NREMT Skill Sheets in 2026: All 10 EMT Stations, Points to Pass and Critical Criteria

Published October 8, 2026 · By VMS, Alehundred Studios

NREMT skill sheets are the National Registry's scoring forms for the EMT psychomotor exam: one sheet per skill, 1 point for each observable step, a minimum score to pass and a list of critical criteria that fail the station on their own. In 2026 each state approves its own EMR and EMT skills exam, using or adapting these forms.

What are the NREMT skill sheets?

They are the evaluation instruments an examiner fills in while you perform each skill on a simulated patient or manikin. The National Registry's EMT Psychomotor Examination Users Guide explains that "the steps for each skill evaluation instrument were written in observable behavior formats and a point value of 1 point for each observable step was assigned," and that "Critical behaviors were identified for each skill and written out in a 'Critical Criteria' section on each skill evaluation instrument."

They "were not designed as 'teaching' forms," and the National Registry wants students to see them early: "We encourage you to distribute copies of all skill evaluation instruments (available at http://www.nremt.org) to the students prior to the examination."

Who runs the NREMT skills exam in 2026?

For EMR and EMT, your state does; for AEMT and Paramedic, there is no national skills exam at all.

EMR and EMT: "The BLS psychomotor examination process is established and approved by each state" (NREMT, BLS examinations). The updated computer-based exams launched on April 7, 2025, and the same page confirms that "State EMS office approved BLS skills competency requirements for EMR and EMT levels will continue in the current format."
AEMT and Paramedic: Since July 1, 2024, each level has "One examination - no psychomotor examination required" (NREMT, ALS examinations). Skills are verified inside the education program through the Student Minimum Competency (SMC) requirement.

Because states own the BLS process, forms can vary: "State EMS officials may choose to alter the format and design of these materials in order to meet local requirements for state licensure." For exam day, retests and what to bring, see our NREMT practical exam.

What are all the NREMT skill sheets for EMTs?

The National Registry's model EMT exam "contains seven (7) skills": six fixed stations plus one random skill drawn from four, so there are 10 skill sheets. Each entry below links to the official PDF and gives the points on the sheet, the recommended minimum from the guide's Appendix F and the time limit:

Patient Assessment/Management - Trauma: 42 points, pass with 33, 10 minutes.
Patient Assessment/Management - Medical: 42 points, pass with 33, 15 minutes.
BVM Ventilation of an Apneic Adult Patient: 16 points, pass with 12, 5 minutes.
Oxygen Administration by Non-rebreather Mask: 11 points, pass with 8, 5 minutes.
Cardiac Arrest Management/AED: 17 points, pass with 13, 10 minutes.
Spinal Immobilization (Supine Patient): 14 points, pass with 11, 10 minutes.
One random skill, drawn from the four sheets below.

The random skill is one of:

Spinal Immobilization (Seated Patient): 12 points, pass with 9, 10 minutes.
Bleeding Control/Shock Management: 7 points, pass with 5, 10 minutes.
Long Bone Immobilization: 10 points, pass with 8, 5 minutes.
Joint Immobilization: 9 points, pass with 7, 5 minutes.

The hosted sheets carry 2016 copyright dates (2017 for cardiac arrest), and the Users Guide was last revised in October 2019 against the 2015 American Heart Association CPR guidelines. If your state updated a station, its version is the one graded in 2026.

How are the NREMT skill sheets scored?

You fail a skill if you score below the minimum or if the examiner checks a single critical criterion. Appendix F is explicit: "Failure must be noted for any skill where minimum points were not realized," and failure must also be noted when any critical criteria statement is checked.

Three rules run across the sheets:

PPE is always step one. All 10 sheets open with "Takes or verbalizes appropriate PPE precautions," and on six of them (trauma, medical, BVM, oxygen, cardiac arrest, bleeding control) skipping it is also a critical fail.
Three general critical criteria close every sheet: "Failure to manage the patient as a competent EMT," "Exhibits unacceptable affect with patient or other personnel" and "Uses or orders a dangerous or inappropriate intervention."
Examiners must justify a critical fail. Each form says: "You must factually document your rationale for checking any of the above critical items on the reverse side of this form."

What does the NREMT trauma assessment skill sheet cover?

The trauma sheet scores a hands-on assessment of a patient with multisystem trauma, 42 points in 10 minutes, in this order:

PPE and scene size-up: scene safety, mechanism of injury, number of patients, additional help, spine stabilization.
Primary survey and resuscitation: general impression, level of consciousness, chief complaint, airway (2 points), breathing (4 points), circulation (4 points), then a priority and transport decision "based upon calculated GCS."
History taking: baseline vital signs and a SAMPLE history.
Secondary assessment: head, neck, chest, abdomen and pelvis, all four extremities, and the posterior thorax, lumbar and buttocks areas, plus management of secondary injuries.
Reassessment.

The examiner essay sets the rule: "The candidate will be required to physically perform all assessment steps listed on the evaluation instrument. However, all interventions should be verbalized instead of physically performed." The sheet also notes that "Areas denoted by '**' may be integrated within sequence of Primary Survey/Resuscitation."

The time and sequence criteria end the most attempts: "Failure to initiate or call for transport of the patient within 10 minute time limit," missing scene safety or spinal protection, and "Performs other assessment before assessing/treating threats to airway, breathing and circulation."

What does the NREMT medical assessment skill sheet cover?

The medical sheet also totals 42 points, but you get 15 minutes and the weight moves to the interview. After the same scene size-up and primary survey, the history earns 13 points: 8 for the present illness (onset, provocation, quality, radiation, severity, time and 2 points for clarifying questions) and 5 for allergies, medications, past pertinent history, last oral intake and events.

Then come the affected body system (5 points), vital signs (4 points), a field impression, interventions, reassessment and a verbal report. You must actually measure vital signs; the guide accepts plus or minus 10 mmHg for blood pressure, 10 beats per minute for pulse and 5 breaths per minute for respirations. Two critical criteria are specific to this sheet: no call for transport within 15 minutes, and "Failure to provide accurate report to arriving EMS unit."

What is on the NREMT joint immobilization skill sheet?

It is a 9-point, 5-minute station in which you immobilize a suspected shoulder injury; the guide states that "the only splint available in this skill is a sling and swathe." The steps:

Take or verbalize PPE precautions.
Direct manual stabilization of the injury.
Assess distal motor, sensory and circulatory functions.
Select the proper splinting material.
Immobilize the site of the injury.
Immobilize the bone above the injury site.
Immobilize the bone below the injury site.
Secure the entire injured extremity.
Reassess distal motor, sensory and circulatory functions.

The classic mix-up is with the long bone sheet. For a joint, you immobilize the bones above and below; for a long bone fracture, you immobilize "the joint above the injury site" and the joint below, with the hand or foot in the position of function. Breaking that rule, or skipping the distal check before and after splinting, is a critical fail on both sheets.

What details matter most on the other EMT skill sheets?

The short stations hinge on numbers and sequences written into each sheet:

BVM ventilation: suction before ventilating, start ventilations within 30 seconds after suctioning, and ventilate at "10 – 12/minute (1 ventilation every 5 – 6 seconds)" with the reservoir on oxygen at 15 L/minute.
Oxygen by non-rebreather: check for leaks, prefill the reservoir and set "at least 10 L/minute."
Cardiac arrest/AED: check breathing and pulse together for no more than 10 seconds, and never interrupt CPR "for more than 10 seconds at any point."
Spinal immobilization: manual head stabilization first, the collar before releasing it, the torso secured before the head.
Bleeding control/shock: direct pressure, then a tourniquet when the wound keeps bleeding, then position, oxygen, warmth and transport. The guide notes that "There is no published evidence that supports controlling arterial hemorrhage from an extremity with elevation or pressure to an arterial pressure point."

How do NREMT practical exam scenarios work?

The trauma, medical and bleeding control stations are scenarios: the examiner reads a short case and you manage the patient as findings unfold, and the cases change on purpose. For bleeding control, the guide says "Variations of the scenario are possible and should be utilized in order to reduce the possibility of candidates knowing the scenario before entering this skill." Memorizing scenarios is a weak plan; the sheet never changes.

How should you practice with the NREMT skill sheets?

Use the sheets as your self-test, out loud, on a timer, with someone grading you. The guide's advice is that once basic competence develops, "the candidate should refer to the appropriate skill evaluation form for self-assessment in identifying areas of strength and weakness."

Learn each skill with an instructor, then use the sheet as your checklist.
Have a classmate grade you, critical criteria included.
Run the full time limit and say every step aloud.

Looking for an NREMT practice test? For the skills exam, the sheets are the test. For the computer-based exam, the National Registry's BLS page offers official sample items: "Explore interactive sample questions for the EMR and EMT Certification Examinations."

Tracked repetition works. In a three-year study of 71 EMS students at King Saud University (Alrazeeni et al.), success rates across psychomotor skills were 26.58% to 35.74% during the clinical practicum and 85.49% to 99.4% after an internship year that added steady practice hours and a skills attainment checklist. A 2025 joint position statement from CoAEMSP, NAEMSE, the National Registry and the Society for Simulation in Healthcare adds that "SBE allows for standardization of assessment to address student learning outcomes."

How can VMS help you practice EMS patient assessment?

VMS, the Virtual Medical Simulator, gives you extra repetitions of the assessment habits the sheets score, on a PC with mouse and keyboard or in VR with a laser pointer. You pick the EMS program (EMT or Paramedic), and every case runs as an OSCE station: one virtual patient, a step-by-step checklist and a score from 0 to 100%.

In each encounter you introduce yourself, gain consent, wash your hands or put on gloves, examine the patient with your hands (palpate, auscultate, take a pulse) and with tools such as the stethoscope, and close the encounter. Cases show the exam content areas they train, including the National EMS Education Standards. Teach and Train modes guide you; Test mode has no hints and a time limit. The OSCE exam button picks a random patient from your program in Test mode, much like walking into an unknown station.

Attempts are saved to your account; educators set up cases on the web and see results per student. Play solo or in multiplayer with your class, with an educator running the room as an option. VMS comes with 3 free cases, so you can try the whole workflow without paying. A subscription unlocks every case, and a subscriber can share their cases with friends or classmates in multiplayer, as long as the subscriber hosts the session and stays connected.

FAQ

Where can I find the official NREMT skill sheets for 2026?

On content.nremt.org, the National Registry's file site; every link in the list above goes to the official PDF. Ask your program whether your state uses them as is.

Are NREMT skill sheets the same in every state?

Not necessarily. Each state approves its BLS psychomotor process and may alter the National Registry's model forms to meet licensure requirements.

What are the NREMT psychomotor skills?

Trauma and medical assessment, BVM ventilation, oxygen by non-rebreather, cardiac arrest/AED, supine spinal immobilization and one random skill (seated spinal immobilization, bleeding control, long bone or joint immobilization).

How many points do you need to pass the NREMT trauma assessment?

The recommended minimum is 33 of 42 points with no critical criteria checked. Missing scene safety, spinal protection or the call for transport within 10 minutes fails the station regardless of points.

Was the NREMT psychomotor exam discontinued?

Only for AEMT and Paramedic. The national ALS psychomotor exam ended on June 30, 2024. EMR and EMT candidates still complete a state-approved skills exam.

Is there an NREMT practice test for the skills exam?

Not an official one; a classmate grading you on the real sheet against the clock is the closest thing. For the cognitive exam, the National Registry offers official sample items.

Sources

National Registry of Emergency Medical Technicians. The Updated EMR and EMT Certification Examinations. NREMT, 2026.
National Registry of Emergency Medical Technicians. AEMT and Paramedic Certification Examinations. NREMT, 2026.
National Registry of Emergency Medical Technicians. Emergency Medical Technician Psychomotor Examination Users Guide, Version 1.1. NREMT, 2019.
National Registry of Emergency Medical Technicians. Patient Assessment/Management - Trauma (E201). NREMT, 2016.
National Registry of Emergency Medical Technicians. Patient Assessment/Management - Medical (E202). NREMT, 2016.
National Registry of Emergency Medical Technicians. BVM Ventilation of an Apneic Adult Patient (E203). NREMT, 2016.
National Registry of Emergency Medical Technicians. Oxygen Administration by Non-rebreather Mask (E204). NREMT, 2016.
National Registry of Emergency Medical Technicians. Cardiac Arrest Management/AED (E215). NREMT, 2017.
National Registry of Emergency Medical Technicians. Spinal Immobilization (Supine Patient) (E212). NREMT, 2016.
National Registry of Emergency Medical Technicians. Spinal Immobilization (Seated Patient) (E211). NREMT, 2016.
National Registry of Emergency Medical Technicians. Bleeding Control/Shock Management (E213). NREMT, 2016.
National Registry of Emergency Medical Technicians. Long Bone Immobilization (E217). NREMT, 2016.
National Registry of Emergency Medical Technicians. Joint Immobilization (E216). NREMT, 2016.
CoAEMSP, NAEMSE, National Registry and SSH. Joint Position Statement on Simulation-Based Education in Emergency Medical Services Education. Society for Simulation in Healthcare, 2025.
Alrazeeni D, Younas A, Rasheed SP. Experiential Learning for Psychomotor Skills Development of Emergency Medical Services (EMS) Students: An Action Research. Journal of Multidisciplinary Healthcare, 2021.