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NATIONAL REGISTRY OF EMERGENCY MEDICAL TECHNICIANS EMERGENCY MEDICALTECHNICIANPSYCHOMOTOREXAMINATIONUSERS GUIDENOVEMBER 1, 2011With MAINE EMSREVISIONSfor Randomized SamplingPSEsRevised by Maine EMS - May 12, 2016 2011 by the National Registry of EMTs REVISED for MAINE USE – May 12, 2016November 2011 NREMT Emergency Medical Technician Users GuidePage 1

COPYRIGHT 2011by theNATIONAL REGISTRY OF EMERGENCY MEDICAL TECHNICIANS, INC.6610 Busch BoulevardP.O. Box 29233Columbus, OH 43229-0233(614)888-4484http://www.nremt.orgAll Rights Reserved.COPYRIGHT WARNING:This manual is protected by Copyright laws of the United States of America. Only non-commercialreproduction of this material for educational purposes or the advancement of medical science ispermitted. No part of this manual may be reproduced, stored in a retrieval system, or transmitted,in any form or by any means, electronic, mechanical, photocopying, recording, or by any othermeans whatsoever. Violators will be subject to prosecution and other actions. 2011 by the National Registry of EMTs REVISED for MAINE USE – May 12, 2016November 2011 NREMT Emergency Medical Technician Users GuidePage 2

Table of ContentsWelcome . 5Introduction . 7Examination Coordinator Responsibilities . 10Examination Coordinator’s Timeline . 11Requesting to Host the Psychomotor Examination . 12Maintaining a Reservation List of Candidates . 12Equipment . 13Facilities for the Psychomotor Examination . 13Staffing for the EMT Psychomotor Examination. 14Physician Medical Director . 14EMT Assistants. 15Simulated Patients . 15Roster . 16Budget . 16Running an Efficient Psychomotor Examination . 16Administration of the Psychomotor Examination .18General Responsibilities . 19EMT Psychomotor Examination Skills . 22EMT Psychomotor Examination Results . 24Psychomotor Examination Accommodations . 26Skill Examiner Orientation . 27Candidate Orientation . 31Quality Assurance Committee Procedure . 37Complaint Form. 39Review Form . 42False Identification. 43Late Arrivals. 43Interruption of the Psychomotor Examination . 43Use of Prohibited Materials . 44Candidates Suspected of Dishonest Action . 45Irregular Behavior . 45Dismissal from the Psychomotor Examination . 46Reporting EMT Psychomotor Examination Results . 46Same-Day Retest Considerations . 48Same-Day Retest Roster . 49Completion of the Psychomotor Examination . 52Skill Examiner Responsibilities. 53Skill Examiner Qualifications . 53Essays to Skill Examiners . 56 2011 by the National Registry of EMTs REVISED for MAINE USE – May 12, 2016November 2011 NREMT Emergency Medical Technician Users GuidePage 3

Patient Assessment/Management – Trauma . 57Patient Assessment/Management – Medical . 63BVM Ventilation of an Apneic Adult Patient . 70Oxygen Administration by Non-rebreather Mask. 72Cardiac Arrest Management/AED . 75Spinal Immobilization (Supine Patient)And Random EMT Skills . 78AppendicesAppendix A:Appendix B:Appendix C:Appendix D:Appendix E:Appendix E:Appendix F:Reservation List . 89Signs for Skills . 90Examination Staff Roster . .95Equipment List . .97EMT Psychomotor Examination Report Form (Legacy) .101EMT Psychomotor Examination Report Form (Maine) . 104Recommended Pass/Fail Criteria . 106Note: This document incorporates changes made to Maine EMS’ process forEMT Practical Skills Evaluations (PSEs) as approved by the Maine EMS Boardin April 2016.Questions concerning interpretation, errors or omissions should be directed tothe Maine EMS office email or to your designated PSEAdministratorThe Revision Information for EMT Exam Guide 2016-05-12may be found in the Testing section of the Maine EMS web ml and contains specificlanguage changes made by Maine EMS concerning the Random Samplingtesting model 2011 by the National Registry of EMTs REVISED for MAINE USE – May 12, 2016November 2011 NREMT Emergency Medical Technician Users GuidePage 4

WelcomeDear Examination Coordinator:Thank you for your interest in hosting an Emergency Medical Technician (EMT) psychomotorexamination. We are pleased to provide you with this copy of the NREMT’s Emergency MedicalTechnician Psychomotor Examination Users Guide. This comprehensive manual details the suggestedaspects of coordinating an EMT psychomotor examination and is designed to assist you in planning for allrelated aspects of the examination. Additional information concerning national EMS certification forEMTs is located at following information reflects years of experience in examination administration. The quality of theexamination process is due in part to feedback we have received from Examination Coordinators such asyou in the past. As a result of our continuous efforts to improve the examination process and keep itcurrent with out-of-hospital medical care, we proudly present this suggested EMT psychomotorexamination as implemented effective November 2011. This material consists of skills presented in ascenario-type format to approximate the abilities of the Nationally Registered EMT to function in the outof-hospital setting. All skills have been developed in accordance with the 2009 National EMS EducationStandards and Instructional Guidelines for the Emergency Medical Technician; the National TraumaTriage Protocol published by the U.S. Department of Health and Human Services Centers for DiseaseControl and Prevention; and current American Heart Association guidelines for Basic Life Support forHealthcare Providers (BLS) that are updated as necessary. The suggested process outlined is a formalverification of the candidate's "hands-on" abilities and knowledge, rather than a teaching, coaching, orremedial training session. The NREMT strongly advises that specific errors in any performance not beexplained or discussed as this is not a responsibility or function of any certification process. Acandidate’s attendance at a scheduled examination does not automatically guarantee eligibility forNational EMS Certification or state licensure. Candidates should also be warned that they assume allrisks and consequences of testing inappropriate skills if testing at a site where their name was not read aspart of the official examination roster.This manual describes all suggested aspects related to coordinating an EMT psychomotor examination.As an Examination Coordinator, you assume many responsibilities that are vital to the success of thepsychomotor examination process. The quality of your experience with this certification process isdirectly dependent upon your thorough familiarization with all of the material contained herein. We arecommitted to assist you to help ensure that all candidates who attend your examination site will be testedin a fair, consistent, objective, and impartial manner in accordance with all suggested policies andprocedures of the National Registry of Emergency Medical Technicians (NREMT) outlined in thismanual. Please contact us immediately if we can clarify or answer any questions concerning this process.The NREMT has copyrighted this material. Only non-commercial reproduction of this material foreducational purposes or the advancement of medical science is permitted. All other unauthorizedreproductions of this material for any reason whatsoever are subject to penalties in accordance with allcopyright laws of the United States of America. We encourage you to distribute copies of all skillevaluation instruments (available at to the students prior to the examination so theymay be become familiar with the examination expectations well in advance of the actual examination.Likewise, we suggest that you forward a copy of the skill evaluation instrument and essay (included inthis document) to the respective Skill Examiner one (1) week prior to the examination to give him/herample time for familiarization prior to the examination. 2011 by the National Registry of EMTs REVISED for MAINE USE – May 12, 2016November 2011 NREMT Emergency Medical Technician Users GuidePage 5

In closing, please keep in mind that this material serves only as a guide to facilitate coordination andadministration of the Emergency Medical Technician psychomotor examination. State EMS officials maychoose to alter the format and design of these materials in order to meet local requirements for statelicensure. We encourage you to adhere to any mandated state requirements for administration andcoordination of EMT psychomotor examinations. The NREMT will continue to recognize results fromstate-approved EMT psychomotor examinations, provided they appropriately measure and validateequivalent EMT competencies contained herein.Thank you again for your interest in hosting an EMT psychomotor examination. We trust that you willfind this resource document beneficial and sincerely hope that your psychomotor examination is asuccessful endeavor for all involved.Sincerely,eÉu jtzÉÇxÜRob Wagoner, Associate Director 2011 by the National Registry of EMTs REVISED for MAINE USE – May 12, 2016November 2011 NREMT Emergency Medical Technician Users GuidePage 6

IntroductionThis manual was developed a result of the NREMT Board of Directors continued awareness of the needfor standardization and uniform criteria for psychomotor examinations. The evolution of psychomotorexaminations has been guided by many changes within emergency medical services in the United States.In the spring of 1993, the NREMT Board of Directors convened a meeting of its EMT-Basic ExaminationCommittee to review and revise the current practical examination skill instruments used to assess skillscompetency at the EMT-Basic level. In conjunction with the development of the 1994 EMT-BasicNational Standard Curriculum, the NREMT began peer-review and pilot testing of the proposedevaluation instrument. Following the review and revision process, the staff of the NREMT was directedto develop a revised EMT-Basic Practical Examination User’s Guide which would reflect the scope ofpractice identified in the 1994 EMT-Basic National Standard Curriculum, the National EMS Educationaland Practice Blueprint and would include up-to-date skill evaluation instruments as well as criteria forconducting a practical examination.The NREMT Board of Directors believes that as with all other levels of National EMS Certification, thepsychomotor examination should be cost-effective while continuing to assure protection of the publicthrough adequate measurement of minimal skill competencies. They also stressed the importance ofkeeping our testing philosophies consistent between levels whenever possible. Each of the skills includedin the psychomotor examination were chosen based upon the frequency of use in day-to-day, out-ofhospital care as well as the potential of harm they pose to public safety and patient care. When possible,the steps for each skill evaluation instrument were written in observable behavior formats and a pointvalue of 1 point for each observable step was assigned. Critical behaviors were identified for each skilland written out in a “Critical Criteria” section on each skill evaluation instrument. This helped eliminateinconsistencies in scoring that results whenever certain steps were weighted and assigned higher pointvalues than others with no explanation on how to disburse partial credit. In order to improve consistencyand inter-rater reliability, each skill evaluation form is accompanied by a detailed essay to help focus theskill examiner on the consistent, proper testing of each skill. Finally, predetermined passing criteria foreach skill were established and endorsed by the NREMT Board of Directors.In 2008 as the drafted National EMS Education Standards were being revised, the NREMT assembled anad hoc committee from various communities of interest to review the existing NREMT EmergencyMedical Technician certification process in October 2008. The committee reviewed the revisedEmergency Medical Technician standards and made recommendations for revising the National EMSCertification process for Emergency Medical Technicians. Members of this committee included: Bob Graff, Director, Office of EMS, South Dakota Department of HealthDan Manz, Director, EMS Division, Vermont Department of HealthMary Beth Michos, Chief, Executive Director, IAFC, Past NREMT ChairLeann Domonoske, Ambulance Coordinator, Wilton Boro Ambulance District, NDDavid Burns, Department for EMS Education, Center for Emergency Response Training,University of South Alabama, Mobile, ALLinda Pace, EMS Instructor/Program Coordinator, Rio, WICarlos Falcon, MD, Chair Iowa EMS Advisory CouncilJohn E. Manley, State Training Coordinator, Oklahoma State Department of HealthWilliam E. Brown, Jr., RN, MS, NREMT-P, NREMT Executive DirectorGregg Margolis, PhD, NREMT-P, NREMT Associate DirectorGabriel Romero, MBA, NREMT-P, NREMT Examination CoordinatorRob Wagoner, BSAS, NREMT-P, NREMT Associate Director 2011 by the National Registry of EMTs REVISED for MAINE USE – May 12, 2016November 2011 NREMT Emergency Medical Technician Users GuidePage 7

The Committee urged the NREMT to develop an enhanced, comprehensive Emergency MedicalTechnician Users Guide similar to one that has been in use for years for NREMT-Basic certification. Thismanual provides for a structured, organized approach to conducting a psychomotor examination. TheCommittee reviewed the drafted EMT Education Standards and identified skills that represent criticalcompetencies necessary for the EMT to demonstrate in order to help assure that safe and effective carewill be provided to patients in their time of need. The Committee agreed to continue the format ofNREMT skill evaluation forms with accompanying essays that were initially implemented in 1991. Thematerials included in this guide represent the latest refinement in psychomotor evaluations that we haveundertaken since 1991.The NREMT was sensitive to input requesting that the NREMT develop an administratively feasible andcost-effective psychomotor examination. The following factors were carefully considered as thesematerials were developed and approved for this guide:1. Helping to assure protection of the public is the primary responsibility of the NREMT certificationprocess.2. Approved EMT educational programs include scheduled state-approved psychomotor skillssessions that meet or exceed the National EMS Educational Standards.3. Approved EMT educational programs or the state are responsible for attesting to the competencyof candidates who seek National EMS Certification. Candidates who are deemed less-thancompetent by the approved educational program should not be permitted entry to the NationalEMS Certification process.4. In order to help assure protection of the public, verification of psychomotor competencies forNational EMS Certification should be accomplished by agencies or individuals not directlyassociated with the approved educational program’s graduates.In June 2009, the ad hoc NREMT Psychomotor Examination Revision Committee met in Chicago, IL tocomplete development of the revised NREMT psychomotor examination process as identified in 2008.Members of this committee included: Kenneth Navarro, Assistant Professor UT Southwestern Medical Center, Dallas, TXJon Politis, MPA, NREMT-P, Chief, Colonie EMS, NYAlex Butman, BA, DSc, NREMT-P, Fairlawn, OHWilliam Clark, MD, State EMS Medical Director, Baton Rouge, LAGabriel Romero, MBA, NREMT-P, NREMT Examination CoordinatorRob Wagoner, BSAS, NREMT-P, NREMT Associate DirectorAfter reviewing the drafted materials, the proposed EMT psychomotor examination was reviewed by theNREMT Standards & Examination Committee and approved by the NREMT Board of Directors inNovember 2010 for implementation effective September 2011. It was felt that this schedule for releasebest fit with implementation of the new EMT level for National EMS Certification as well as AHAGuidelines 2010 for CPR and Emergency Cardiovascular Care beginning January 1, 2012.The Maine revision of the sample NREMT psychomotor examination outlined in this guide contains four(4) skills. When using this sample psychomotor examination for National EMS Certification, allcandidates should be tested over the four (4) skills outlined. The administrati

November 2011 NREMT Emergency Medical Technician Users Guide Page 5 Welcome Dear Examination Coordinator: Thank you for your interest in hosting an Emergency Medical Technician (EMT) psychomotor examination. We are pleased to provide you with this copy of the NREMT’s Emergency Medical Technician Psychomotor Examination Users Guide.

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