This is the reference page. Screenshot it, print it, tape it inside your protocol book. Every number below is within EMT-Basic scope or is a threshold you are expected to recognize and act on.
Two standing rules before the tables. First, local protocol and medical direction override any number on this page. Second, textbook ranges differ by a few beats or millimeters between publishers; the pattern matters more than the decimal, and the exam is written around the pattern.
Adult vital signs
| Measurement | Normal adult range | Act when |
|---|
| Heart rate | 60-100 /min | Under 60 with poor perfusion, or over 100 with poor perfusion |
| Respiratory rate | 12-20 /min | Under 12 or over 20, or any inadequate depth |
| Systolic BP | 100-140 mmHg | Under 90 mmHg is hypotension in an adult |
| Diastolic BP | 60-90 mmHg | Narrowing pulse pressure suggests compensated shock |
| SpO2 | 94-99% on room air | Under 94% is hypoxia; under 90% is significant |
| Temperature | 98.6 F / 37 C | Over 100.4 F / 38 C is fever |
| Capillary refill | Under 2 seconds | Over 2 seconds suggests poor perfusion |
| Blood glucose | 80-120 mg/dL | Under 60-70 mg/dL is hypoglycemia per protocol |
| Pupils | 2-6 mm, equal, reactive | Unequal, fixed, pinpoint, or blown |
Pediatric vital signs by age band
| Age band | Heart rate | Respiratory rate | Systolic BP |
|---|
| Neonate, 0-1 month | 90-180 /min | 30-60 /min | 50-70 mmHg |
| Infant, 1-12 months | 100-160 /min | 25-50 /min | 70-95 mmHg |
| Toddler, 1-3 years | 90-150 /min | 20-30 /min | 80-100 mmHg |
| Preschool, 3-6 years | 80-140 /min | 20-25 /min | 80-100 mmHg |
| School age, 6-12 years | 70-120 /min | 15-30 /min | 80-110 mmHg |
| Adolescent, 12-18 years | 60-100 /min | 12-20 /min | 100-120 mmHg |
The direction of travel is the memorable part: as age rises, heart rate falls, respiratory rate falls, and blood pressure rises. If you can reconstruct that trend you can sanity-check any number you are handed.
| Pediatric rule | Formula |
|---|
| Minimum acceptable systolic BP, 1-10 years | 70 + (2 x age in years) |
| Hypotension, 1-10 years | Systolic below 70 + (2 x age in years) |
| Hypotension, over 10 years | Systolic below 90 mmHg |
Bradycardia in a child is a late and ominous sign. A slowing heart rate in a sick infant usually means hypoxia, and the answer is ventilation, not reassurance.
Pediatric Assessment Triangle
| Side | What you are looking at | Abnormal means |
|---|
| Appearance | Tone, interactivity, consolability, gaze, speech or cry | Altered mental status or poor perfusion to the brain |
| Work of breathing | Retractions, nasal flaring, grunting, position, audible sounds | Respiratory distress or failure |
| Circulation to skin | Pallor, mottling, cyanosis | Poor perfusion or shock |
No equipment, no contact, roughly four seconds from the doorway.
Glasgow Coma Scale
| Score | Eye opening | Verbal response | Motor response |
|---|
| 6 | — | — | Obeys commands |
| 5 | — | Oriented | Localizes pain |
| 4 | Spontaneous | Confused | Withdraws from pain |
| 3 | To voice | Inappropriate words | Abnormal flexion (decorticate) |
| 2 | To pain | Incomprehensible sounds | Abnormal extension (decerebrate) |
| 1 | None | None | None |
| Total score | Interpretation |
|---|
| 13-15 | Mild |
| 9-12 | Moderate |
| 3-8 | Severe; 8 or less is the airway threshold |
| 3 | Minimum possible score. There is no zero |
AVPU is the faster field version: Alert, responds to Verbal, responds to Painful stimulus, Unresponsive.
APGAR
Scored at 1 minute and again at 5 minutes after birth. It guides documentation and communication. It does not delay resuscitation.
| Sign | 0 | 1 | 2 |
|---|
| Appearance (color) | Blue or pale all over | Body pink, extremities blue | Completely pink |
| Pulse | Absent | Under 100 /min | Over 100 /min |
| Grimace (irritability) | No response | Grimace only | Cough, sneeze, cry, or pulls away |
| Activity (tone) | Limp | Some flexion | Active motion |
| Respirations | Absent | Slow, irregular, weak cry | Strong cry |
| Total | Interpretation |
|---|
| 7-10 | Normal newborn |
| 4-6 | Moderately depressed; stimulate, warm, support ventilation |
| 0-3 | Severely depressed; begin resuscitation |
A newborn heart rate under 100 with inadequate respirations gets positive pressure ventilation. Under 60 despite adequate ventilation gets compressions.
SpO2 targets
| Patient | Target | Note |
|---|
| General adult and pediatric | 94-99% | Titrate to the target, not to the highest number |
| Chronic COPD | 88-92% | Many systems use this range; never withhold oxygen from a COPD patient in failure |
| Post-resuscitation | 94-99% | Avoid sustained 100% where you can titrate |
| Suspected carbon monoxide | Reading is unreliable | Pulse oximetry reads falsely high; give high-concentration oxygen regardless |
| Any patient in respiratory failure | Ventilate | A number does not replace assisted ventilation |
Anemia, hypothermia, poor perfusion, nail polish, and motion all degrade the reading. Treat the patient in front of you.
Oxygen delivery devices
| Device | Flow rate | Approximate FiO2 | Use when |
|---|
| Nasal cannula | 1-6 L/min | 24-44% | Mild hypoxia, adequate tidal volume |
| Simple face mask | 6-10 L/min | 35-60% | Moderate need, adequate tidal volume |
| Nonrebreather mask | 10-15 L/min | Up to about 90% | Significant hypoxia, adequate tidal volume |
| Venturi mask | 4-12 L/min | 24-60%, precise | When a controlled concentration is wanted |
| Bag-valve mask with reservoir | 15 L/min | Nearly 100% | Inadequate rate or depth, apnea |
| Blow-by | 6-10 L/min | Variable | Small child who will not tolerate a mask |
Inflate the nonrebleather reservoir before applying it. A nasal cannula above 6 L/min dries the mucosa without buying meaningful oxygen.
Ventilation rates
| Situation | Rate | Notes |
|---|
| Adult, respiratory arrest with a pulse | 1 breath every 6 seconds (10 /min) | Each breath over about 1 second |
| Infant or child, respiratory arrest with a pulse | 1 breath every 2-3 seconds (20-30 /min) | Each breath over about 1 second |
| Cardiac arrest with an advanced airway in place | 1 breath every 6 seconds | Continuous compressions, no pauses |
| Any patient | Ventilate to visible chest rise | Excess volume causes gastric distention |
CPR by age
| Parameter | Adult | Child (1 year to puberty) | Infant (under 1 year) | Newly born |
|---|
| Compression rate | 100-120 /min | 100-120 /min | 100-120 /min | 90 compressions with 30 breaths per minute |
| Depth | At least 2 in (5 cm), no more than 2.4 in (6 cm) | About 2 in (5 cm), or 1/3 chest depth | About 1.5 in (4 cm), or 1/3 chest depth | About 1/3 chest depth |
| Ratio, one rescuer | 30:2 | 30:2 | 30:2 | 3:1 |
| Ratio, two rescuers | 30:2 | 15:2 | 15:2 | 3:1 |
| Hand position | Two hands, lower half of sternum | One or two hands, lower half of sternum | Two fingers, or two thumbs encircling with two rescuers | Two thumbs encircling |
| Compressor change | Every 2 minutes | Every 2 minutes | Every 2 minutes | Per team |
Allow full chest recoil, minimize interruptions, and aim to keep hands on the chest more than 60% of the arrest.
AED
| Question | Answer |
|---|
| Adult pads | 8 years and older, or 25 kg and above |
| Pediatric pads or dose attenuator | Under 8 years or under 25 kg, when available |
| No pediatric pads available | Use adult pads; do not let pads touch or overlap |
| Rhythm analysis interval | Every 2 minutes |
| After a shock | Resume compressions immediately, do not check a pulse first |
| Wet patient | Move off standing water and dry the chest |
| Implanted device or patch | Place pads at least 1 inch away, remove medication patches |
EMT-B medications
Eight entries. That is the whole list at the Basic level, and everything outside it belongs to an ALS intercept.
| Medication | Indication | Adult dose and route | Pediatric | Key contraindications |
|---|
| Oxygen | Hypoxia, respiratory distress, shock, altered mental status | By device, 1-15 L/min | Same devices, pediatric sizes | No absolute contraindication; titrate in chronic COPD |
| Aspirin | Suspected cardiac chest pain | 160-324 mg PO, chewed (commonly four 81 mg tablets) | Not given | Allergy, active GI bleeding, known bleeding disorder, pediatric patients |
| Oral glucose | Suspected hypoglycemia, conscious | 15-25 g PO (one tube is commonly 15 g) | Per protocol | Unresponsive, unable to swallow, absent gag reflex |
| Epinephrine auto-injector | Anaphylaxis | 0.3 mg IM, lateral thigh | 0.15 mg IM for under 30 kg | No absolute contraindication in true anaphylaxis; repeat per medical direction |
| Nitroglycerin (patient-assisted) | Chest pain of suspected cardiac origin, patient's own prescription | 0.4 mg SL tablet or spray, may repeat about every 5 minutes to a protocol maximum, commonly 3 doses | Not given | Systolic below the protocol floor (commonly 100 mmHg), PDE-5 inhibitor use, head injury, maximum dose reached |
| Albuterol MDI (patient-assisted) | Bronchospasm with wheezing, patient's own prescription | Commonly 2 puffs, spacer if available, repeat per protocol | Per protocol | Not the patient's prescription, maximum dose reached, tachycardia caution |
| Naloxone | Suspected opioid overdose with respiratory depression | Intranasal, commonly a 4 mg single-dose device or 2 mg per nostril depending on product; IM where authorized; repeat per protocol | Per protocol | No absolute contraindication; ventilate first, alertness is not the goal |
| Activated charcoal | Selected ingestions, under medical direction | 25-50 g PO (about 1 g/kg) | 12.5-25 g PO (about 1 g/kg) | Altered mental status, absent gag, corrosives, petroleum products, inability to swallow |
| PDE-5 inhibitor | Withhold nitroglycerin for |
|---|
| Sildenafil | 24 hours |
| Vardenafil | 24 hours |
| Tadalafil | 48 hours |
START triage
Adults, and the sequence is respirations, perfusion, mental status.
| Step | Finding | Category |
|---|
| 1. Walk | Able to walk to the collection point | Minor (green) |
| 2. Respirations | Absent after opening the airway | Expectant (black) |
| 2. Respirations | Absent, returns after opening the airway | Immediate (red) |
| 2. Respirations | Over 30 /min | Immediate (red) |
| 3. Perfusion | Radial pulse absent, or capillary refill over 2 seconds | Immediate (red) |
| 4. Mental status | Cannot follow simple commands | Immediate (red) |
| 4. Mental status | Follows simple commands | Delayed (yellow) |
Remember it as 30-2-Can Do: respirations over 30, capillary refill over 2 seconds, cannot follow commands. Any one of those makes the patient immediate. Triage is assessment only. The only interventions during triage are opening an airway and controlling life-threatening bleeding.
| JumpSTART difference (roughly 1-8 years) | Detail |
|---|
| Apneic with a palpable pulse | Give 5 rescue breaths before assigning expectant |
| Breathing resumes after rescue breaths | Immediate (red) |
| Respiratory rate | Under 15 or over 45 /min is immediate |
| Mental status | Uses AVPU; posturing or unresponsive is immediate |
Rule of nines
| Body region | Adult | Infant or child |
|---|
| Head and neck | 9% | 18% |
| Each upper extremity | 9% | 9% |
| Each lower extremity | 18% | 14% |
| Anterior trunk | 18% | 18% |
| Posterior trunk | 18% | 18% |
| Genitalia | 1% | — |
The shift is the whole point: a child carries more surface area in the head and less in the legs. The palm of the patient's own hand is roughly 1% and is the fastest tool for scattered burns.
Airway and suction
| Item | Number |
|---|
| OPA sizing | Corner of the mouth to the earlobe or angle of the jaw |
| NPA sizing | Tip of the nose to the earlobe; lubricate, bevel toward the septum |
| Suction, adult | No more than 15 seconds per pass |
| Suction, child | No more than 10 seconds per pass |
| Suction, infant | No more than 5 seconds per pass |
| Suction unit vacuum | At least 300 mmHg with the tubing clamped |
An OPA needs an unresponsive patient with no gag reflex. Avoid an NPA with suspected skull fracture or significant midface trauma.
Oxygen cylinder duration
| Cylinder | Constant |
|---|
| D | 0.16 |
| E | 0.28 |
| M | 1.56 |
| G | 2.41 |
| H or K | 3.14 |
Minutes remaining = (gauge pressure in psi − 200 safe residual) x constant ÷ flow rate in L/min. A full cylinder commonly reads about 2000 psi. Change the cylinder at or before 200 psi.
Timing and thresholds
| Item | Number |
|---|
| Reassessment, unstable patient | Every 5 minutes |
| Reassessment, stable patient | Every 15 minutes |
| Reassessment after any intervention or change | Immediately |
| Minimum sets of vital signs | At least two, so you have a trend |
| Scene time goal, critical trauma | 10 minutes or less |
| Airway threshold, GCS | 8 or less |
| Tourniquet | Note the time applied; do not loosen in the field |
| Stroke | Establish and document last known well |
Numbers the exam twists
- A normal SpO2 in suspected carbon monoxide exposure. The reading is wrong, not the patient.
- A normal blood pressure in a patient who is tachycardic, pale, cool, and anxious. That is compensated shock.
- An adult respiratory rate applied to an infant. Thirty breaths a minute is a crisis at 40 years old and unremarkable at 4 months.
- Aspirin offered for a pediatric patient, or for chest pain with an active bleed.
- Nitroglycerin offered when the systolic pressure is already at the floor, or after a PDE-5 inhibitor.
- Oral glucose offered to a patient who is too altered to swallow.
- Two-rescuer 30:2 offered for a child or infant. Two rescuers means 15:2 below puberty.
- A pulse check offered immediately after an AED shock. Compressions come first.
- Treatment offered during triage. Airway and bleeding only, then move on.
Drill the numbers under pressure
- OB and Pediatrics — age-band vitals and newborn care applied to cases.
- Pharmacology — the eight medications with the contraindications buried in the vitals.
- Shock and Resuscitation — CPR ratios, AED sequencing, and perfusion thresholds.
- Free NREMT practice test — find out which numbers you only think you know.
Practice this in MedRelay
Turn this guide into reps: run a simulator case, then drill the NREMT domain that gave you trouble.