Failed ITLS the first time — what finally helped me pass

by Daniel M. 34 views3 replies
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Daniel M.OP
May 27, 2026

So I failed my ITLS Advanced on the first attempt back in March and honestly wasn't sure where I went wrong. I'd been an EMT for three years and figured my field experience would carry me through, but the written portion caught me off guard. The scenario stations went fine, but I bombed the multiple choice — especially the pathophysiology questions around tension pneumo and spinal motion restriction protocols.

After that I spent about six weeks really digging in. I used the official ITLS textbook (10th edition), watched some YouTube walkthroughs, and found a solid ITLS practice test site that actually mirrored the format of the real exam questions. That made a huge difference for identifying my weak spots before I wasted another $200 on a retake.

My ITLS study guide approach the second time was to focus on mechanism of injury decision trees and the patient assessment sequence until I could do it in my sleep. Passed with a 91 on the written. Anyone else struggled with the written more than the practicals? Would love to compare notes on exam tips that actually worked.

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priya.test
May 27, 2026
Same experience here — the practicals feel intuitive but the written is sneaky. What helped me most was timing myself on practice questions. I was spending way too long on trauma assessment questions and running out of time. Once I started treating each question like a 90-second clock, my accuracy actually went up. Also, know your Glasgow Coma Scale cold. Feels basic but it shows up constantly.
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Chris D.
May 27, 2026
Which practice test site did you use? I'm retesting in July and I've mostly been using Quizlet decks but they feel kind of shallow compared to what I remember from the actual exam. The real questions seemed more scenario-based than straight definition stuff. Also curious — did your course instructor give any specific advice on how the scoring works for the written portion versus practicals?
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Tom W.
May 28, 2026
Congrats on the 91! Honestly the patient assessment sequence tip is gold. I wrote it out on index cards and drilled it every morning for two weeks. Muscle memory is everything in this cert.

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