CONTENT LIST
The CTRN exam contains, but is not limited to, the following items.

Single System Emergencies

Cardiopulmonary (26 Items)

Obtain 12-lead ECG
Evaluate characteristics of chest pain
Initiate and manage noninvasive transcutaneous cardiac pacemaker
Interpret 12-lead ECG
Determine need for and perform cardiopulmonary resuscitation
Recognize pericardial tamponade
Manage transvenous pacemaker
Initiate fibrinolytic infusion
Perform cardioversion/defibrillation
Auscultate heart sounds
Initiate monitoring and interpret ECG rhythm strips
Initiate ACLS protocols
Identify patients who are candidates for fibrinolytic agents
Assist with pericardiocentesis
Assess for neck vein distention
Assess peripheral pulses and capillary refill
Initiate PALS protocols
Manage IABP during transport

Gastrointestinal/Genitourinary and Obstetrical (9 Items)

Insert and irrigate NG/OG tubes
Inspect, auscultate, percuss, and palpate the abdomen
Assess for flank tenderness and ecchymosis
Perform neonatal resuscitation
Assess fetal heart tones (Doppler)
Perform emergency delivery
Position a patient who has a prolapsed cord during labor
Position a pregnant patient for uterine displacement
Determine risk for delivery during transport
Manage OB hypertensive disorders
Manage neonates during transport
Massage uterine fundus postpartum
Manage vaginal bleeding/drainage
Palpate for uterine contractions and fetal movement

Maxillofacial and Orthopedic (8 Items)

Assess for upper respiratory distress/difficulty
Assess for maxillofacial trauma
Inspect oropharynx
Manage ocular emergencies
Reduce orthopedic injury
Apply a traction splint
Preserve amputated body part for reimplantation
Manage pelvic instability
Immobilize injured extremities
Assess neurovascular status of injured or immobilized extremity (e.g. compartment syndrome)

Neurological Emergencies (17 Items):

Perform cranial nerve assessment
Assess drainage from ears and nose for blood and/or cerebrospinal fluid
Perform or maintain full spinal immobilization
Assess level of consciousness/mental status
Assess seizure activity and initiate seizure precautions
Evaluate reflexes (e.g. DTRs and clonus)
Manage increased intracranial pressure
Identify patients at risk for increased intracranial pressure
Assess for nuchal rigidity
Manage ventilation for a patient with suspected head injury
Assess sensation and motor function
Monitor intracranial pressure monitor devices

Multi-system Emergencies

Environmental Emergencies (7 Items)

Manage fluid resuscitation for burn injury
Measure/restore core body temperature
Determine degree and extent of burn injury
Evaluate decontamination of patient after exposure to hazardous materials
Manage heat/cold related emergencies
Plan measures for treating hazardous materials exposure

General/Medical Emergencies (9 Items)

Assess/manage hematological disorders
Initiate isolation precautions
Identify and manage symptoms of hypoglycemia or hyperglycemia
Assess risk of communicable disease transmission/exposure
Assess patient for signs of envenomation
Identify and manage fever
Assess patient's fluid status
Maintain patients who are potential organ/tissue donors

Patient Management

Patient Care (10 Items)

Interpret laboratory results
Perform bedside laboratory testing (e.g., glucose, Hgb/Hct)
Manage pain
Evaluate a chest x-ray
Apply/manage patient restraints
Evaluate cervical spine x-rays
Perform primary and secondary surveys
Determine priority of patient care management
Plan priorities of patient care management
Evaluate patient response to interventions (e.g. medications, procedures)
Initiate use of vasoactive drugs
Calculate and titrate intravenous medication infusions
Determine care based on age/weight parameters
Monitor arterial line pressure
Assess pulmonary artery (Swan Ganz) waveforms
Monitor trends in blood pressure
Plan care according to hemodynamic parameters
Monitor central venous pressure readings
Calculate appropriate fluid resuscitation for the pediatric patient
Plan care based on developmental stages and age appropriate considerations
Plan care based on cultural considerations
Manage patient with delayed consequences of trauma (e.g. DIC, SIRES, MODS, ARDS)
Develop transport diagnosis/impression based on assessment

Advanced Airway Care (7 Items)

Determine treatment plans based on colormetric end-tidal CO2 results
Manage patients based on continuous capnography (wave form)
Select appropriate measures to provide an airway (e.g. basic and advanced)
Determine treatment plans based on pulse oximetry values
Manage mechanical ventilation
Perform a needle cricothyrotomy
Perform oral intubation
Choose device for oxygen delivery (e.g. nasal cannula, mechanical ventilator, mask)
Perform nasal intubation
Perform rapid sequence induction intubation
Manage patients with surgical airway (cricothyrotomy and tracheostomy)
Suction airway
Insert nasal and/or oral airway
Ventilate patient using a bag-valve-mask device
Maintain neuromuscular blockade with sedation
Facilitate airway management using alternative airway devices (e.g. LMAs, Combitube, bougie)
Manage BiPAP

Respiratory (5 Items)

Evaluate the patient's response to oxygen therapy
Interpret results of arterial blood gas studies
Maintain chest tube and drainage system
Assess for abnormal breathing patterns
Assess for inhalation injury
Perform needle thoracostomy
Administer nebulizer treatment
Assess for pulsus paradoxus
Inspect, palpate, percuss, and auscultate chest
Manage chest wall injury
Develop plan of care based on mechanism of injury

Shock/Trauma (5 Items)

Assess and manage shock
Administer blood products
Monitor urinary output
Perform rapid volume resuscitation
Initiate ATLS/TNATC protocols
Perform intraosseous placement
Perform Trauma Score assessment
Control visible hemorrhage
Apply dressings to wounds
Assess for soft tissue injury
Manage patient based on type of shock

Substance Abuse/Toxicological (3 Items)

Determine need for medication antagonist in an overdose situation
Perform gastric emptying for toxic substance ingestion
Plan measures for treating complications of toxic ingestion/inhalation/exposure
Consult information resources about management of poisoning
Recognize patients with drug overdose
Identify substance abuse patients at risk for acute withdrawal symptoms

Transport Considerations (4 Items)

Assess and manage violent patient behavior
Manage patient transport stressors
Determine necessity for diversion
Determine appropriate mode of transport (i.e., rotor, ground, fixed wing)
Determine emergent versus non-emergent transport status (e.g. lights and sirens, code 3)

Safety Issues

Safety (5 Items)

Assist in safe transport vehicle operation
Perform vehicle decontamination and disposal of biohazardous waste
Secure equipment in the transport vehicle
Secure patient in the transport vehicle
Manage crew transport stressors
Communicate with EMS personnel
Manage radio communication operations (e.g., frequencies)
Report patient's condition to receiving staff

Disaster Management (3 Items)

Triage patient care during a disaster
Implement steps of disaster plan
Participate in a plan for mass casualties
Participate in a plan for the effects of weapons of mass destruction

Survival (3 Items)

Train for transport vehicle emergencies
Ensure safety of team and patient(s) in post-crash situation
Participate in emergency operations plan

Professional Issues

Legal (3 Items)

Notify authorities of reportable situations
Evaluate patient's capacity to refuse treatment
Ensure preservation evidence for legal/forensic situations
Assess for signs of abuse
Recognize legal requirements for transport (e.g. EMTALA, HIPPA)
Provide documentation of transport care

Organizational Issues (3 Items)

Participate in conflict resolution
Participate in critical incident stress management
Participate in quality assurance/improvement activities
Evaluate applicability of published evidenced-based research to practice

Patient/Community Education (3 Items)

Inform patients/families regarding procedures/patient condition
Provide public education
Provide transport safety briefing to patient/family member prior to transport
Provide support to family after patient death
Participate in continuing education/inservice
Orient new staff to work responsibilities