EMS Operations
Free points — if you actually studied them.
High-yield before the exam
- Incident Command: first unit establishes command; you report to it, you don't invent your own.
- MCI triage (START): respirations → perfusion → mental status. Red = immediate, yellow = delayed, green = walking, black = expectant.
- Hazmat: upwind, uphill, upstream. You cannot help anyone from inside the hot zone.
- Documentation protects you: if it isn't written, it didn't happen.
- Know your scope: protocols and medical direction override anything a test question implies.
Skills to drill4
Radio report / handoff
Mastery: A 60-second report that paints the patient: age, chief, vitals, findings, treatment, ETA — no filler.
Drill: Record yourself giving mock reports; cut every wasted word until it is under a minute.
Documentation (PCR)
Mastery: Chart written like a lawyer reads it: times, findings, refusals with capacity, narrative that matches the monitor.
Drill: After every call, write the refusal or AMA paragraph from memory and compare to the real one.
Protocol fluency
Mastery: Runs every cardiac algorithm from memory and knows exactly which drugs need online medical control.
Drill: Blank-page test: write the ACS, brady, and arrest algorithms from scratch, then grade yourself.
Ultrasound / capnography use
Mastery: Reads ETCO₂ trends as a vital sign — CPR quality, tube confirmation, ROSC spike, sepsis clue.
Drill: Narrate the capno waveform on every call: number, shape, trend, and what you will do about it.
Board-style exam questions44
1. A competent adult refuses care after a fall. Correct approach?
2. In START triage, a patient who walks to the collection area is tagged:
3. Under START, an adult breathing at 34 per minute is tagged:
4. First action at a suspected hazmat scene?
5. Best defense against a negligence claim?
6. Which action violates patient privacy?
7. Ambulance collisions most commonly occur:
8. The four elements required to prove negligence are:
9. Leaving a patient without transferring care to an equal or higher level provider is:
10. Under the incident command system, who assigns triage, treatment and transport roles?
11. Standard precautions on a call with airborne infection risk include:
12. An unconscious adult with no family present is treated under:
13. At an active shooter incident, EMS should:
14. Best practice when giving a handoff report at the hospital?
15. START triage tags a patient who is walking as:
16. A respiratory rate over 30 in START triage means:
17. A competent adult refusing care requires:
18. Leaving a patient without transferring care to equal or higher training is:
19. The primary purpose of a CISM debrief is:
20. Ambulance crashes most often occur:
21. At a hazmat scene, EMS should stage:
22. The correct sequence for a NIMS-managed MCI is:
23. HIPAA permits sharing patient information with:
24. Best evidence-preservation practice at a crime scene?
25. A competent adult in cardiac chest pain refuses transport after you explain the risks. Legally you should:
26. Implied consent applies when treating:
27. Abandonment occurs when:
28. Treating a patient without their consent when they are alert, oriented and objecting may constitute:
29. For a minor with a true emergency and no parent or guardian reachable, consent is:
30. An advance directive (DNR) is verified on scene. The patient is in cardiac arrest. You should:
31. You make a medication error that did not harm the patient. Ethically and legally you should:
32. A colleague appears impaired by alcohol on shift. Your ethical duty is to:
33. A patient's relative demands to know the patient's HIV status. You should:
34. A bystander filmed your resuscitation and posts it online. The ethical violation committed by crew members who shared it would be:
35. Good Samaritan laws generally protect EMS volunteers who:
36. A complete patient care report matters most legally because:
37. During START triage, an adult who is not breathing begins breathing after you open the airway. Tag as:
38. JumpSTART triage is used for:
39. Who assumes incident command at a growing MCI once a chief officer arrives?
40. Safest landing zone for a medical helicopter?
41. You are exposed to a patient's blood through a needlestick. First action?
42. Which patient meets criteria for direct transport to a trauma center?
43. Purpose of continuous quality improvement in an EMS system?
44. You arrive at a domestic dispute with shouting inside and no police on scene. Correct action?
Keep going
Educational review only — always follow your local protocols and medical direction. Not affiliated with or endorsed by the NREMT.