NREMT skill sheet · E201
NREMT trauma patient assessment skill sheet (E201)
The National Registry's EMT sheet for trauma patient assessment, line by line: 42 points, almost half of them in a head-to-toe secondary assessment, a 10-minute limit for calling transport, and the critical criteria that fail the station on their own.
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The sheet
Every line and its points
- points
- 42
- to call for transport
- 10 min
- critical criteria on the sheet
- 12
Note on the sheet: Areas denoted by "**" may be integrated within sequence of Primary Survey/Resuscitation.
- Takes or verbalizes appropriate PPE precautions, 1 point
Scene size-up5 pts
- Determines the scene/situation is safe, 1 point
- Determines the mechanism of injury/nature of illness, 1 point
- Determines the number of patients, 1 point
- Requests additional EMS assistance if necessary, 1 point
- Considers stabilization of the spine, 1 point
Primary survey/resuscitation14 pts
- Verbalizes general impression of the patient, 1 point
- Determines responsiveness/level of consciousness, 1 point
- Determines chief complaint/apparent life-threats, 1 point
- Airway, 2 points
- Opens and assesses airway, 1 point
- Inserts adjunct as indicated, 1 point
- Breathing, 4 points
- Assess breathing, 1 point
- Assures adequate ventilation, 1 point
- Initiates appropriate oxygen therapy, 1 point
- Manages any injury which may compromise breathing/ventilation, 1 point
- Circulation, 4 points
- Checks pulse, 1 point
- Assess skin [either skin color, temperature or condition], 1 point
- Assesses for and controls major bleeding if present, 1 point
- Initiates shock management [positions patient properly, conserves body heat], 1 point
- Identifies patient priority and makes treatment/transport decision (based upon calculated GCS), 1 point
History taking2 pts
- Obtains baseline vital signs [must include BP, P and R], 1 point
- Attempts to obtain SAMPLE history, 1 point
Secondary assessment19 pts
- Head, 3 points
- Inspects and palpates scalp and ears **, 1 point
- Assesses eyes, 1 point
- Inspects mouth**, nose** and assesses facial area, 1 point
- Neck**, 3 points
- Checks position of trachea, 1 point
- Checks jugular veins, 1 point
- Palpates cervical spine, 1 point
- Chest**, 3 points
- Inspects chest, 1 point
- Palpates chest, 1 point
- Auscultates chest, 1 point
- Abdomen/pelvis**, 3 points
- Inspects and palpates abdomen, 1 point
- Assesses pelvis, 1 point
- Verbalizes assessment of genitalia/perineum as needed, 1 point
- Lower extremities**, 2 points
Inspects, palpates and assesses motor, sensory and distal circulatory functions (1 point/leg)
- Upper extremities, 2 points
Inspects, palpates and assesses motor, sensory and distal circulatory functions (1 point/arm)
- Posterior thorax, lumbar and buttocks**, 2 points
- Inspects and palpates posterior thorax, 1 point
- Inspects and palpates lumbar and buttocks areas, 1 point
- Manages secondary injuries and wounds appropriately, 1 point
Reassessment1 pts
- Demonstrates how and when to reassess the patient, 1 point
Line text from NREMT form e201/10-16, © 2016 by the National Registry of Emergency Medical Technicians, Inc., Columbus, OH. Official copies are published at nremt.org. Medceptor is independent and isn't affiliated with or endorsed by the NREMT.
Critical criteria
What fails the station outright
Any one of these fails the station, however many points you earned.
- Failure to initiate or call for transport of the patient within 10 minute time limit
- Failure to take or verbalize appropriate PPE precautions
- Failure to determine scene safety
- Failure to assess for and provide spinal protection when indicated
- Failure to voice and ultimately provide high concentration oxygen
- Failure to assess/provide adequate ventilation
- Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock
- Failure to differentiate patient's need for immediate transportation versus continued assessment/treatment at the scene
- Performs other assessment before assessing/treating threats to airway, breathing and circulation
- Failure to manage the patient as a competent EMT
- Exhibits unacceptable affect with patient or other personnel
- Uses or orders a dangerous or inappropriate intervention
Scoring
How points are won and lost
- Some steps can move up
- Areas marked ** may be integrated within the primary survey, so you can examine the neck or chest while you work through airway, breathing and circulation.
- Priority comes from the GCS
- The transport decision line says "based upon calculated GCS", so score eye opening, verbal response and motor response before you call priority.
- Vitals need all three
- The baseline vital signs point requires blood pressure, pulse and respirations.
- SAMPLE is one point
- Trauma history is a single point for attempting a SAMPLE history, where the medical sheet scores past history element by element.
- Each limb counts on its own
- The extremity lines score one point per arm and per leg, and each point covers inspection, palpation, and motor, sensory and distal circulation checks on that limb.
- Spine and oxygen are critical
- Unlike the medical sheet, the trauma sheet has critical criteria for spinal protection when indicated and for high-concentration oxygen.
Practice
Practice E201 on Medceptor
EMT trauma scenarios on Medceptor are scored on these 42 points. You examine an AI patient region by region, the preceptor tells you what each check finds, and your debrief marks every line earned or missed and names any critical criterion that was marked.
Your performance is evaluated by an autonomous AI grading system. Scores are for instructional self-assessment only and are not predictive of the NREMT, the NCLEX or any other certification exam.
Questions
Asked & answered.
How many points is the NREMT trauma patient assessment?
42. Almost half are in the secondary assessment, a 19-point head-to-toe exam, against 14 for the primary survey.
What is the time limit?
You have to initiate or call for transport within 10 minutes, five fewer than on the medical sheet. Missing it is a critical criterion.
What do the ** marks on the trauma sheet mean?
The sheet's header says areas marked ** may be integrated within the sequence of the primary survey. So you can examine the neck or chest, for example, while you work through the primary survey instead of saving them for the secondary.
How is the trauma sheet different from the medical one?
It weights the physical exam over the interview. History taking is 2 points (baseline vitals and a SAMPLE attempt) against 13 on the medical sheet, and the secondary assessment is a 19-point head-to-toe instead of a 5-point focused exam. It also adds critical criteria for spinal protection and high-concentration oxygen.
How can I practice E201 without a partner?
Run EMT trauma scenarios on Medceptor. You assess and treat an AI patient, the preceptor gives you findings as you examine each area, and you're graded on all 42 points.