PHTLS Prehospital Trauma Life Support Practice Test PDF (Free Printable 2026)
Get ready for your PHTLS Prehospital Trauma Life Support certification. Practice questions with step-by-step answer explanations and instant scoring.
Free PHTLS Practice Test PDF Download
The PHTLS (Prehospital Trauma Life Support) certification exam is administered by NAEMT and is designed for EMS providers who respond to traumatic emergencies. Passing it requires mastery of trauma physiology, systematic patient assessment, and hands-on intervention skills. This free PHTLS practice test PDF lets you study offline, quiz yourself on paper, and build the exam-day confidence you need. Download it, print it, and start drilling the concepts that show up most on the real exam.
PHTLS: upcoming dates and official changes
- Updated Oct 27, 2026: Delivery (Provider Course) is now 16 hours; classroom or hybrid (8 h online + 8 h classroom) (previously 16 hours; classroom or hybrid (8 h online + 8 h classroom)).
- Updated Oct 27, 2026: Eligibility (Provider Course) is now EMS practitioners, nurses, physician assistants, physicians, and other prehospital practitioners (previously EMS practitioners, nurses, PAs, physicians and other prehospital practitioners).
- Updated Oct 27, 2026: Validity (Provider Course) is now 4 years (previously 4 years).
Facts verified Oct 28, 2026 against National Association of Emergency Medical Technicians. Dates that have passed are removed automatically.
- NAEMT establishes an administrative student course fee of $10.00 for the Prehospital Trauma Life Support First Responder (PHTLS-FR) course. (National Association of Emergency Medical Technicians)
- NAEMT establishes an administrative student course fee of $15.00 for the Prehospital Trauma Life Support (PHTLS) course. (National Association of Emergency Medical Technicians)
- Students unsuccessful in any one component of PHTLS course evaluation have an opportunity to be re-tested within 30 days using the same written evaluation tool. (National Association of Emergency Medical Technicians)
- Students who successfully complete the PHTLS Provider Course receive a card recognizing them as a PHTLS provider for 4 years. (National Association of Emergency Medical Technicians)
- PHTLS certification can be renewed by completing an 8-hour classroom refresher course within 4 years of completing the provider course. (National Association of Emergency Medical Technicians)
- The PHTLS Provider Course is delivered as a 16-hour course in either a classroom format or a hybrid format of 8 hours online followed by 8 hours in the classroom. (National Association of Emergency Medical Technicians)
- The mission of PHTLS is to promote excellence in trauma patient management by all providers involved in the delivery of prehospital care through global education. (facs.org)
- The PHTLS Provider Course is appropriate for EMS practitioners, nurses, physician assistants, physicians, and other prehospital practitioners. (National Association of Emergency Medical Technicians)
- PHTLS course certificates are issued by the course coordinator and provided at the end of a course or within thirty days post-course. (National Association of Emergency Medical Technicians)
Facts verified Oct 28, 2026 against National Association of Emergency Medical Technicians. Dates that have passed are removed automatically.
PHTLS Exam at a Glance
| Item | Detail | Official source |
|---|---|---|
| Exam fee (PHTLS-FR) | $10.00 per student | National Association of Emergency Medical Technicians |
| Exam fee (Student Course Fee) | $15.00 per student | National Association of Emergency Medical Technicians |
| Retake policy | One re-test within 30 days using the same written evaluation tool | National Association of Emergency Medical Technicians |
| Validity (Provider Course) | 4 years | National Association of Emergency Medical Technicians |
| Renewal (Refresher Course) | 8-hour classroom refresher within 4 years | National Association of Emergency Medical Technicians |
| Delivery (Provider Course) | 16 hours; classroom or hybrid (8 h online + 8 h classroom) | National Association of Emergency Medical Technicians |
| Eligibility (All Prehospital Providers) | All providers involved in the delivery of prehospital care | facs.org |
| Eligibility (Provider Course) | EMS practitioners, nurses, physician assistants, physicians, and other prehospital practitioners | National Association of Emergency Medical Technicians |
| Score release | At the end of a course or within 30 days post-course | National Association of Emergency Medical Technicians |
Facts verified Oct 28, 2026 against National Association of Emergency Medical Technicians. Dates that have passed are removed automatically.
Important: The PHTLS exam covers multiple domains. Allocate more study time to unfamiliar topics while maintaining review of strong areas.
What the PHTLS Exam Covers
Kinematics and Trauma Physiology
PHTLS places heavy emphasis on the mechanism of injury (MOI). You must understand kinematics of trauma — how energy transfer differs between blunt and penetrating forces — and apply that knowledge to predict injury patterns before you even touch the patient.
Primary Survey: MARCH vs. ABCDE
Modern PHTLS uses the MARCH sequence (Massive hemorrhage, Airway, Respiration, Circulation, Hypothermia/Hyperthermia) for tactical and high-threat environments, while the traditional ABCDE approach remains foundational for standard trauma assessment. Know when and why each framework applies.
Airway Management in Trauma
Expect questions on jaw thrust technique, BVM ventilation, supraglottic airway devices, and the indications for surgical airway intervention. Cervical spine precautions must be maintained throughout airway management unless the scene is unsafe.
Hemorrhage Control
Direct pressure remains first-line. The exam tests proper tourniquet application (placement, timing, documentation), wound packing with hemostatic gauze (kaolin or chitosan-based), and management of junctional hemorrhage where limb tourniquets cannot be placed.
Shock Recognition and Management
Distinguish compensated from decompensated hemorrhagic shock using clinical signs. Understand permissive hypotension — the deliberate acceptance of a lower-than-normal blood pressure target (SBP 80–90 mmHg) to avoid disrupting early clot formation during active hemorrhage.
Thoracic Trauma
Key topics include tension pneumothorax (tracheal deviation, absent breath sounds, JVD, hypotension) and needle thoracostomy decompression at the 2nd intercostal space midclavicular line or 4th/5th ICS anterior axillary line. Also study open chest wound management (3-sided occlusive dressing), hemothorax, and flail chest paradoxical movement.
Spinal Motion Restriction
PHTLS now favors selective spinal immobilization based on clinical criteria (pain, neurological deficit, altered mental status, distracting injury) rather than routine full spinal immobilization for every trauma patient.
Head Trauma and Special Populations
Recognize signs of herniation (Cushing triad: hypertension, bradycardia, irregular respirations). Controlled hyperventilation (ETCO2 ~35 mmHg) is reserved for impending herniation only. Also review the rule of nines for burn surface area, inhalation injury signs, pediatric trauma differences, obstetric trauma, and elderly-specific considerations such as anticoagulation and reduced physiologic reserve.
- ✓Memorize the MARCH sequence and know when to use it vs. ABCDE
- ✓Practice identifying blunt vs. penetrating MOI and predicted injury patterns
- ✓Review tourniquet placement steps, timing rules, and documentation requirements
- ✓Study hemostatic gauze wound-packing technique for junctional and extremity wounds
- ✓Know the clinical signs that differentiate compensated from decompensated shock
- ✓Understand permissive hypotension targets and when they are contraindicated (TBI)
- ✓Drill tension pneumothorax recognition and needle decompression landmarks
- ✓Review selective spinal immobilization criteria and documentation requirements
- ✓Study burn assessment using the rule of nines and inhalation injury indicators
- ✓Review pediatric, obstetric, and elderly trauma modifications tested on the PHTLS exam
Free PHTLS Practice Tests Online
Prefer to study on your device? Take our interactive PHTLS practice test online with instant scoring and detailed answer explanations. Combine the online quizzes with the printable PDF above for maximum retention and exam readiness.
How this page was made: written with AI tools and published by Nathan Beja, founder of Practice Test Geeks, who is responsible for its content. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy
Sources & references
Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy