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Exam Name: National Registry of Emergency Medical Technicians (NREMT) Paramedic Trauma Exam
Vendor: National Registry of Emergency Medical Technicians (NREMT)
Exam Duration: 2 hours 30 minutes
Number of Questions: 80-150 (adaptive format)
Passing Score: Determined by adaptive scoring; no fixed percentage
Language: English
Exam Delivery: Computer-based testing at Pearson VUE testing centers

- Trauma Overview (10-15% of Exam)
- Mechanism of Injury (MOI): Understanding how trauma occurs (e.g., blunt vs. penetrating trauma).
- Kinematics of Trauma: Analyzing forces involved in trauma (e.g., motor vehicle collisions, falls).
- Trauma Triage: Prioritizing patients based on injury severity (e.g., START triage).
- Golden Hour: The critical first hour after a traumatic injury.
- Trauma Systems and Centers: Role of trauma centers and regional systems.

- Hemorrhage Control and Shock Management (20-25% of Exam)
- Types of Shock:
- Hypovolemic (e.g., blood loss)
- Cardiogenic (e.g., heart failure)
- Distributive (e.g., septic, anaphylactic, neurogenic)
- Obstructive (e.g., tension pneumothorax, cardiac tamponade)
- Hemorrhage Control:
- Direct pressure, tourniquets, hemostatic agents
- Fluid Resuscitation:
- Crystalloids (e.g., normal saline, lactated Ringer's)
- Blood products (e.g., packed red blood cells)
- Signs and Symptoms of Shock:
- Tachycardia, hypotension, altered mental status, cool/clammy skin

- Thoracic Trauma (15-20% of Exam)
- Pneumothorax:
- Simple vs. tension pneumothorax
- Needle decompression and chest tube management
- Hemothorax: Accumulation of blood in the pleural cavity.
- Flail Chest: Paradoxical chest wall movement due to rib fractures.
- Cardiac Tamponade: Fluid accumulation in the pericardial sac (e.g., Beck's triad).
- Rib Fractures and Pulmonary Contusion: Complications and management.

- Abdominal and Genitourinary Trauma (10-15% of Exam)
- Solid Organ Injuries: Liver, spleen, and kidney injuries.
- Hollow Organ Injuries: Stomach, intestines, and bladder injuries.
- Pelvic Fractures: Associated hemorrhage and stabilization.
- Genitourinary Trauma: Kidney, bladder, and urethral injuries.
- Abdominal Evisceration: Management of protruding organs.

- Head, Facial, and Spinal Trauma (15-20% of Exam)
- Traumatic Brain Injury (TBI):
- Concussion, contusion, intracranial hemorrhage (e.g., epidural, subdural)
- Signs of increased intracranial pressure (e.g., Cushing's triad)
- Facial Trauma:
- Airway management in facial fractures
- Nasal and orbital injuries
- Spinal Trauma:
- Spinal immobilization techniques
- Cervical spine injury assessment (e.g., NEXUS criteria)
- Penetrating Head Injuries: Management and complications.

- Musculoskeletal Trauma (10-15% of Exam)
- Fractures:
- Open vs. closed fractures
- Reduction and splinting techniques
- Dislocations: Shoulder, hip, and knee dislocations.
- Compartment Syndrome: Signs, symptoms, and management.
- Crush Injuries: Systemic effects (e.g., rhabdomyolysis).

- Burn Trauma (5-10% of Exam)
- Burn Classification:
- Superficial, partial-thickness, full-thickness burns
- Rule of Nines: Estimating burn surface area.
- Inhalation Injuries: Carbon monoxide poisoning, airway burns.
- Fluid Resuscitation: Parkland formula for burn management.
- Electrical and Chemical Burns: Specific management considerations.

- Special Considerations in Trauma (5-10% of Exam)
- Pediatric Trauma: Unique anatomical and physiological considerations.
- Geriatric Trauma: Increased risk of complications in older adults.
- Pregnancy Trauma: Managing trauma in pregnant patients.
- Environmental Trauma: Hypothermia, hyperthermia, and drowning.

- Golden Hour: The critical first hour after a traumatic injury.
- Cushing's Triad: Bradycardia, hypertension, and irregular respirations (signs of increased intracranial pressure).
- Beck's Triad: Hypotension, jugular venous distension, and muffled heart sounds (signs of cardiac tamponade).
- Tension Pneumothorax: Life-threatening condition requiring immediate needle decompression.
- Rhabdomyolysis: Breakdown of muscle tissue releasing toxic substances into the bloodstream.
- Parkland Formula: 4 mL x body weight (kg) x % total body surface area (TBSA) burned = fluid requirement in the first 24 hours.