Tools

Psychomotor Skills Study Guide

Practice each psychomotor station out loud, against the clock.

Run a station, out loud

General structure, not exact scored step order. Verify the sequence against your program's official skill sheets and current NREMT documents.

How the stations are scored (reading guide)

General patterns across most skill sheets

Nearly every station opens with taking or verbalizing appropriate PPE/BSI precautions — this is almost always the very first scored item.
Assessment-based stations generally follow: scene safety → primary survey/life threats → history/vitals → secondary assessment → reassessment.
Watch for "critical criteria" — a separate list of automatic-fail actions (like failing to take BSI precautions, or exceeding a time limit) that exist alongside the step-by-step point sheet.
Examiners often feed you specific findings ("the wound continues to bleed," "the patient is unresponsive") that cue the next branch of the skill — expect a scenario to unfold rather than a static checklist.
Practice saying steps out loud as you'd verbalize them in the exam room, not just recalling them silently — the psychomotor exam is verbal and hands-on, not written.
Time limits are real and enforced — running out of time on a station is typically scored as an automatic fail on that station, same as missing a critical criterion.
An evaluator generally can't coach you mid-station. If you skip a step and realize it later, say so and go back rather than assuming it's lost — some programs allow returning to an earlier step if you catch it yourself before the station ends.
"Simulate" and "verbalize" are doing real work in these instructions: if a sheet says to simulate a treatment (like simulating oxygen administration on a manikin), actually going through the physical motions while narrating what you're doing is usually expected, not just saying the words.

How scoring generally works

Across all the stations, there are typically two separate things being scored at once, and you can fail a station by missing either one:

The point sheet — a list of individual steps, each worth points, that add up to a total. Most sheets set a minimum number of points you must earn to pass the station, even if you didn't lose any critical criteria.
Critical criteria — a separate, shorter list of specific failures (examples that commonly appear across programs: not taking/verbalizing BSI precautions, an action that would endanger the patient or team, failing to manage a life threat found during the exam, exceeding the time limit) that fail the station regardless of how many points you scored on the main sheet.

In practice, this means a technically smooth run-through can still fail if a single critical criterion is missed — so when you practice, drill the critical items specifically (out loud, every time) rather than only rehearsing the general flow.

Verbalization cheat-sheet

A common reason for losing points isn't doing the wrong thing — it's doing the right thing silently. Examiners generally can only score what you say or physically demonstrate, not what you're thinking. A few phrasings students are commonly taught to say out loud at the right moments:

On approach: "BSI precautions taken, scene appears safe, I have gloves and eye protection on."
Starting the primary assessment: "I'm forming a general impression — patient appears [alert/in distress/etc.]. Assessing airway, breathing, circulation."
Finding a life threat: state the finding out loud and what you're doing about it immediately, e.g. "I see severe bleeding from the leg — applying direct pressure now."
Before touching a treatment device: "I'm going to simulate/apply [oxygen via non-rebreather / a splint / the AED] now," so the examiner knows to watch that action specifically.
After any intervention: reassess and say so — "Reassessing airway and vital signs after treatment."
Handoff: deliver a structured verbal report even if no one is physically there to receive it — patient's age/sex, chief complaint, key findings, vitals, treatment given.

The official sheets at a glance (points, time, critical criteria)

The official sheets at a glance

The National Registry’s EMT psychomotor sheets, linked from the source. Points are the total on each sheet; the time is the station limit from the Registry’s EMT psychomotor exam guide (the sheets themselves only have “time started” and “time ended” boxes, except the two patient assessment sheets, which name their limit in a critical criterion; for the four randomly chosen skills, seated spinal, long bone, joint and bleeding control, the guide gives a 5 to 10 minute range and the time shown is the one commonly used); the last column paraphrases the critical criteria, any one of which fails the station however many points you score. Your state or program runs the EMT skills exam and may use its own version of a sheet, so practice with the one you will be tested on.

Station and sheet	Points	Time	Critical criteria (summary)
Patient Assessment/Management — TraumaE201	42	10 min	No PPE; no scene safety check; no spinal protection when indicated; no high-concentration oxygen; misses or mismanages an airway, breathing, bleeding or shock problem; does other assessment before treating threats to airway, breathing and circulation; no transport call within the 10 minutes
Patient Assessment/Management — MedicalE202	42	15 min	No PPE; no scene safety check; no high-concentration oxygen when needed; misses or mismanages a life threat; secondary exam before treating threats to airway, breathing and circulation; no medical direction or standing order for a medication; no transport call within the 15 minutes
Cardiac Arrest Management / AEDE215	17	10 min	No PPE; responsiveness not checked, then breathing and pulse not checked together in no more than 10 seconds; compressions not begun as soon as pulselessness is confirmed; compressions not of acceptable quality; CPR interrupted for more than 10 seconds; AED attached or operated incorrectly; shock not delivered in a timely manner; anyone not clear during analysis or shock; compressions not resumed immediately after the shock
BVM Ventilation of an Apneic AdultE203	16	5 min	No PPE; no suctioning before ventilating, or suctioning too long; responsiveness, breathing and pulse not checked (no more than 10 seconds); high-concentration oxygen not voiced and given; inadequate volume per breath (more than 2 errors a minute); ventilation rate below 10 or above 12 a minute (one ventilation every 5–6 seconds); interruption of ventilation for more than 30 seconds
Oxygen Administration by Non-Rebreather MaskE204	11	5 min	No PPE; tank and regulator assembled with leaks; reservoir not prefilled; flow below 10 L/min; mask not sealed to the face
Spinal Immobilization — Supine PatientE212	14	10 min	Manual stabilization not taken at once, or released before mechanical immobilization; collar not applied before release; excessive movement of the patient; head secured before the torso; head not neutral and in line at the end; distal motor, sensory and circulation not reassessed
Spinal Immobilization — Seated PatientE211	12	10 min	As for the supine station, plus the device moving excessively on the torso and the torso straps not tight enough
Long Bone ImmobilizationE217	10	5 min	Extremity not stabilized at once; gross movement of the injured limb; joints above and below not immobilized; hand or foot not in a position of function; distal motor, sensory and circulation not checked before and after splinting
Joint ImmobilizationE216	9	5 min	Joint not supported so it bears no distal weight; bones above and below not immobilized; distal motor, sensory and circulation not checked before and after splinting
Bleeding Control / Shock ManagementE213	7	10 min	No PPE; high-concentration oxygen not applied; bleeding not controlled correctly and in time; need for immediate transport not indicated

Every station, step by step (10 cards)

Patient Assessment — Trauma

Scene size-up → primary survey/resuscitation → history taking → secondary assessment (typically organized head-to-toe by body region) → reassessment.

This station tends to be the most detail-heavy of the stations — budget extra review time for it.

Watch for: failing to manage a life threat (like severe bleeding or an airway problem) the moment you find it during the secondary exam — treating it in the order you found it, rather than finishing the whole exam first, is commonly a critical-criteria item.

Patient Assessment — Medical

Scene size-up → primary survey/resuscitation → history taking and/or focused secondary assessment (order of these two can vary by program — verify yours specifically) → reassessment → verbal report to an arriving unit.

A common point of confusion: whether history-taking or secondary assessment comes first differs between sources — confirm which your program tests on.

Watch for: stating a field impression/diagnosis and appropriate management plan out loud at the end — some sheets score this as a distinct step, separate from just gathering the history and vitals.

Cardiac Arrest Management / AED

Scene safety and responsiveness check → activating the emergency response/getting the AED → high-quality CPR → AED application and analysis → post-shock/no-shock actions.

The exact placement of "direct someone to get the AED" relative to starting compressions is a detail worth double-checking against your program's sheet.

Watch for: minimizing hands-off chest compression time — pausing too long around the AED analysis/shock or during pulse checks is a frequently cited critical-criteria failure, not just a point deduction.

BVM Ventilation of an Apneic Adult

Airway assessment and positioning → adjunct placement as needed → ventilation technique and rate → reassessment of effectiveness.

Ventilation rate and technique are heavily scrutinized here — this pairs well with the Airway & Respiratory topic area in the cognitive exam prep.

Watch for: ventilating too fast or with too much volume — beyond just being poor technique, excessive ventilation (and the gastric distention/aspiration risk it creates) is commonly called out as a critical-criteria failure, not only a lost point.

Oxygen Administration by Non-Rebreather Mask

Assembling and checking equipment → correctly connecting the mask and tubing → priming the reservoir bag before application → applying to the patient and adjusting flow.

A commonly missed step is priming the reservoir bag before placing the mask on the patient — check this specifically.

Watch for: stating and setting the flow rate out loud. A non-rebreather runs at 10–15 L/min — enough that the reservoir bag does not collapse on inspiration, which is the functional test and the reason the range has a floor. Silently adjusting the flow meter without saying the number is a common way to lose this point.

The numbers worth having ready: nasal cannula 1–6 L/min (roughly 24–44% oxygen); non-rebreather 10–15 L/min (up to about 90%); bag-valve mask with a reservoir at 15 L/min (approaching 100%). A nasal cannula above 6 L/min dries and irritates the nose without delivering meaningfully more oxygen, and a non-rebreather below about 10 L/min lets the reservoir bag collapse, which is the real test of whether the flow is high enough.

Long Bone Immobilization

Manual stabilization → initial PMS (pulse, motor, sensation) check → splint application → reassessment of PMS after splinting.

PMS checks both before and after splinting are typically separately scored items — don't combine them into one step when verbalizing.

Watch for: a splint that doesn't immobilize the joints above and below the fracture site — leaving one end free to move is a common way this station is failed, even when the PMS checks themselves were done correctly.

Joint Immobilization

Manual stabilization of the joint in the position found (or as directed) → initial PMS check → splint application immobilizing the bone above and below the joint → reassessment of PMS.

Joint immobilization differs from long bone immobilization in what gets immobilized — confirm the distinction is clear in your own notes.

Watch for: attempting to force a badly angulated joint into a "normal" position before splinting — most sheets score splinting in the position found unless specifically directed otherwise (e.g., absent distal pulse).

Spinal Immobilization — Supine Patient

Manual in-line stabilization taken and held → initial PMS in all four extremities → cervical collar sized and applied → patient log-rolled onto the board with the head-holder directing → padding of voids, then torso, then head secured → repeat PMS in all four.

Whether your state still tests this station varies — many have retired the standalone spinal stations as spinal motion restriction has moved away from routine backboarding. Check with your program before spending practice time on it.

Watch for: the order of securing. Torso before head, every time: strapping the head first leaves the body free to shift and levers the neck. Releasing manual stabilization before the head is fully secured is the other classic critical failure, and the person at the head directs the roll — not whoever is most senior.

Spinal Immobilization — Seated Patient

Manual in-line stabilization taken and held → initial PMS in all four extremities → collar applied → vest-type device positioned behind the patient → torso flaps secured, then groin straps, then head → patient rotated and lowered onto the long board → repeat PMS in all four.

Same caveat as the supine station: confirm with your program whether your state still tests it.

Watch for: securing the head to the device before the torso straps are snug, and forgetting the groin straps — without them the patient slides down inside the device as it is tipped, which undoes the immobilization at the moment it matters most.

Bleeding Control / Shock Management

Direct pressure → escalation to a tourniquet if bleeding continues and is severe → shock management steps (positioning, oxygen, preventing heat loss) → transport decision.

Where exactly the "indicates need for immediate transportation" step falls in the sequence is a documented point of difference between sources — this is a good one to verify directly against your program's printed sheet rather than any secondary source.

Watch for: reaching for a tourniquet as the very first action on ordinary external bleeding — the sheet expects direct pressure first there. Note the tension with current field practice, which puts a tourniquet on a life-threatening extremity bleed immediately: the skill sheet is scoring a scripted scenario, and it scores what it scores. Read the scenario the examiner gives you and follow the sheet in the station.

Verify against the source

Each sheet in the table above links to the National Registry’s own PDF. Your program’s portal or printed materials are the other essential source — when the two differ, ask your instructor which one you’re actually tested on.