EMT exam prep

NREMT Skills Sheets: Every Station, Explained Step by Step

The psychomotor exam, station by station, in the order the proctor runs them.

2026-10-15 · 11 min read

How the NREMT psychomotor exam is scored

The NREMT skills exam is the psychomotor exam: you show the skills on a simulated patient while a proctor scores you against a sheet. It tests what you can do with your hands, not what you can remember for the written test.

The exam has 10 stations and 175 steps in total. 76 steps are critical criteria: safety and life-threat steps you must do the exact right way. Miss a critical criterion and that station fails, however well the rest went.

  • Critical criteria are the steps that keep the patient and the crew safe: scene safety, body substance isolation, airway, breathing, and bleeding control.
  • Say what you are doing and what you find, out loud, because the proctor scores what they hear and see.
  • Recheck a failed step if you catch it, but know the critical criteria have no second chance on most state sheets.

The NREMT skills exam, station by station

Below is every station in the approved list, with every step and the critical criteria marked. Open a station to see its steps.

The two patient assessment stations (trauma and medical) are the longest and the ones candidates fail most, so start there and work the others in between.

Patient Assessment/Management: Trauma42 steps - 11 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), like gloves, or I say out loud that I am taking PPE precautions.
    must say
  2. I make sure the scene is safe.
    must say
  3. I figure out what caused the injury (the mechanism of injury).
  4. I find out how many patients there are.
  5. I call for more EMS help if I need it.
  6. I think about whether the spine needs to be held still, and if needed I have someone hold the head and neck still.
    must say
  7. I say my general impression of the patient.
  8. I check how awake and responsive the patient is (level of consciousness).
  9. I find the chief complaint and any obvious life threats.
  10. I open the airway and check it.
    must say
  11. If the patient needs one, I put in an airway adjunct, like an oral airway.
  12. I check the patient's breathing.
    must say
  13. I say I am giving high-concentration oxygen, and I start it.
    must say
  14. I make sure the patient is moving enough air, and I breathe for them if they are not.
    must say
  15. I treat any injury that could make it hard for the patient to breathe.
    must say
  16. I check the pulse.
  17. I check the skin color, temperature, or condition.
  18. I look for major bleeding and stop it if I find it.
    must say
  19. I start treating for shock: I position the patient the right way and keep them warm.
    must say
  20. I decide how urgent the patient is and whether we transport now or keep treating here, and I call for transport (the limit is 10 minutes).
    must say
  21. I take baseline vital signs, including blood pressure, pulse, and breathing rate.
  22. I try to get a SAMPLE history.
  23. I look at and feel the scalp and ears.
  24. I check the eyes.
  25. I look in the mouth and nose and check the face.
  26. I check the position of the trachea (windpipe).
  27. I check the jugular veins in the neck.
  28. I feel along the cervical spine (the back of the neck).
  29. I look at the chest.
  30. I feel the chest.
  31. I listen to the chest with a stethoscope.
  32. I look at and feel the abdomen.
  33. I check the pelvis.
  34. When needed, I say that I check the genital area and perineum.
  35. I look at and feel the left leg and check movement, feeling, and circulation (motor, sensory, and distal pulse).
  36. I look at and feel the right leg and check movement, feeling, and circulation (motor, sensory, and distal pulse).
  37. I look at and feel the left arm and check movement, feeling, and circulation (motor, sensory, and distal pulse).
  38. I look at and feel the right arm and check movement, feeling, and circulation (motor, sensory, and distal pulse).
  39. I look at and feel the back of the chest (posterior thorax).
  40. I look at and feel the lower back and buttocks.
  41. I treat other injuries and wounds the right way.
  42. I show how and when I would check the patient again.

Source: National Registry EMT skill sheet E201

Patient Assessment/Management: Medical37 steps - 8 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), like gloves, or I say out loud that I am taking PPE precautions.
    must say
  2. Before I go to the patient, I make sure the scene is safe.
    must say
  3. I figure out the nature of the illness (or what caused it).
  4. I find out how many patients there are.
  5. I call for more EMS help if I need it.
  6. I think about whether the spine needs to be held still.
  7. I say my general impression of the patient.
  8. I check how responsive the patient is using AVPU (alert, responds to voice, responds to pain, or unresponsive).
  9. I find the chief complaint and any obvious life threats.
  10. I check the airway and breathing.
    must say
  11. I make sure the patient is moving enough air, and I breathe for them if they are not.
    must say
  12. I say what oxygen the patient needs, and I start it.
    must say
  13. I check for major bleeding and stop it if I find it, and I treat for shock if I see signs of it.
    must say
  14. I check the skin color, temperature, or condition.
  15. I check the pulse.
  16. I decide how urgent the patient is and whether we transport now or keep treating here, and I call for transport (the limit is 15 minutes).
    must say
  17. I ask when it started (onset).
  18. I ask what it feels like (quality).
  19. I ask how bad it is (severity).
  20. I ask what makes it better or worse (provocation).
  21. I ask if it spreads or moves anywhere else (radiation).
  22. I ask how long it has been going on (time).
  23. I ask follow-up questions about other signs and symptoms that go with the OPQRST answers.
  24. I ask about allergies.
  25. I ask about past medical history that matters here.
  26. I ask what happened leading up to this illness.
  27. I ask what medications the patient takes.
  28. I ask when the patient last ate or drank.
  29. I assess the body part or system that is affected, for example the heart, lungs, nervous system, skin, muscles and bones, digestive and urinary system, reproductive system, or mental and social state.
  30. I take the blood pressure.
  31. I take the pulse as a vital sign.
  32. I count the breathing rate.
  33. I check the quality of the breathing.
  34. I say my field impression of what is wrong.
  35. I say the treatment I would give.
  36. I show how and when I would check the patient again to catch changes.
  37. I give an accurate verbal report to the EMS crew that arrives.
    must say

Source: National Registry EMT skill sheet E202

BVM ventilation of an apneic adult patient16 steps - 8 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
    must say
  2. I check whether the patient responds.
    must say
  3. I call for more EMS help.
  4. I check breathing and pulse at the same time, for no more than 10 seconds.
    must say
  5. I open the airway the right way.
  6. I get the rigid suction catheter ready.
  7. I turn on the suction unit, or I get a hand-powered suction device.
  8. I put the rigid catheter into the mouth without suction on.
  9. I suction the mouth and the back of the throat (oropharynx), and I keep each suction brief.
    must say
  10. I open the airway by hand.
  11. I put in a right-sized oral airway (OPA), only if there is no gag reflex.
  12. Right after suctioning, I start giving breaths with the BVM, even before it is hooked to oxygen. My first breath comes within 30 seconds after suctioning, and I never stop breathing for the patient for more than 30 seconds.
    must say
  13. I check the pulse again, for no more than 10 seconds.
  14. I hook the BVM (mask, bag, and reservoir) to oxygen at 15 L/minute.
    must say
  15. I give each breath with enough air to make the chest rise.
    must say
  16. I give 10 to 12 breaths a minute, which is 1 breath every 5 to 6 seconds.
    must say

Source: National Registry EMT skill sheet E203

Oxygen administration by non-rebreather mask11 steps - 6 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
    must say
  2. I gather the equipment I need.
  3. I crack the tank valve (open it a little, then close it).
  4. I attach the regulator to the oxygen tank.
    must say
  5. I open the tank valve.
  6. I check the pressure in the tank.
  7. I check for leaks.
    must say
  8. I connect the non-rebreather mask to the right port on the regulator.
  9. I turn on the oxygen and let it fill the reservoir bag before the mask goes on.
    must say
  10. I set the flow to at least 10 L/minute.
    must say
  11. I put the mask on the patient's face and adjust it so it fits snug.
    must say

Source: National Registry EMT skill sheet E204

Spinal immobilization (seated patient)12 steps - 6 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
  2. I tell my assistant to put the head in a neutral, in-line position and keep it there.
    must say
  3. I tell my assistant to keep holding the head still by hand until the head is strapped to the device.
    must say
  4. I check movement, feeling, and circulation in each arm and leg.
  5. I put on a cervical collar that is the right size.
    must say
  6. I place the immobilization device behind the patient.
  7. I strap the device to the patient's torso.
    must say
  8. I check the torso straps and adjust them if needed, so they do not keep the chest from rising.
  9. I check for a gap behind the head and pad it if needed.
  10. I strap the patient's head to the device.
    must say
  11. I say that I would move the patient onto a long backboard.
  12. I check movement, feeling, and circulation in each arm and leg again.
    must say

Source: National Registry EMT skill sheet E211

Spinal immobilization (supine patient)14 steps - 7 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
  2. I tell my assistant to put the head in a neutral, in-line position and keep it there.
    must say
  3. I tell my assistant to keep holding the head still by hand until the head is strapped to the device.
    must say
  4. I check movement, feeling, and circulation in each arm and leg.
  5. I put on a cervical collar that is the right size.
    must say
  6. I place the immobilization device where it needs to be.
  7. I direct the team to move the patient onto the device without twisting or bending the spine.
    must say
  8. If there are gaps between the torso and the device, I fill them with padding.
  9. I strap the patient's torso to the device.
    must say
  10. I check for a gap behind the head and pad it if needed.
  11. I strap the patient's head to the device.
    must say
  12. I strap the patient's legs to the device.
  13. I secure the patient's arms to the device.
  14. I check movement, feeling, and circulation in each arm and leg again.
    must say

Source: National Registry EMT skill sheet E212

Bleeding control and shock management7 steps - 5 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
    must say
  2. I press directly on the wound.
    must say
  3. When it keeps bleeding, I put on a tourniquet.
    must say
  4. I put the patient in the right position for shock.
  5. I give high-concentration oxygen.
    must say
  6. I take steps to keep the patient from losing body heat.
  7. I say the patient needs to be transported right away.
    must say

Source: National Registry EMT skill sheet E213

Cardiac arrest management / AED17 steps - 14 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
    must say
  2. I make sure the scene is safe.
  3. I check whether the patient responds.
    must say
  4. I tell my assistant to go get the AED.
  5. I call for more EMS help.
  6. I check breathing and pulse at the same time, for no more than 10 seconds.
    must say
  7. As soon as I find no pulse, I start chest compressions at the right depth and rate and let the chest come all the way back up.
    must say
  8. During 2 minutes of one-rescuer adult CPR, I push at the right depth and at the right rate, not too slow and not too fast.
    must say
  9. I use the right number of compressions for each set of breaths (the compression-to-breath ratio).
    must say
  10. I let the chest come all the way back up after every compression.
    must say
  11. Each breath I give has enough air.
    must say
  12. I keep pauses in CPR short, never more than 10 seconds.
    must say
  13. I turn on the AED.
    must say
  14. I follow the AED's prompts and put the pads on the patient correctly.
    must say
  15. I stop CPR, say "all clear," and make sure no one is touching the patient while the AED checks the rhythm.
    must say
  16. As soon as the AED advises a shock, I make sure everyone is clear, I say "all clear" and look, and then I press the shock button.
    must say
  17. Right after the shock, I tell the other rescuer to restart chest compressions.
    must say

Source: National Registry EMT skill sheet E215

Joint immobilization9 steps - 5 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
  2. I tell my assistant to hold the injured area still by hand, and we move the injured limb as little and as gently as we can.
    must say
  3. I check movement, feeling, and circulation below the injury.
    must say
  4. I choose the right splinting material.
  5. I immobilize the injured joint itself.
  6. I immobilize the bone above the injured joint.
    must say
  7. I immobilize the bone below the injured joint.
    must say
  8. I secure the whole injured arm or leg.
  9. I check movement, feeling, and circulation below the injury again.
    must say

Source: National Registry EMT skill sheet E216

Long bone immobilization10 steps - 6 must-say

Say each step as you do it, the way you would for the examiner. Steps marked "Must say" match the sheet's critical criteria; missing one can fail the station. Your state may use its own copy of the sheet, so check it.

  1. I put on my protective gear (PPE), or I say out loud that I am taking PPE precautions.
  2. I tell my assistant to hold the injured area still by hand, and we move the injured limb as little and as gently as we can.
    must say
  3. I check movement, feeling, and circulation below the injury.
    must say
  4. I measure the splint to the right length.
  5. I put the splint on.
  6. I immobilize the joint above the injury.
    must say
  7. I immobilize the joint below the injury.
    must say
  8. I secure the whole injured arm or leg.
  9. I splint the hand or foot in the position of function (its natural resting position).
    must say
  10. I check movement, feeling, and circulation below the injury again.
    must say

Source: National Registry EMT skill sheet E217

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The steps that fail a station

Across the 10 stations, 76 steps are critical criteria. They cluster around the same priorities every time: scene safety, the ABCs, and controlling life threats before anything else.

  • Scene safety: say the scene is safe and you have body substance isolation on, before you touch the patient.
  • Airway: open the airway and check it is clear, and say how you would manage it if it is not.
  • Breathing: assess rate and quality, and ventilate or give oxygen when the sheet calls for it.
  • Circulation and bleeding: control life-threatening bleeding before anything less urgent.

The full list marks each critical criterion so you can drill exactly the steps that decide pass or fail.

Practice saying each station out loud

Reading the sheets is the easy half. The exam is performing the skill while you talk through it, in order, under a timer.

The exam prep practice tool listens while you speak the station, marks the steps you said against this same list, and shows the critical criterion you missed. Two scored runs on the EMT skills exam are free.

NREMT skills test day: what to expect

The psychomotor exam is usually run by your state or your training program on a set day, separate from the written exam. You rotate through stations, and each station has a time limit.

  • Bring your photo ID and your course completion record. Ask your program what else your state requires.
  • Say scene safety and body substance isolation first, out loud, on every station.
  • Verbalize what you would do when you cannot actually do it on a manikin, and ask before you touch a real patient.
  • If you forget a step, name it as soon as you remember instead of skipping ahead. A recalled step beats a silent gap.

How EMT training gets paid for

EMT training is short and inexpensive compared to most medical careers, and much of it is free: many fire departments and ambulance services pay for the course, and WIOA training grants cover tuition and the exam fee for people who qualify.

Find out what your state will pay for before you enroll. The step-by-step version is in the EMT training guide linked below.

Next step

Practice the steps out loud

Part of the guide: AI interview practice app: what it scores, plans and free guides

Frequently asked questions

How many stations are on the NREMT skills exam?

The approved list has 10 stations, including the two patient assessment stations (trauma and medical) that carry the most steps. Your state or program sets the exact lineup and time limits.

What are critical criteria on the NREMT skills exam?

Critical criteria are the safety and life-threat steps you must do the exact right way or the whole station fails. There are 76 of them across the 10 stations, and they cluster around scene safety, the ABCs, and bleeding control.

Do I have to verbalize on the EMT skills exam?

Yes. The proctor scores what they hear and see, and many steps are things you cannot actually do on a manikin, so you say what you would do. Say scene safety and body substance isolation first on every station.

Is the NREMT skills exam the same in every state?

The stations come from the same NREMT standard, so the skills are nearly the same everywhere, but your state or training program runs the day and may add state-specific stations. Ask your program for its sheet.

Can I retake the NREMT skills exam?

Yes. Retest rules, limits, and fees are set by your state or program. Most candidates who fail a station fail one critical criterion, and pass the retest after one session that scores what they said out loud.

Can I practice the EMT skills without equipment?

Yes. The part being scored is remembering the steps in order and saying them, and you can practise that anywhere. The exam prep tool scores your spoken run against this list and shows the critical criterion you missed.

For individuals

Practice it out loud until it's automatic

The exam prep tool listens while you speak the steps, scores what you named against this list, and shows the part you missed. Two scored runs on the EMT skills exam are free, then Exam Prep Practice unlocks unlimited runs: $4.99 for 7 days, $9.99 for 30 days, or $14.99 until you pass.

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Last updated: 2026-10-15