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 NREMT-Intermediate/85 registration must meet the following requirements to
be eligible for National Registration:
Applicant must be 18 years of age or older.
Possess current National Registration at the EMT-Basic level or current state certification at the EMT-Basic level or higher.
Successful completion of a state-approved EMT-Intermediate/85 educational program, within the past
two (2) years, that equals or exceeds the behavioral objectives of the 1985 EMT-Intermediate National
Standard Curriculum as promulgated by the U.S. Department of Transportation. Candidates in
EMT-Paramedic education programs may be eligible to take the NREMT-Intermediate/85 examination
provided they supply a course completion certificate from an approved program, which verifies the
candidate has successfully completed a course, which equals or exceeds the education objectives of
the 1985 EMT-Intermediate National Standard curriculum.
If the candidate's initial Intermediate/85 education is beyond two (2) years and the candidate has
maintained state license at the EMT-Intermediate/85 level, the candidate must submit official
documentation verifying the candidate has successfully completed 36 hours of education review with a
recognized instructor over the topics outlined in the re-registration brochure.
If the initial training is beyond two (2) years and the candidate has not maintained state license at
the EMT-Intermediate/85 level, the candidate must complete an entire, state approved
EMT-Intermediate/85 education program prior to application.
Truthfully complete the Licensing Action and Felony Statements on the application and supply the documentation if necessary.
Possess current CPR credential at the healthcare provider or equivalent level.
Successful completion of the National Registry EMT-Intermediate/85 cognitive and practical
examinations.
A non-refundable/non-transferable application fee of $100.00 payable to the National Registry of Emergency Medical Technicians must
be submitted to cover the cost of processing the application. Authorization to test will not be issued until all entry
requirements are verified and the application fee is received by the NREMT.
Note - Each examination attempt will require an additional application and an
additional application fee.
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 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 NREMT-Intermediate/85 Registration has lapsed, the candidate must:
If lapsed within a two-year period, document successful completion of 36 hours of educational
review with a recognized instructor over the topics outlined in the re-registration brochure; submit a new application and fee; and successfully complete the
NREMT-Intermediate/85 cognitive and practical examinations.
If lapsed beyond a two-year period, and still currently state certified at the
EMT-Intermediate/85 level, document successful completion of 36 hours of educational review with a
recognized instructor over the topics outlined in the re-registration brochure; submit a new application and fee; and successfully complete the NREMT-Intermediate/85
cognitive and practical examinations.
If lapsed beyond a two-year period, and state licensure at the EMT-Intermediate/85 level has
not been maintained, complete a new, entire, state approved National Standard EMT-Intermediate/85
educational program, submit a new application and fee; and successfully complete the
NREMT-Intermediate/85 cognitive and practical examinations.
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
36 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-Intermediate/85 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 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.
EMT-Intermediate/85 Practical Examination
The practical section of the examination process consists of four (4) skills presented in a
scenario-type format to approximate the abilities of the NREMT-Intermediate/85 to function in the
out-of-hospital setting. All skills have been developed in accordance with the EMT-Basic National
Standard Curriculum, the behavioral and skill objectives of the 1985 EMT-Intermediate National
Standard Training Curriculum, and current A.H.A. guidelines. The process is a formal verification of
the candidate's "hands-on" abilities and knowledge, rather than a teaching, coaching, or remedial
training session. The NREMT will not explain any specific errors in any performance. Candidates are
permitted to bring their own equipment for the examination, provided it is approved for testing by
the National Registry Representative in attendance at the examination. All candidates are urged to
review all practical examination criteria in the supplemental brochure "Performance Standards for
Advanced Level Practical Examination Candidates" before attempting the examination.
All candidates must complete the practical examination in a standardized format. All candidates must
demonstrate an acceptable level of competency in each of the following skills:
1. Patient Assessment/Management
All candidates will be required to perform a "hands-on," head-to-toe, physical assessment and voice
treatment of a moulaged simulated patient for a given scenario. This skill includes:
a. Scene Size-Up
b. Initial Assessment/Resuscitation
c. Focused History and Physical Examination - Rapid Trauma Assessment
d. Detailed Physical Examination
2. Ventilatory Management
Given a scenario of having just found an apneic adult patient with a palpable carotid pulse, the
NREMT-Intermediate/85 candidate must demonstrate immediate management of the patient using simple
airway maneuvers and adjuncts, bag-valve-mask device, and supplemental oxygen. Each candidate must
then choose and insert a dual lumen airway device (Combitube®, PTL® or endotracheal tube (ET).
Requirements for state licensure may mandate which of these devices may be used.
3. Intravenous Therapy
All Candidates will be required to establish a patent IV in a manikin arm in accordance with a given
scenario.
4. Random Basic Skills
All candidates will be evaluated over one (1) of the following EMT-Basic skills tested at random.
All instruments for these skills will adhere to the National Registry EMT-Basic Practical Examination
material:
a. Spinal Immobilization (Seated Patient)
b. Spinal Immobilization (Supine Patient)
c. Bleeding Control/Shock Management
NREMT-Intermediate/85 candidates are required to complete four (4) skills when taking the
entire practical examination. Grading of the practical examination is on a Pass/Fail basis.
Failure of two (2) or less skills (when taking the entire NREMT-Intermediate/85 practical) entitles
the candidate to two (2) retesting opportunities of just the skill(s) failed. If a same-day retest
is offered at the examination site, only one (1) retest attempt may be completed at that test.
Retests must be completed in an all-or-none fashion. The NREMT cannot score or report incomplete
practical attempts. Candidates are not permitted to complete only a portion of the skills that need
to be retested. The NREMT does not mandate of guarantee same-day retest opportunities at any
National Registry Advanced level practical examination site.
Failure of any portion of the second retest attempt constitutes failure of the entire practical
examination. The candidate is then required to officially document remedial training over all skills
before starting the next full attempt of the practical examination and re-examining over all four (4)
skills on another date, provided all other requirements for National Registration are fulfilled.
Failure of three (3) or more skills constitutes failure of the entire practical examination. The
candidate is then required to officially document remedial training over all skills before starting
the next full attempt of the practical examination and re-examining over all four (4) skills on
another date, provided all other requirements for National Registration are fulfilled.
The passed portion of the examination, either the cognitive or practical, will remain valid for a
twelve (12) month period from the date of the examination, provided all other requirements for
National Registration are fulfilled. Candidates not completing the failed portion of the examination
within that twelve (12) month period will be required to repeat the invalid portion.
Candidates are allowed three (3) full attempts to pass the practical examination (one "full attempt"
is defined as completing all four (4) skills and two retesting opportunities if so entitled).
Candidates who fail a full attempt or any portion of a second retest must submit official
documentation of remedial training over all skills before starting the next full attempt of the
practical examination and re-examining over all four (4) skills, provided all other requirements for
National Registration are fulfilled. This official documentation must be signed by the
EMT-Intermediate/85 Training Program Director or Physician Director of training/operations that
verifies remedial training over all skills has occurred since the last unsuccessful attempt and the
candidate has demonstrated competence in all skills. Should a candidate fail the third full and final
attempt of the practical examination, the candidate must complete a new, state-approved
EMT-Intermediate/85 Training Program.
An inactive status is designed for Nationally Registered EMTs who are not actively engaged in the
EMT-Intermediate/85 service at the time of re-registration. 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 all refresher, CPR, and continuing education requirements. A
registrant may not request inactive status in his/her initial registration period if he/she has
never been affiliated with an ALS EMS service or functioned in a patient health care setting as an
NREMT-Intermediate/85 for a period of at least six (6) months.
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.
