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Learning route for paramedics

Paramedic practice: scenarios, ECG and clinical handover

Practise the first assessment and the next decision, then communicate what changed and what the receiving team needs. Select advanced interpretation only where it fits your training and service.

Start here: assessment → ECG → prehospital decisions → handover

Start this route See the sequence

Starting sequence

Start here: your first three exercises

Each card says what you will do, the level, roughly how long it takes and whether it is a guide or an exercise. The sequence is a suggestion: start anywhere, and there is no enrolment or score to unlock the next step. Use fictional cases for practice and agree your scope with your supervisor or employer.

  1. Assessment

    Rehearse a structured ABCDE assessment and when to interrupt it to treat.

    Beginner · about 11 min · Practice prompts with explained debriefs

    Rehearse ABCDE assessment

  2. ECG

    Six traces with answers, including inferior STEMI and a broad-complex tachycardia.

    Beginner to intermediate · about 25 min · Interactive exercises with answers

    Start the ECG exercises

  3. Prehospital decisions

    How can I practise clinical decision-making as a paramedic?

    Choose one of the three fictional prehospital scenarios. Commit to the action you would take, reveal the explanation and compare it with your reasoning. Then practise handing the case over.

    Beginner to intermediate · about 11 min, plus a 7 min case · Decision exercises

    Try the three free paramedic scenarios

Further practice

Skills to build, in order

Carry on from step 4. Each activity builds on the ones before it.

  1. Handover

    Lead with the critical fact, include what the receiving team needs and say the recommendation.

    Beginner to intermediate · about 8 min · Handover exercises

    Practise SBAR handover

  2. Prioritisation and reassessment

    Four patients at once, then a deterioration: scenarios 5–8, open to every role.

    Intermediate · 8 decisions · Interactive scenarios

    Start the emergency scenarios

  3. Ambulance SBAR

    A stroke pre-alert and a trauma handover, then your own version to compare.

    Intermediate · examples 3 and 4 · Practice builder

    Practise an ambulance handover

  4. Stroke or remote transfer OSCE

    Stations 5 and 6: stroke assessment and pre-alert, and a remote transfer request.

    Intermediate · 8 min each, marked /20 · OSCE stations

    Open stations 5 and 6

  5. Calculation refresher

    Infusion arithmetic with visible working. Choose only material that fits your service.

    Beginner to intermediate · 3 questions · Calculation trainer

    Practise infusion arithmetic

ABG and CXR cases are optional interpretation practice; they do not assume that equipment is carried on every ambulance.

Skill 1 of 3

Prehospital decision scenarios

Each scenario stops at the decision that matters: treat and leave, convey and where to, or accept a refusal. Say why out loud, including how you assessed capacity, because that reasoning is what is reviewed later. Then reassess four patients at once when one deteriorates.

Skill 2 of 3

ECG interpretation

Read the rhythm first, then the 12-lead for ST changes, using the same order on every trace. The six exercises include an inferior STEMI and a broad-complex tachycardia, two traces that can change your destination or your treatment on scene.

Skill 3 of 3

SBAR and clinical handover

Lead with the critical fact, give the receiving team what they need to prepare, and say what you are asking for. The ambulance examples include a stroke pre-alert and a trauma handover, and OSCE stations 5 and 6 rehearse a pre-alert and a remote transfer request.

What to practise before your first shift

Before your first shift with a new service, rehearse ABCDE against the clock, one STEMI and one stroke pre-alert out loud, and the infusion arithmetic your service actually uses. Check which drugs and interpretation skills sit within your scope and local guidelines before practising beyond them.

Where this fits with your exams

Paramedic programmes commonly assess through OSCEs and practice assessments, where structured assessment, ECG recognition and handover recur. National certification, such as the NREMT cognitive and psychomotor exams in the United States, tests the same decisions in a different format. These exercises practise the reasoning rather than the exam format, and there is no score.

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Other learning routes

Every route uses the same free exercises. Back to all learning resources, including the resource finder and all seven practice tools.