary for Preparedness and Response (DHHS) ATLS – Advanced Trauma Life Support ATS – American Trauma Society ATT – Authorization to Test Letter AVL – Agency Vehicle Licensure Committee (NASEMSO) B BDLS – Basic Disaster Life Support BIS – Benchmarks, Indicators and Scoring BLS – Basic Life Support BOH – Board of Health (Virginia) BOM – Board of Medicine BON – Board of Nursing BOP – Board of Pharmacy BP – Blood Pressure BREMS – Blue Ridge EMS Council BSI – Body Substance Isolation BVM – Bag Valve Mask [Ambu Bag ™] C CAAHEP – Commission on Accreditation of Allied Health Programs CAAS – Commission on Accreditation of Ambulance Services (US) CAD – Computer Aided Dispatch CAD – Coronary Artery Disease CoAEMSP – Committee on Accreditation of Educational Programs for the EMS Professions CAH – Critical Access Hospital 2 CAMTS – Commission on Accreditation of Medical Transport Systems CAP – Civil Air Patrol CARS – Commonwealth Accounting and Reporting System CAT1 – Category 1 Continuing Education CAT2 – Category 2 Continuing Education CBRNE – Chemical, biological, radiological, nuclear and explosive CCU – Critical Care Unit CDC – Centers for Disease Control and Prevention (US government) CE – Continuing Education CECBEMS – Continuing Education Coordinating Board for Emergency Medical Services (national accrediting body for EMS continuing education courses and course providers) CERT – Community Emergency Response Team CESC – Commonwealth Enterprise Solutions Center (VITA) CICO – Commonwealth Interoperability Coordinator’s Office CIREN – Crash Injury Research Engineering Network (funded by NHTSA) CFR – Code of Federal Regulations (US) CFR – Crash Fire Rescue (airports) CGAP – Consolidated Grant Application Program CHF – Congestive Heart Failure CISD – Critical Incident Stress Debriefing CISM – Critical Incident Stress Management CMS – Centers for Medicare and Medicaid Services CODES – Crash Outcome Data Evaluation System COG – Council of Governments, Continuity of Government COIVPP – Council on Injury, Violence and Poison Prevention (AAP) COOP – Continuity of Operations Plan COPD – Chronic Obstructive Pulmonary Disease COPEM – Committee on Pediatric Emergency Medicine (AAP) COPN – Certificate of Public Need COV – Commonwealth of Virginia CP – Community Paramedicine CPAP – Continuous Positive Airway Pressure CPR – Cardio-Pulmonary Resuscitation CPS – Child Passenger Safety CQI – Continuous Quality Improvement CSDR – Course Student Disposition Report CSEMS – Central Shenandoah EMS Council CSHCN – Children with Special Health Care Needs CTS – Consolidated Test Site CVA – Cerebro-vascular Accident CVCC – Central Virginia Community College D DAN – Diver’s Alert Network DCC – Danville Community College DDNR – Durable Do Not Resuscitate 3 DEA – Drug Enforcement Agency (US) DED – Division of Educational Development (Virginia Office of EMS) DERA – Designated Emergency Response Agency DGIF – Department of Game and Inland Fisheries (Virginia) DGS – Department of General Services (COV) DHP – Department of Health Professions (Virginia) DHRM – Department of Human Resources Management (COV) DHS – Department of Homeland Security DMAT – Disaster Medical Assistance Teams DMC – Data Managers Council (NASEMSO) DMRT – Disaster Mortuary Response Teams DMV – (Virginia) Department of Motor Vehicles DNR – Do Not Resuscitate DO – Designated Officer DOA – Department of Accounts (COV) DOA – Dead on arrival DOH – Department of Health DoD – Department of Defense (US) DOT – Department of Transportation (US) DPB – Department of Planning and Budget (COV) DRT – Disaster Recovery Team E E911 – Enhanced 911 (the system that displays calling number and address) EAS – Emergency Alert System EBG – Evidence Based Guidelines EC – EMS Education Coordinator ECC – Emergency Coordination Center located at James Madison Bldg. (VDH) or Emergency Communications Center ECCC – Emergency Care Coordination Center (ASPR) ECG – Electro Cardiogram ED – Emergency Department EHS – Emergency Health Services EKG – ElectroCardioGram (old, from German ElectroKardioGram) EMAC – Emergency Management Assistance Compact EMAP – Emergency Management Accreditation Program EMD – Emergency Medical Dispatcher EMR – Emergency Medical Responder EMSAT – Emergency Medical Satellite Training EMS – Emergency Medical Services EMSC – EMS for Children EMSI – Emergency Medical Services Instructor EMSR – Emergency Medical Services Registry EMSTF – Emergency Medical Services Training Fund EMT – Emergency Medical Technician EMTALA – Emergency Medical Treatment and Labor Act EMT-I – Intermediate EMT-P – Paramedic ENA – Emergency Nursing Association EOC – Emergency Operations Center EPC – Emergency Pediatric Care Course (NAEMT) ePCR – Electronic Patient Care Record 4 EP&R – Emergency Preparedness and Response ER – Emergency Room ESF – Emergency Support Function ETA – Estimated Time of Arrival ET – EndoTracheal (tube) EVOC – Emergency Vehicle Operation and Control F $4 for Life – EMS Fund; Established in 1983 as $1 for Life; increased to $2 for Life in 1990; increased to $4 for Life in 2004; 2008 Virginia General Assembly increased fund to $4.25; increased to $6.25 in 2010. FAA – Federal Aviation Administration FAN – Family Advisory Network FARC – Financial Assistance Review Committee FARS – Fatality Analysis Reporting System FCC – Federal Communications Commission FDA – Food and Drug Administration (US) FEMA – Federal Emergency Management Agency (US) FHWA – Federal Highway Administration FICEMS – Federal Interagency Committee on Emergency Medical Services FIPS – Federal Information Processing Standard (State, County and City Code) FISDAP – Field Internship Student Data Acquisition Project, documents and measures students’ experiences in field, lab, and clinical settings; evaluate skill performances; generate progress reports; gain or maintain accreditation; prepare students for certification exams; manage internship schedules; and more. FLEX – Medicare Rural Hospital Flexibility Grant Program FLSA – Fair Labor Standards Act FOIA – Freedom of Information Act FR – First Response/First Responder FTE – Full Time Equivalent FTL – Field Team Leader G GA – General Assembly GAB – EMS Advisory Board, often times referred to as the Governor’s Advisory Board (GAB). The technical term used in the Code of Virginia and Virginia Administration Code for the advisory board appointed by the Governor to advise the State Board of Health concerning the administration of the statewide emergency medical care system and emergency medical services vehicles maintained and operated to provide transportation to persons requiring emergency medical treatment, and for reviewing and making recommendations on the Statewide Emergency Medical Services Plan is State EMS Advisory Board. GCS – Glasgow Coma Scale GED – General Equivalency Diploma GEMS – Geriatric Education for Emergency Medical Services GIS – Geographic Information System GPS – Global Positioning System GSA – General Services Administration (US) GSW – Gunshot wound H HAN – Health Alert Network HazMat – Hazardous Material HEMS – Helicopter EMS 5 HHS – Department of Health and Human Services HIPAA – Health Insurance Portability & Accountability Act of 1996 HITS – Highway Incident & Transportation Systems Committee (NASEMSO) HMERT – Health and Medical Emergency Response Teams HPP – Hospital Preparedness Program (DHHS) HRSA – Health Resources and Services Administration HTR – Heavy and Tactical Rescue I IAEMSC – International Association of EMS Chiefs IAFC – International Association of Fire Chiefs IAFF – International Association of Fire Fighters IAOC – Internal Agency Oversight Committee (VITA) IC – Incident Commander ICD-10 – International Classification of Diseases, Tenth Revision ICE – In Case of Emergency ICISF – International Critical Incident Stress Foundation ICS – Incident Command System ICO – Infection Control Officer ICP – Infection Control Plan ICU – Intensive Care Unit IFB – Invitation for Bid IM – Intramuscular IMT – Incident Management Team I/O – Intraosseous Infusion ISS – Injury Severity Score IOM – Institute of Medicine IT – Information Technology ITDR – Information Technology Disaster Recovery ITLS – International Trauma Life Support IV – IntraVenous J JAMA – Journal of the American Medical Association JCREC – Joint Committee on Rural EMS Care JEMS – Journal of Emergency Medical Services JCHC – Joint Commission on Health Care JLARC – Joint Legislative Audit and Review Commission JNEMSLF – Joint National EMS Leadership Forum JSRCC – J. Sergeant Reynolds Community College JTCC – John Tyler Community College K KED – Kendrick Extrication Device KTB! – (Keeping the Best) EMS Workforce Retention Toolkit and Workshops L L&D – Labor and Delivery L&P – Legislation and Planning Committee (state EMS Advisory Board) LEO – Law Enforcement Officer LFCC – Lord Fairfax Community College LFEMS – Lord Fairfax EMS Council LMS – Learning Management System LOC – Level of Consciousness (in Glasgow scale) LODD – Line of Duty Death LZ – Landing Zone (aeromedical) 6 M MAST – Military Anti Shock Trousers or PASG (Pneumatic Anti-shock garment) MCHB – Maternal and Child Health Bureau MCI – Mass Casualty Incident MDC – Medical Direction Committee MDC – Medical Directors Council (NASEMSO) MDT – Mobile Data Terminal(s) or MDC – Mobile Data Computer MEC – Medical Education Campus MECC – Mountain Empire Community College MEDEVAC – Medical Evacuation, aka helicopter EMS, aero medical services, air ambulance MHA – Masters of Health Administration MHz – MegaHertz, unit of frequency MI – Myocardial Infarction MICU – Mobile Intensive Care Unit MIH – Mobile Integrated Health MMRS – Metropolitan Medical Response System Program MOA – Memorandum of Agreement MOI – Mechanism of Injury MOU – Memorandum of Understanding MPH – Masters of Public Health MRI – Magnetic Resonance Imaging MSDS – Material Safety Data Sheet MSV – Medical Society of Virginia MVA – Motor Vehicle Accident MVC – Motor Vehicle Crash (formerly known as Motor Vehicle Accident) N NAEMSE – National Association of EMS Educators NAEMSP – National Association of EMS Physicians NAEMT – National Association of Emergency Medical Technicians (US) NASAR – National Association for Search and Rescue NASEMSO – National Association of State EMS Officials NCIC – National Criminal Information Center NDMS – National Disaster Medical System (US) NEDARC – National EMSC Data Analysis Resource Center NEMSAC – National EMS Advisory Council (NHTSA) NEMSMA – National EMS Management Association NEMSIS – National EMS Information System NENA – National Emergency Number Association (9-1-1) NFA – National Fire Academy (US) NFFA – National Fallen Firefighters Foundation NFIC – National Fire Information Center NFIRS – National Fire Incident Reporting System NFPA – National Fire Protection Association NFPA – National Flight Paramedic Association NG – Northrop Grumman NG Tube – Nasogastric Tube NHTSA – National Highway Traffic Safety Administration NICU – Neo-natal Intensive Care Unit NIH – National Institutes of Health 7 NIMS – National Incident Management System NIOSH – National Institute for Occupational Safety and Health (US) NPRP – National Pediatric Readiness Project NRHA – National Rural Health Association NOIRA – Notice of Intended Regulatory Action NOSORH – National Organization of State Offices of Rural Health NOVA – Northern Virginia EMS Council NP – Nurse Practitioner NR – National Registry NRB – Nonrebreather Mask NRC – EMSC National Resource Center NRCC – New River Community College NREMT – National Registry Emergency Medical Technician test (US) NREMT – National Registry of Emergency Medical Technicians NREMT – Nationally Registered EMT (US) REMT is preferred NRHA – National Rural Health Association NRP – Neonatal Resuscitation Program NSC – National Standard Curriculum NTIMC – National Traffic Incident Management Coalition NTSB – National Transportation Safety Board (US) NUG – National Unified Goal NVCC – Northern Virginia Community College NVFC – National Volunteer Fire Council NVOAD – National Volunteer Organizations Active in Disasters NWS – National Weather System O OAG – Office of Attorney General OCP – Office of Commonwealth Preparedness ODEMSA – Old Dominion EMS Alliance OEMS – Office of Emergency Medical Services OFM – Office of Financial Management (VDH) OHR – Office of Human Resources (VDH) OIM – Office of Information Management (VDH) OMB – Office of Management and Budget (US) OMD – Operational Medical Director OPGS – Office of Purchasing and General Services (VDH) OR – Operating Room OSHA – Occupational Safety and Health Administration P PA – Physician Assistant PADI – Professional Association of Diving Instructors PALS – Pediatric Advanced Life Support PASG – Pneumatic Anti-Shock Garment PAT – Regional EMS Council (Process Action Team) PCC – Poison Control Center PCD – Physician Course Director PDC – Professional Development Committee PEA – Pulseless electrical activity PEARS – Pediatric Emergency Assessment, Recognition and Stabilization 8 PECARN – Pediatric Emergency Care Applied Research Network PECC – Pediatric Emergency Care Council (NASEMSO) PEMS – Peninsulas EMS Council PEPP – Pediatric Education for Prehospital Professionals PHCC – Patrick Henry Community College PHI – Protected Health Information PHTLS – Pre-Hospital Trauma Life Support PIC – Performance Improvement Coordinator PITLS – Pediatric International Trauma Life Support PIO – Public Information Officer PMD – Commonwealth Project Management Division (VITA) POV – Privately Owned Vehicle PPE – Personal Protective Equipment PPV – Positive Pressure Ventilation PR – Public Relations PSAP – Public Safety Answering Point (911) PUG – Practical exam Users Guide (VA OEMS) PUM – Public Utility Model PVCC – Piedmont Virginia Community College Q QA/QI – Quality Assurance/Quality Improvement R RACES – Radio Amateur Civil Emergency Services R&C – Regulation and Compliance (Virginia Office of EMS) R&R – Recruitment and Retention RCC – Rappahannock Community College REMS – Rappahannock EMS Council REPLICA – Recognition of EMS Personnel Licensure Interstate CompAct RFP – Request for Proposals RFS – Request for Service RHP – Rural Health Plan RN – Registered Nurse RS – Rescue Squad RSAF – Rescue Squad Assistance Fund RSI – Rapid Sequence Intubation RT – Respiratory Therapist RTL – Return to Locality (26% portion of EMS funds returned to the local government for EMS purposes.) Rx – Prescription S SACS – Southern Association of Colleges and Schools (education accreditation) SAR – Search and Rescue SAVER – System Assessment and Validation for Emergency Responders SCBA – Self Contained Breathing Apparatus SCHEV – State Council on Higher Education in Virginia SCHIP – State’s Child Health Insurance Program SHHR – (Virginia) Secretary of Health and Human Resources SHHS – Secretary of Health and Human Services SIDS – Sudden Infant Death Syndrome SIEC – State Interoperability Executive Committee SITREP – Situation Report SMA – Statewide Mutual Aid 9 SMART – Specific, Measurable, Attainable, Realistic and Timely (measures of performance in an evaluation process) SME – Subject Matter Expert SNS – Strategic National Stockpile SOB – Shortness of Breath SOG – Standard Operating Guidelines SoP – Scope of Practice SOP – Standard Operating Procedures SORH – State Offices of Rural Health SQ – Subcutaneous SSM – System Status Management STEMI – ST Elevation Myocardial Infarction SVCC – Southside Virginia Community College SVT – Supraventricular tachycardia; an EKG rhythm SWaM – Small, Woman Owned or Minority business SWCC – Southwest Virginia Community College SWESC – Southwest Enterprise Solutions Center (VITA) SWOT – Strengths, Weaknesses, Opportunities and Threats SWVEMS – Southwest Virginia EMS Council T TBI – Traumatic Brain Injury TCC – Tidewater Community College TCC – Training and Certification Committee (state EMS Advisory Board) TEMS – Tidewater EMS Council TIA – Transient Ischemic Attack (mini-stroke) TIM – Traffic Incident Management TJEMS – Thomas Jefferson – EMS Council TMC – Trauma Managers Council (NASEMSO) TNCC – Thomas Nelson Community College TNCC – Trauma Nurse Core Course (ENA) TPAM – Training Program Administrative Manual TRAINVirginia – Training Finder Real-time Affiliate Integrated Network (Learning Management System) TRB – Transportation Research Board TSA – Transportation Security Administration (US) TSAG – Transportation Safety Advancement Group TSOMC – Trauma System Oversight and Management Committee U USAR – Urban Search and Rescue USFA – United States Fire Administration UASI – Urban Areas Security Initiative V VAA – Virginia Ambulance Association VAC – Virginia Administrative Code VACO – Virginia Association of Counties VAVRS – Virginia Association of Volunteer Rescue Squads, Inc. VAGEMSA – Virginia Association of Governmental EMS Administrators VaCEP – Virginia Chapter of the College of Emergency Physicians VCCS – Virginia Community College System 10 VDEM – Virginia Department of Emergency Management VDFP – Virginia Department of Fire Programs VDOT – Virginia Department of Transportation VDH – Virginia Department of Health VENA – Virginia Emergency Nurses Association VERT – Virginia Emergency Response Team VFCA – Virginia Fire Chiefs Association VFIB – Ventricular fibrillation; an EKG rhythm VFD – Volunteer Fire Department VFIRS – Virginia Fire Incident Reporting System VHAC – Virginia Heart Attack Coalition VHCC – Virginia Highlands Community College VHF – Very High Frequency (radio) VHHA – Virginia Hospital and Healthcare Association VHI – Virginia Health Information VITA – Virginia Information Technologies Agency VML – Virginia Municipal League VMRC – Virginia Marine Resource Commission VMS – Variable Message Sign VNA – Virginia Nurses Association VoIP – Voice over Internet Protocol VPFF – Virginia Professional Firefighters VPHIB – Virginia Pre-hospital Information Bridge VRHA – Virginia Rural Health Association VRS – Volunteer Rescue Squad VRS – Virginia Retirement System VSC – Virginia Standard Curriculum VSP – Virginia State Police VSTR – Virginia Statewide Trauma Registry VSSTF – Virginia Stroke System Task Force VWCC – Virginia Western Community College W WCC – Wytheville Community College WDC – EMS Workforce Development Committee WMD – Weapons of Mass Destruction WSP – Wireless Service Provider WVEMS – Western Virginia EMS Council


Missouri State junk:




oddball links and stuff (some utilized in above, some not)


nice powerpoint search tools – a lot of different powerpoints on vitals. – a lot of different powerpoints on first responder search – bunch of powerpoints on abdominal pain… do various searches on it for terms like coma, stroke, etc.







a few online course info packets… well worth the read (If you really like these, I’d suggest using httrack (see below) on them before they become unavailable in the future?…


paid websites that costs more than a few bucks for apps on google play, etc. (have not looked in to them much yet other than the one for my particular class – saw these links in a thread on emtlife, so not sure if reliable and worth the cost or not?)


Scenarios: – Scenarioville – emt life section on scenarios – webpage listing a few scenarios  – scenarios – scenarios


VISUAL AIDS/FLOWSHEETS – amazing flow chart showing the decision tree that first responders use. It helps you visualize the process and the order that it should go in.  It also includes many of the mnemonic abbreviations to help you along the way. (I believe that someone put a copy of this url in to the internet archive’s way back machine before I had a chance to do so… good idea to do that any time you come across a link with this much detailed info that you don’t want to die anytime soon)

Copy of the chart is below: – Ohio State’s guidelines for EMRs. Has nice flowsheet (not as nice as the lifeguard one above, but it’s same basic info) and info on various acroynms, etc.. Copy of that chart is below:



That Ohio Document has a couple of other interesting images in it that are useful study tools:

sample avpu START 9s

——————————————— – abbreviation list for the ems reddit. – httrack website copier software. This isn’t really EMS related, but for a lot of the websites I visit if I think they are ones that won’t exist in a few months/years I use this thing to make a local copy for my own reference. I also sometimes, on the very important stuff, use the internet archive’s way back machine to make a copy on the internet archive’s server for my references.  If the internet archive doesn’t have a copy on their server you can request that they make one easily… – another neat little tool to download various stuff that you want saved for future reference such as swf and mk4 files. – EMT Training Scenario’s for Alaska (may be a bit outdated as it’s dated March, 1995?) – Scenarioville blog… it’s a blog with various EMS scenarios listed in the fictional town of Scenarioville.  Interesting reading. – same blog as the scenarioville but different section. This is the “digital research library” section that lists a lot of different links to a lot of different medical articles around the internet. Good reading in your spare time. – interesting ems related blog… – Nice little blog on ems system with flowcharts.

Usaf emt protocols app on google play store. I used a lot of various apps in studying for the class, but this one was great since it had nice flowcharts for most scenarios discussed in various chapters in the book… I’m more of a visual learner than a lot of folks, so flowcharts help me visualize processes a lot more than lengthy paragraphs do.

quizer app on Android link is below – I used this app a lot… Basically I used an excel file for this app for almost every paragraph and definition in the book and then uploaded it to the app via an email to myself that I downloaded from regularly. You have to name the excel file questions.xls and format it the special way the app wants, but it works great for flashcards.  Although app works for multiple choice questions, I just used it for straight flashcard type things, putting questions in column B, answers in D and chapter title in A column so that I could sort by chapter title so that I could study last chapters first sometimes, etc.  I made generic names like Chapter 999 and 000 for some duplicates of the hard stuff that I was having trouble studying week to week…  I’d upload a copy of the xls file but don’t want to upload stuff that is that copyrighted here, and also don’t want folks reading that that have not taken a class to have a way to cheat through something like that… make your own xls file since the process of typing it up will help you learn… back in elementary school I was always taught you learn by studying things at least 3 ways… hearing it…. reading it… and writing it… the xls file makes you read and write… I didn’t record much audio to listen to as I had busy schedule during class and didn’t have a lot of time to do that (working 6 days a week, 10+ hours some of those days while taking the class some weeks)… but if I had infinite time, I’d definitely do more with audio.  I’ve have been reviewing a lot of stuff on youtube… search for nremt… although emr level is below emt level, a lot of topics on videos and stuff is similar since emt is really more advanced level above emr level… eventually I would not mind taking nremt (national registry of emts) test and a class for it, but only time will tell if I do that or not (having an infant at home and missing out on time playing with her on my one day a week off has been tough for this class, not sure I want to continue that bad dad trend any time too soon) – nice website notes on an EMT class… covers a lot of the basics. – article about how EMS professions are one of the most dangerous ones in the world today. – Jems forum topic about that particular article. – great forum for EMTs – Reddit page for EMS (Emergency Medical System) – Missouri State EMS related links – Missouri state child abuse hotline information – diagram showing basics of START. – START (Simple Triage and Rapid Treatment) info page*/ – web archive link to above page – main webpage for Pearsonmylearningmastering lab. This is the online side of the EMR class I am taking. The book that I used for my EMR course was EMR complete:

A newer, second edition of it is out now:

DON’T BUY YOUR BOOK UNTIL YOU KNOW FOR SURE WHICH BOOK YOUR INSTRUCTOR WANTS YOU TO BUY. I bought mine second hand off of another individual that was taking the same class I ended up taking a few weeks prior to the class beginning since he ended up dropping out about halfway through. (There are many more folks that drop out of this type of thing than you’d think there would be as it is a profession that is not exactly for the feint of heart… Even I contemplated it a time or two when viewing some of the more graphic slides in the Powerpoint presentations given in class — The one showing the guy that flinched when trying to commit suicide, resulting in his him blowing off his mandible, and nasal area, but leaving his brain and eyes in tact kinda hit me hard the first time I saw it… especially when I was running through my head the scenario that we were discussing in class at the time we viewed the image – how to keep an airway open and assess breathing before checking circulation and trying to control bleeding)

Web Links from class’s online sections (note some of the below urls may not work any longer. This info is here mainly for my own reference, but also for anyone visiting this page that may be curious too I suppose.  I guess technically some of this stuff is copyrighted, but if it’s a url that is visible to the general internet via the http protocol, and is not protected in some way via a password or some similar type of method, I’m under the assumption that the copyright owner wants the information out there in the general public (after all it is likely visible to any search engine or individual with the url) unless the copyright owner tell me otherwise directly.):


Media Resources from online class

Anatomical Landmarks
The Human Skeleton
Introduction to the Cardiac Cycle
Blood Flow into the Atria
Ventricular Contraction
Digestive System
Structure of the Ear
Structure of the Eye
The Skull
Female Reproductive System


Media Resource Videos from class:

Ankle Dorsiflexion / Extension
Ankle Inversion / Eversion
Elbow Flexion / Extension
Elbow Pronation / Supination
Hand Opposition
Humerus Adduction / Abduction
Humerus Circumduction
Humerus Rotation
Wrist Circumduction
Wrist Flexion / Extension
Domestic Violence
Chronic Obstructive Pulmonary Disease
Cardiac Compromise
Introduction to Seizures
Complex Partial Seizures
Tonic-Clonic Seizures
First Stage of Labor
Second Stage of Labor
Transition Stage
Assessment of the Newborn
Third Stage of Labor
Vacuum Extraction Delivery
Alzheimers Disease

Virtual Tours from class:

Media Resources

Nervous System
Head and Neck
Trunk and Abdomen
Upper Limb
Lower Limb
Cardiovascular System
Head and Neck
Trunk and Abdomen
Virtual Tour: Heart
Muscle-Skeletal System
Head and Neck
Trunk and Abdomen
Upper Limb
Lower Limb

Trauma Gallery from Online Class:


More links from online class: