Transition Series: Topics for the EMT—Trauma

A review of the new education standards pertaining to trauma assessment for the EMT

   Brady is pleased to share with you a preview of our forthcoming EMS Transition Series. Our first offering is for the EMT level. Transition Series: Topics for the EMT by Joseph Mistovich and Daniel Limmer provides both an overview of new information contained within the Education Standards at the EMT level and a source of continuing education for practicing EMTs. Intended for a new generation of EMTs, the text integrates new "topics" that were not contained in the U.S. DOT 1994 EMT-Basic National Standard Curriculum and existing "topics" at a much greater depth and breadth than what was contained in the typical EMT-Basic education program. This text covers what new EMTs need such as medical terminology, expanded pathophysiology and critical thinking. Educating and training EMTs using the new Education Standards, this text provides a solid foundation of knowledge to practice prehospital care. During 2011, EMS World Magazine will feature exclusive excerpts from this new textbook. Transition Series: Topics for the EMT will be available in March 2011. Visit for more information and stay tuned for new topic previews throughout the year!

Standard: Patient Assessment

   Competency: Applies scene information and patient assessment findings (scene size-up, primary and secondary assessment, patient history, reassessment) to guide emergency management

Transition Highlights

  • Comparison of the 1994 EMT-Basic curriculum and the National EMS Educational Standards regarding terminology used during the assessment of a trauma patient
  • Increased importance of patient physiologic status rather than mechanism of injury in determining patient instability or potential instability
  • Primary assessment process for the trauma victim
  • Comparison of the secondary assessment for a stable versus an unstable trauma patient
  • How vital sign trending can help identify types of traumatic conditions
  • Importance of performing a reassessment of the injured or traumatized patient


   The first two excerpts in this series will discuss patient assessment: Trauma assessment is the focus of this chapter, and the next chapter in the April issue is medical assessment. This split is done because the ways trauma patients and medical patients are assessed are significantly different. These topics will also introduce you to the patient assessment process as outlined in the National EMS Education Standards because it will differ from the way you were taught in your initial EMT course.

   Trauma assessment is a hands-on process. A medical axiom states that 80% of the key information you will obtain to care for your trauma patient comes from a hands-on exam, and 20% comes from the history. You will later learn that the opposite is true for medical patients. This is not to say there is no value in the history; it is just that a hands-on exam is likely to produce more finite and applicable results.

   The 1994 EMT-B curriculum provided a detailed, scripted approach to patient assessment. You likely learned a scene size-up, initial assessment, and rapid trauma exam or focused assessment, followed by a detailed, then an ongoing, assessment.

   The National EMS Education Standards do not provide this scripted approach. The standards do include a scene size-up, which is very similar to the existing size-up, and a primary assessment, which is similar to the existing initial assessment. Missing from the standards is the detailed information on executing the subsequent hands-on assessments. The standards do include a reassessment, which is similar to the existing ongoing assessment.

   The 1994 EMT-B curriculum provided a detailed, scripted approach to patient assessment. The National EMS Education Standards do not provide this scripted approach.

   As an experienced EMT, you will notice new EMTs and reference sources using this new assessment terminology. It will not affect your assessment or your ability to work with new EMTs. Table 1 compares the old EMT-B curriculum with the education standards.

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