⚠ DRAFT — EMTs work under medical direction; a state-approved course, skills & field time are required
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K
Coach Katie
On every call, EMTs work the same way: make the scene safe, protect yourself (BSI), then find and fix life threats — in order. Master the order first. It's what keeps a patient alive long enough for everything else to matter.
Before you touch the patient
Scene safety & BSI come first
The assessment doesn't begin with the patient — it begins with you. Size up the scene for hazards, decide it's safe to approach, and put on your BSI / PPE (gloves, eye protection as needed). Note the number of patients and the nature of illness or mechanism of injury.
You can't help anyone if you become the next patient. Scene safety and body substance isolation always come before hands-on care.
The most important skill
Primary assessment: life threats, in order
The primary assessment is a rapid pass to find and treat immediate life threats in a set order. Do them in sequence — a blocked airway kills faster than low blood pressure, so airway comes before circulation.
1
General impression — sick vs. not sick, formed in the first seconds.
2
Level of consciousness (AVPU) — Alert · responds to Verbal · responds to Pain · Unresponsive.
3
Airway — is it open and clear? Open it if needed.
4
Breathing — is the patient breathing adequately? Support it if not.
5
Circulation — pulse and skin, and control major bleeding.
6
Decision — priority for transport and level of care.
AVPU is your fast read on mental status: Alert, responds to Verbal, responds to Pain, Unresponsive.
Major bleeding: control life-threatening extremity bleeding with direct pressure first, then a tourniquet if pressure doesn't stop it. Big bleeds are part of the "C" step — don't leave them for later.
Sick or not sick?
Form a general impression fast
In the first few seconds, before any numbers, form a gut general impression: does this patient look sick or not sick? Age, position, work of breathing, skin color, and how they respond all feed that snapshot. It sets your urgency and tells you how fast to move.
Numbers that trend
Vital signs: get a baseline, watch the trend
Vitals turn "looks sick" into something you can measure and hand off. Get a baseline set early, then repeat them — one number is a snapshot; two or more show a trend.
💓 Pulse
Rate, strength, regular vs. irregular.
🌬️ Respirations
Rate, depth, effort/quality.
🖐️ Skin
Color, temperature, moisture.
🩸 Blood pressure
Baseline, then trended.
👁️ Pupils
Size, equality, reaction to light.
🫁 SpO₂
Oxygen saturation reading.
Tell the story
History: SAMPLE and OPQRST
Once life threats are handled, gather the history. Two memory tools do the heavy lifting.
SAMPLE — the whole-patient history
S — Signs / symptoms
What you see and what they feel.
A — Allergies
Meds, foods, environment.
M — Medications
What they take, including recent doses.
P — Past history
Relevant medical history.
L — Last oral intake
Last food or drink.
E — Events
What led up to today's call.
OPQRST — for pain or a specific complaint
O — Onset
What were they doing when it started?
P — Provocation
What makes it better or worse?
Q — Quality
Sharp, dull, crushing, pressure?
R — Region / radiation
Where is it; does it move?
S — Severity
How bad, 0–10?
T — Time
How long; constant or coming and going?
Never assess once
Reassess — the assessment is a loop
Patients change. After your first pass, reassess: repeat the primary assessment and vitals, recheck any interventions, and watch the trend.
Unstable patient
Reassess about every 5 minutes.
Stable patient
Reassess about every 15 minutes.
Trends beat snapshots. A patient who is getting worse over two sets of vitals tells you something a single reading never could.
K
Coach Katie
Two calls. Pick the choice that works life threats in order and stays in your scope.
K
Coach Katie
Five questions. 75% to pass, then make your pledge.
K
Coach Katie
Learning sticks when you commit to a next step. Pick at least two pledges you'll actually do.
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