Emergency Medical Responder (EMR)
Cognitive Exam Retest Information
Disciplinary Policy and Rights of Appeal
Responsibilities of Certified Emergency Medical Responder
Emergency Medical Responder Recertification
Individuals applying for Emergency Medical Responder certification must meet the following requirements:
Successful completion of a state-approved Emergency Medical Responder (EMR) course that meets or exceeds the National Emergency Medical Services Education for Emergency Medical Responder. You must have completed the course within the past two years. Your Program Director must verify your successful completion of the course on the NREMT web site.
If you are seeking national certification as an EMR and are currently state licensed, you must document successful completion of an approved National Scope of Practice EMR refresher course or 12 hours of appropriate continuing education topic hours within the past two years. If you are not currently state licensed and it has been more than two years from the completion of your EMR course, you must complete an entire state-approved EMR course prior to applying for National Certification.
Verification from the Program Director that you hold a current CPR credential for health care providers and have demonstrated competence in EMR skills.
Successful completion of a state-approved Emergency Medical Responder (EMR) psychomotor exam.
Create a login on this website.
Complete a National Registry online application, including truthfully completing the Licensing Action and Felony statements. click here for more information on the NREMT Felony Policy. The NREMT may deny certification or take other appropriate actions in regards to applicants for certification or recertification when a felony conviction has occurred.
Pay the application fee of $65.00 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive examination.
You will receive an Authorization to Test (ATT) once you are eligible for the exam. The ATT letter contains scheduling instructions and important details concerning proper identification required at testing centers.
National Emergency Medical Responder (EMR) certification requires successful completion of both a cognitive and psychomotor exam. Passed portions of the exam (both cognitive and psychomotor) remain valid for a twelve (12) month period..
The NREMT First Responder / EMR cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the First Responder / EMR exam will range from 80 to 110. The maximum amount of time given to complete the exam is 1 hour 45 minutes.
The exam will cover the entire spectrum of EMS care including: Airway, Respiration & Ventilation, Cardiology & Resuscitation; Trauma; Medical & Obstetrics/Gynecology; and EMS Operations. Items related to patient care are focused on adult patients (85%) and pediatric patients (15%). In order to pass the exam, you must meet a standard level of competency. The passing standard is defined by the ability to provide safe and effective entry level emergency medical care.
Cognitive Exam Retest Information
In the event you are unsuccessful passing the cognitive exam, the NREMT will provide feedback on your performance. You may apply to retest 15 days after your last examination.
Candidates are given three opportunities to pass the cognitive examination provided all other requirements for National EMS Certification are met. Candidates who fail the examination on the third attempt will be required to repeat the entire Emergency Medical Responder (EMR) program in order to apply for subsequent examination attempts.
The psychomotor exam provides a hands-on opportunity for you to demonstrate the skills you have learned. Speak with your instructor or state EMS Office about the format and logistics of completing a state-approved Emergency Medical Responder (EMR) psychomotor exam.
Initial expiration dates are determined by the date of successful completion of the entire certification process. Individuals successfully completing the certification process between the dates of January 1 - June 30 will receive an expiration date of September 30 two years in the future. Individuals successfully completing the certification process between July 1 and December 31 will receive an expiration date of September 30 three years in the future.
For example: successful completion of February 14, 2013, certification expiration = September 30, 2015
successful completion of July 7, 2013, certification expiration = September 30, 2016
All subsequent certification periods will be for a two-year period (October 1 - September 30).
If your National EMS Certification lapsed as an Emergency Medical Responder (EMR) within a two year period or you are currently state licensed as an Emergency Medical Responder (EMR), you can obtain National EMS Certification by completing a state-approved Refresher course and successfully completing the cognitive and psychomotor examinations. If your EMS certification expired more than two years ago, you must complete an entire state-approved Emergency Medical Responder (EMR) course, and complete the cognitive and psychomotor examinations.
The NREMT complies with the Americans with Disabilities Act (ADA) of 1990, and offers reasonable accommodations for individuals with disabilities. Pearson VUE test centers are also ADA compliant.
Complete information about the NREMT Accommodations Disability Policy can be found here.
Disciplinary Policy and Rights of Appeal
The NREMT has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the NREMT Disciplinary Policy and Rights of Appeal can be found here.
Responsibilities of Certified Emergency Medical Responders (EMRs)
Certified Emergency Medical Responders (EMRs) must notify the NREMT within 30 days regarding the following matters:
change in mailing address.
any felony conviction.
disciplinary action taken by any state has resulted in suspension, revocation, or expiration of state registration/licensure; termination of right to practice; voluntary surrender of state registration/licensure while under investigation.
The NREMT considers the individual to be solely responsible for their certification.
Emergency Medical Responder (EMR) Recertification
In applying for recertification, certified EMS professionals agree to comply with all recertification requirements, rules and standards of the National Registry of Emergency Medical Technicians (NREMT). The recertification applicant bears the burden of demonstrating and maintaining compliance at all times.
To Apply For Recertification You Need to:
Be actively working within an emergency medical service, rescue service, or patient health care facility using your EMR skills.
If you wish to request Inactive Status and this is your first recertification, you must provide documentation that you have worked in a patient care setting for at least six months.
Complete all recertification requirements.
Demonstrate continued cognitive competency through continuing education or examination.
Submit your completed recertification application prior to September 30 of the year your certification expires.
Continuing Education Option
- Complete a State or CECBEMS (F1, F2, F5) approved 12 hour EMR refresher
- Pay the $10 (U.S. funds) non-refundable processing fee at the time of submission of documentation
All continuing education hours must be completed within the current recertification cycle. Education completed prior to your previous September 30 expiration date will NOT be accepted. If this is your first recertification, only education completed after the date of initial certification will be accepted. See below for detailed recertification requirements.
The recertification by examination option enables you to demonstrate continued cognitive competence without requiring you to document your continuing education.
All other recertification requirements (including felony statement, CPR, active affiliation/practice, verification of skills, etc.) must still be met and verified.
- Log in to your NREMT account. Complete a recertification by examination application and pay the exam fee. Be sure you are completing the recertification application (and not the initial certification application)
- After 24-48 hours, go to the NREMT website, log in to your account and print your Authorization to Test (ATT) letter. Follow the directions on the letter to schedule your exam.
- Take and pass the exam between April 1 and September 30 (of the year your certification expires). You may make one attempt to demonstrate continued cognitive competency by taking an exam (in lieu of documenting continuing education). You will receive an abbreviated recertification application upon successful completion of the exam.
- Return the abbreviated recertification application by September 30 (of the year your certification expires) with signatures and supporting documentation.
The EMR refresher course can be completed through two different options:
Traditional refresher course - Completion of a State or CECBEMS (F1, F2, F5) approved 12 hour EMR Refresher Course
- Continuing education topic hours - EMR refresher may be completed by continuing education* and must include the topic and hours listed below:
|Topics||Hours Required||Suggested Courses|
|Preparatory||1 hour||Roles and Responsibilities, Well-being of the Emergency Medical Responder, Medical Direction, Quality Improvement, Personal Protection, Scene Safety, Medical/Legal, Human Anatomy, Lifting and Moving|
|Airway||2 hours||Basic Airway Management, Oxygen Delivery Systems and Techniques Adjuncts, Oxygen Therapy|
|Patient Assessment||2 hours||Scene Size-up, Initial Assessment, Vital Signs and History Taking, Assessment of Trauma Patients, Assessment of Medical Patients, Ongoing Assessment, Communications, Documentation|
|Circulation||3 hours||Management of Shock, Cardiac Emergencies, Bleeding/Wounds/Shock, Arrest Management|
|Illness & Injury||3 hours||General Pharmacology, Respiratory Emergencies, Environmental Emergencies, Acute Abdominal Emergencies, Diabetic Emergencies, Allergic Reactions, Poisoning and Overdose, Behavioral Emergencies, Soft-Tissue Injuries, Musculoskeletal Injuries, Injuries to Head and Spine|
|Childbirth & Children||1 hour||Obstetrical Emergencies, Gynecological Emergencies, Childbirth and Complications, Care of the Newborn, Assessing the Pediatric Patient, Medical Emergencies in Kids, Airway Management in Pediatrics, Trauma Emergencies and Care in Kids|
* Some states require the traditional refresher course and will not accept continuing education hours. Please refer to your state’s particular requirements. A maximum number of 6 hours can be applied from Distributive Education towards this section and must be state or CECBEMS approved.
Hours from the following courses can be applied hour for hour with no maximum: EMS Course Instruction and Wilderness EMS Train
Courses that Can Not Be Applied Towards Additional Continuing Education Hours: Clinical Rotations, CPR, home study programs, instructor courses, management/leadership courses, performance of duty, preceptor hours, serving as a skill examiner, and volunteer time with agencies
- Maintain skills as verified by your Training Officer/Supervisor (requires signature on your recertification application validating
competency of skills).
- Obtain current CPR certification at the appropriate level.