The founding of the NREMT in 1970 came as a result of recommendations made by President Lyndon Johnson’s
Committee on Highway Traffic Safety. The committee proposed the establishment of uniform standards for training
and examination of personnel active in the delivery of emergency ambulance service. Since then, uniform standards
have been established for training and examination of the people who provide out-of-hospital emergency medical
care. As a non-profit, non-governmental, independent certification agency, the NREMT provides four distinct
areas of service:
Entry level competency assessment
A Registry of nationally certified EMS professionals
Re-registration certification process
Research that benefits the EMS community
The NREMT is governed by a Board of Directors representing the broad EMS community. The Board consists
of twenty-one individuals—including physicians, state EMS office officials, EMS professionals, educators, and members
of the public—highly regarded in their respective areas of practice. We encourage you to review the biographical
outlines that cover the accomplishments of the distinguished members of our Board of Directors.
Accreditation by the National Commission For Certifying Agencies (NCCA) is the highest assurance that the health,
welfare and safety of the public is being met through a credible exam and certification process. Accreditation also
ensures that the NREMT complies with the standards outlined in the “Standards for Education and Psychological Testing”,
developed jointly by the American Psychological Association (APA), American Educational Research Association (AERA)
and National Council on Measurement in Education (NCME).
All individuals applying for First Responder registration must meet the following requirements to be
eligible for national registration.
Successfully complete, within the last two years, an approved National Standard First Responder
education program, as developed and promulgated by the U. S. Department of Transportation.
Candidates who are currently educated and state licensed/certified as First Responders are eligible
provided they have completed a USDOT First Responder education program within the past two years.
Candidates who completed the First Responder education program more than two years ago and are
currently state licensed/certified must complete the First Responder Refresher Program within the
past two years.
Candidates who completed the First Responder education program more than two years ago and are not
currently state licensed/certified must complete the entire First Responder education program.
Candidates are required to successfully complete, within the past 24 months, all sections of an
approved First Responder practical examination that equals or exceeds the criteria established by the
U.S. Department of Transportation, First Responder Final Practical Skills Exam, Appendix "H";
including One and Two Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway.
Candidates in states which license/certify First Responders must complete the practical examinations
approved by the state.
A non-refundable/non-transferable application fee of $65.00 to the National Registry of Emergency
Medical Technicians, must be submitted with the application to cover the cost of processing the application.
Please Note - Each examination attempt will require
an additional application and an additional application fee.
Successfully complete the above requirements and the National Registry First Responder cognitive
examination.
Initial expiration dates are established in reference to the date of successful completion of the
examination. Individuals initially registered during the first six months of the year will revert to
the beginning of that year for an anniversary date. Those initially registered during the last six
months of the year will begin their biennium the first day of the following year. All subsequent
registration periods will be for the full two-year period.
For example:
Individuals successfully completing the examination between the dates of January 1, 2007 and June 30,
2007, will receive an expiration date of September 30, 2009.
Individuals successfully completing the examination between the dates of July 1, 2007 and December 31,
2007, will receive an expiration date of September 30, 2010.
To be reinstated once the First Responder national registration has lapsed, the candidate must:
If lapsed within a two-year period, successfully complete a First Responder Refresher Program,
submit a new application and fee, successfully complete the National Registry cognitive examination and
a practical examination that equals or exceeds the criteria established by the
U.S. Department of Transportation: First Responder Final Practical Skills Exam, Appendix "H";
including One and Two Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway.
If lapsed beyond a two-year period and state licensure/certification has been maintained,
successfully complete a USDOT First Responder Refresher Program, submit a new application and
fee, successfully complete the National Registry cognitive examination and a
practical examination that equals or exceeds the criteria established by the U.S. Department of
Transportation: First Responder Final Practical Skills Exam; Appendix "H"; including One and Two
Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway.
If lapsed beyond a two-year period and state licensure/certification has not been maintained,
successfully complete another entire First Responder education program, submit a new application and
fee; successfully complete the National Registry cognitive examination and a
practical examination that equals or exceeds the criteria established by the U.S. Department of
Transportation: First Responder Final Practical Skills Exam, Appendix "H"; including One and Two
Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway.
The NREMT cognitive (knowledge) examination has been developed to provide the most precise definition of entry-level competency
in a fair method. The NREMT uses a computer adaptive test (CAT) to deliver the NREMT-First Responder
examination. With computer adaptive testing each question is tailored to the individual candidate’s ability. This means that when a
candidate answers a question correctly, the next question will be slightly more challenging. If a candidate answers a question
incorrectly the next question will be slightly easier. A CAT examination re-estimates the candidate’s ability after each set of
questions. This allows the test to adjust to the candidate’s ability and as the examination progresses the ability estimate becomes more
precise. No two tests are alike. Every test experience is tailored to the The purpose of the examination is to determine the ability
to reach entry-level competency. At the NREMT-First Responder level an examination will range from 80 to 110 items. The maximum amount of time
once the test begins is 1 hour 45 minutes.
All examinations have pilot items that do not count toward the pass/fail decision. These pilot items can be used in future examinations.
There is no way to identify a pilot item, so candidates should answer every question to the best of their ability. A candidate can not
“trick” the computer by missing items and then attempting to pass. It is important that candidates take their time to answer each
question. This is not a “speeded” test; there is plenty of time to answer each question.
A candidate should know that there is no minimum number or percent of correct items needed to pass as with a traditional
pencil-paper examination. Typically strong and weak candidates finish more quickly and those near the entry-level
of competency have more questions to demonstrate their true ability. All candidates will think the test is
difficult because the test will be reaching toward their maximum ability. Candidates should not conclude they have
failed the test because it was difficult.
The National EMS Certification for the NREMT-First Responder
has a test plan that is based upon research findings of the practice of EMS
First Responders from throughout the nation. The percentage of the test plan for each area is as follows:
Test Plan Topics
Percent of overall test
Airway and Breathing
17.0%
Cardiology
17.0%
Trauma
17.0%
Medical
16.0%
Obstetrics and Pediatrics
16.0%
Operations
17.0%
TOTAL
100%
If you want further information on the specifics of how the examination was constructed you should review,
About the Cognitive Examination
Candidates are given three opportunities to pass the cognitive examination provided all other requirements for National EMS
Certification as state above are met. After three attempts candidates who fail are required to repeat the entire state
approved First Responder education program.
If you want to watch a video of what will occur at a Pearson
Professional Center you can see this by referring to Tour a Pearson VUE Testing Center
If you have any questions regarding your application status you should log-into the NREMT website (www.nremt.org)
and check your application status.
Candidates who pass the examination will be sent National
EMS Certification materials. Candidates who fail the examination will be sent a results letter from the NREMT which
will identify by test plan the areas on the examination where the candidate
performance was near or below the passing standard. Candidates should tailor their studying and any remedial training
necessary toward the tasks that make up the areas where they were near or below
the standard. Because each examination
experience is completely different it is important for candidates to change
their ability level by studying further for the examination. If the candidate’s ability is not improved,
the likely outcome on the examination will be consistent.
The National Registry reserves the right to investigate any
irregularities that occur in conjunction with the application process, course
completion verification and/or in conjunction with any test experience. The NREMT has disciplinary actions that may
be taken in these cases. Rights of appeal of NREMT decisions are outlined in the NREMT Disciplinary Policy.
The Practical Examination
The practical examination requires the candidate to physically apply the
necessary skills of a First Responder. All candidates are required to successfully complete all sections of
a practical examination which meets or exceeds the established criteria of the
U.S. Department of Transportation: First Responder Final Practical Skills Exam,
Appendix "H"; including One and Two Person CPR, Infant CPR and Unresponsive
Adult Obstructed Airway.
In states which mandate a practical examination for state licensure/certification at the First Responder level, candidates must
successfully complete the practical examination under the rules of the state.
The Program Director of Education or an approved state official must verify that the candidate has
demonstrated an acceptable level of competency in each of the following skill
areas as measured by the skill evaluation instruments provided in the USDOT
curriculum, including:
Trauma Patient Assessment/Management
Bleeding Control/Shock Management
Upper Airway Adjuncts and Suction
Mouth-to-Mask Ventilation
One and Two Rescuer CPR
Infant CPR
Unresponsive Adult Obstructed Airway
The National Registry First Responder application requires the Program Director or state-approved
officials to verify, by electronic signature, successful completion of a practical
examination that meets or exceeds the criteria listed above.
The National Registry reserves the right to review and investigate any practical
examination which may be in question.
It is the policy of the National Registry of Emergency Medical Technicians to administer its certification examinations
in a manner that does not discriminate against an otherwise qualified applicant. An applicant with a disability, who is
otherwise eligible to take the certification examination may file a request for reasonable testing accommodations if, by
virtue of a disability, the applicant cannot demonstrate under standard testing conditions that he/she possesses the
knowledge and skills to be certified as an EMS provider at the level of certification requested. The NREMT will make
reasonable accommodations to individuals with documented disabilities unless such an accommodation fundamentally alters
the measurement of the examination or the established eligibility requirements for gaining National
Registration.
The National Registry of Emergency Medical Technicians offers reasonable and appropriate accommodations for the written
and practical components of the registration examination for those persons with documented disabilities,
as required by the Americans with Disabilities Act (ADA). At a minimum, all requests for accommodations must be received
by the NREMT no less than three (3) weeks before the scheduled test date. The NREMT urges candidates requesting any
accommodation to submit such requests as early as possible to provide adequate time to resolve any documentation issues
that may arise. The NREMT will review each request on an individual basis and make decisions relative to appropriate
accommodations based on the following general guidelines:
In order to be considered for accommodations under the ADA, an individual
must present documentation indicating that his/her disability substantially limits some major life activity.
Only individuals with disabilities who, with or without reasonable
accommodations, meet the eligibility requirements for certification at the
level of the requested examination are eligible for accommodations.
Accommodations being requested must be reasonable and appropriate for the documented
disability and must not fundamentally alter the examination’s
ability to assess the essential functions of pre-hospital care, which the
test is designed to measure.
Documents relative to current functioning of a candidate must be no older than three
(3) years to help ensure accommodations are based on assessment of the
current impact of the candidate’s disability on the examination activity.
Professionals conducting assessments, rendering diagnoses of specific disabilities
and/or making recommendations for appropriate accommodations must be
credentialed to do so.
The NREMT realizes that each candidate’s circumstances are unique and a case
by case approach to review the documentation is required.
Candidates requesting accommodations for the cognitive component of the examination should go to our
Examination Accommodations Policy for further details.
NREMT has disciplinary procedures, rights of appeals and due process within its policies. Individuals
applying for registration or re-registration, who wish to exercise these rights should read our
Disciplinary Policy. Requests to appeal must be submitted within
thirty (30) days of receipt of notice of determination.
