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).
Individuals applying for EMT-Basic registration must meet the following requirements to be eligible
for the national registration as an EMT-Basic.
Applicant must be 18 years of age or older.
Successfully complete, within the last two (2) years, a state-approved National Standard
EMT-Basic education program, as developed and promulgated by the U.S. Department of Transportation.
Candidates who are not state certified and fail to become registered within two (2) years following
EMT-Basic course completion must retake the entire EMT-Basic educational program.
If the candidate's initial training is beyond two (2) years and the candidate has maintained
state certification, the candidate must complete a current state approved EMT-Basic refresher
training program. Refresher training programs must be completed within the past two (2) years
and meet or exceed the requirements of the U.S. Department of Transportation EMT-Basic Refresher
Training Program, National Standard Curriculum.
If the candidate's initial training is beyond two (2) years and state certification has not been
maintained, the candidate must complete the entire EMT-Basic education program.
Successfully complete, within the past twelve months, all sections of
a state-approved EMT-Basic practical examination that equals or exceeds the established criteria of
the National Registry.
Truthfully complete the Licensing Action and Felony statements on the application and submit the
requested documentation if necessary.
Possess a current CPR Credential at the healthcare provider or equivalent level
A non-refundable/non-transferable application fee of $70.00 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 EMT-Basic cognitive examination.
Initial expiration dates are established in reference to the date of initial registration.
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
re-registration periods will be for the full two-year period running from April 1 through March 31.
For example:
Individuals successfully completing the examination between the dates of January 1, 2007 and June
30, 2007, will receive an expiration date of March 31, 2009.
Individuals successfully completing the examination between the dates of July 1, 2007 and December
31, 2007, will receive an expiration date of March 31, 2010.
To be reinstated once EMT-Basic national registration has lapsed, the candidates must:
If lapsed within a two-year period, document successful completion of a state-approved DOT National
Standard EMT-Basic Refresher education program within the past two (2) years; submit a new
application and fee; and successfully complete the NREMT-Basic cognitive examination and
state-approved practical examination (within the past 12 months) that meets or exceeds Registry standards.
If lapsed beyond a two-year period and still currently state-certified at the EMT-Basic level,
document successful completion of a state-approved DOT National Standard EMT-Basic Refresher
Training Course within the past two (2) years; submit a new application and fee; and successfully
complete the NREMT-Basic cognitive examination and state-approved practical examination (within the
past 12 months) that meets or exceeds Registry standards.
If lapsed beyond a two-year period and state certification at the EMT-Basic level has also lapsed,
document successful completion of a new state-approved DOT National Standard EMT-Basic education program
within the past two (2) years; submit a new application and fee; and successfully complete
the NREMT-Basic cognitive examination and state-approved practical examination (within the past 12
months) that meets or exceeds Registry standards.
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-Basic 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 candidates ability after each set of questions. This allows the test to adjust to the candidates ability and as the
examination progresses the ability estimate becomes more precise. No two tests are alike. Every test experience is tailored to the individual. The
purpose of the examination is to determine the ability to reach entry-level competency. At the NREMT-Basic level an examination will range from
70 to 120 items. The maximum amount of time once the test begins is 2 hours.
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-Basic has a test plan that is based upon research findings of the practice of EMT-Basic
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
18.0%
Cardiology
17.3%
Trauma
16.7%
Medical
15.3%
Obstetrics and Pediatrics
16.0%
Operations
16.7%
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
are met. After three attempts candidates must submit official documentation verifying completion of 24 hours of
remedial training. Remedial training is designed to provide further education to change the performance of the candidate taking subsequent
examination attempts. It is suggested that this education be over areas within the test plan where the candidate has been identified on
their result letters to be near or below the passing standard. Following remedial training the candidate is given three more attempts to pass
the examination, provided all other requirements for National EMS Certification are met. Candidates who fail to pass after a total of six attempts
are required to complete an entire state approved EMT-Basic 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 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 candidates 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 the
EMT-Basic. All candidates are required to successfully complete all sections of a state-approved EMT-Basic practical
examination that meets or exceeds the established criteria of the National Registry.
National Registry requires the Program Director or the Service Director of Training/Operations to verify, by electronic signature, that the candidate has
demonstrated an acceptable level of competency in each of the following skill areas as a result of the training program:
Patient Assessment/Management - Trauma
Patient Assessment/Management - Medical
Cardiac Arrest Management/AED
Spinal Immobilization (Seated Patient)
Spinal Immobilization (Supine Patient)
Bag-Valve-Mask Apneic Patient with a Pulse
Long Bone Fracture Immobilization
Joint Dislocation Immobilization
Traction Splinting
Bleeding Control/Shock Management
Upper Airway Adjuncts and Suction
Mouth-to-Mask with Supplemental Oxygen
Supplemental Oxygen Administration
The EMT-Basic Practical Examination Verification section of the NREMT application process requires the Program Director of education or
state approved officials to verify, by electronic signature, successful completion of a state-approved practical examination that, as a
minimum, evaluates the following skills and meets or exceeds the established criteria of the National Registry.
Station #1
Patient Assessment/Management - Trauma
Station #2
Patient Assessment/Management - Medical
Station #3
Cardiac Arrest Management/AED
Station #4
Spinal Immobilization (Seated or Supine Patient)
Station #5
Bag-Valve-Mask Apneic Patient with a Pulse
Station #6
Random Skill Station (one of the following)
Long Bone Fracture Immobilization
Joint Dislocation Immobilization
Traction Splinting
Bleeding Control/Shock Management
Upper Airway Adjuncts and Suction
Mouth-to-Mask with Supplemental Oxygen
Supplemental Oxygen Administration
The National Registry reserves the right to review and investigate any practical examination that may be in question.
An inactive status is designated for Nationally Registered EMTs who are not actively engaged in
ambulance/rescue service or health/patient care activity. Inactive status is designed for those
registrants who must be inactive for a period of time due to moving, illness, pursuit of education,
family responsibilities, etc. Educators, administrators or regulators who are not actively treating
patients should consider this status. Inactive status will be awarded only to those who have
fulfilled refresher, CPR and continuing education requirements. A registrant may not request
inactive status in his/her initial registration if he/she has never been affiliated with an
ambulance/rescue service or functioned in a patient health care setting.
A request to return to active status must be accompanied by a completed
Inactive to Active Registration form which may be download here, or
obtained by calling the NREMT Re-registration Department.
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.
