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AEMT-Advanced Emergency Medical Technician

Contents:
    Entry Requirements
    Application Process
    Certification Process
    Cognitive Examination
    Cognitive Exam Retest Information
    Psychomotor Examination
    Psychomotor Exam Retest Information
    Expiration Date
    Lapsed Certification
    ADA Accommodations
    Disciplinary Policy and Rights of Appeal
    Responsibilities of Certified Advanced Emergency Medical Technician
    Advanced Emergency Medical Technician Recertification
    Inactive Status

Entry Requirements

Individuals applying for Advanced Emergency Medical Technician (NRAEMT) certification must meet the following requirements:

  • 18 years of age or older.

  • Possess current National Certification at the EMT level or a current state license at the EMT level or higher.

  • Successful completion of a state-approved Advanced Emergency Medical Technician course that meets or exceeds the National EMS Education Standards for the Advanced Emergency Medical Technician. 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 website.

    If your initial Advanced Emergency Medical Technician (AEMT) educational program was completed more than two years ago and you are currently state licensed at the AEMT level, you must submit documentation verifying completion of a state-approved AEMT refresher course or 36 hours of equivalent continuing education covering the mandatory and flexible core content topics specified within the past two years. If you are not currently state licensed as an AEMT and it has been more than two years from the completion of your AEMT course, you must complete an entire state-approved AEMT course prior to applying for National Certification.

  • • Verification from the Program Director that you hold a current CPR-BLS for Healthcare Providers or equivalent credential and have demonstrated competence in Emergency Medical Technician (EMT) skills.

Application Process

  • 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 $100.00 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive (knowledge) 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.

Certification Process

National Advanced Emergency Medical Technician certification requires successful completion of both a cognitive (knowledge) and psychomotor (skills) exam. Passed portions of the exam (both cognitive and psychomotor) remain valid for a twelve (12) month period.

Cognitive Examination

The NREMT Advanced Emergency Medical Technician cognitive exam is a computer based test (CBT). Each candidate will see 135 questions. The maximum amount of time given to complete the exam is 2 hours and 15 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 and geriatric 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 advanced 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 six 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. The candidate is given three additional attempts to pass, provided all other requirements for National Certification are met. Candidates who fail to pass after a total of six attempts are required to repeat the entire Advanced Emergency Medical Technician course.

Psychomotor Examination

The psychomotor section of the examination process consists of ten (10) separate skills presented in a scenario-type format to approximate the abilities of the Advanced Emergency Medical Technician to function in the out-of-hospital setting. All skills have been developed in accordance with the U.S. Department of Transportation National EMS Education Standards for the Emergency Medical Technician, the Advanced Emergency Medical Technician, American Heart Association Guidelines for CPR and ECC, and the U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Trauma Triage Protocol. The process is a formal verification of the candidate's "hands-on" abilities and knowledge. As a result, you will not be provided with any specific feedback on your performance.

  • You are encouraged to review all the Practical Exam information and worksheets, click here, before attempting the examination.

  • Advanced Emergency Medical Technician candidates may take the psychomotor evaluation (skills exam) following completion of the didactic and laboratory portions of an approved program if permitted by the program director and the State EMS Licensing Agency.

  • 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 must complete the psychomotor examination in a standardized format. All candidates must demonstrate an acceptable level of competency in each of the following skills:

  1. Patient Assessment-Trauma

    You will be required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a simulated patient for a given scenario, including:

    • Scene Size-Up

    • Initial Assessment/Resuscitation

    • Focused History and Physical Examination - Rapid Trauma Assessment

    • Detailed Physical Examination


  2. Patient Assessment-Medical

    You will be required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a simulated patient for a given scenario, including:

    • Scene Size-Up

    • Initial Assessment/Resuscitation

    • Focused History and Physical Examination - Rapid Trauma Assessment

    • On-Going Assessment


  3. Ventilatory Management



  4. You will be evaluated over the following two (2) ventilatory management scenarios:
    • Apneic Adult

    • Pediatric Respiratory Compromise


    Given a scenario of having just found an apneic adult patient with a palpable carotid pulse, you must demonstrate immediate management of the patient using simple airway maneuvers and adjuncts, bag-valve-mask device, and supplemental oxygen. You will then complete the adult presentation by placing a supraglottic airway device (King®,Combitube®, etc.).

    Additionally, you will be given a scenario of having just found an infant in respiratory distress and must demonstrate immediate management of the patient using simple airway maneuvers, adjuncts, and supplemental oxygen. You will then be required to demonstrate bag-valve-mask ventilation as the patient progresses from respiratory distress to respiratory failure.

  5. Cardiac Arrest Management/AED




  6. You will be evaluated on your ability to manage a cardiac arrest situation, including 1-rescuer CPR and usage of the AED given a cardiac arrest scenario where no bystanders are present.

  7. IV and Medication Skills



    • Intravenous Therapy
      You will be required to establish a patent IV in a mannequin arm in accordance with a given scenario.

    • Intravenous Bolus Medications
      After establishing a patient IV line, you will be required to administer an IV bolus of medication in accordance with a given scenario.



  8. Pediatric Intraosseous Infusion Skills



  9. You will be required to establish an intraosseous line in a pediatric IO mannequin. Either manual insertion using Jamshidi® needles or electric, drill-type devices are permitted to establish intraosseous access.

  10. Spinal Immobilization (Supine Patient)



  11. You will be required to immobilize an adult patient who is found supine with a suspected unstable spine using a long spine immobilization device. An EMT Assistant will be provided and you are also responsible for the direction and subsequent actions of the EMT Assistant.

  12. Random EMT Skills



  13. You will be evaluated over one (1) of the following EMT skills tested at random. All instruments for these skills will adhere to the National Registry EMT Users Guide material:
    • Spinal Immobilization (Seated Patient)

    • Long Bone Immobilization

    • Joint Immobilization

    • Bleeding Control/Shock Management

Psychomotor Exam Retest Information

Advanced Emergency Medical Technician candidates are allowed two (2) full attempts to pass the psychomotor examination (one "full attempt" is defined as completing all skills and two retesting opportunities if so entitled).

Candidates are eligible to retest four (4) or less skills when taking a full attempt of the psychomotor examination. Candidates are eligible for two (2) retest attempts of the four (4) or less skills failed for no more than twelve (12) months from the date of the examination, provided they meet all other current requirements for National EMS Certification. If offered, only one (1) retest attempt may be completed on the same day. Candidates not completing the failed portion of the examination within that twelve (12) month period will be required to repeat the invalid portion. Failure of any skill on the second retest attempt constitutes complete failure of the entire psychomotor examination. Candidates who fail five (5) or more skills have failed the entire psychomotor examination. Candidates who fail the entire psychomotor examination must submit official documentation of remedial education before attempting the entire psychomotor examination (all ten [10] skills) on their second and final attempt of the psychomotor examination. Passed NREMT examination results are valid for up to twelve (12) months from the date of the examination, provided all other “Entry Requirements” of the NREMT are met.

Should a candidate fail the second full and final attempt of the psychomotor examination, the candidate must complete a new, state approved Advanced Emergency Medical Technician Training Program.

Expiration Date

Initial expiration dates are determined by the date of successful completion of the entire national certification process. Individuals successfully completing the national certification process between the dates of January 1 - June 30 will receive an initial expiration date of March 31 two years in the future. Individuals successfully completing the national certification process between July 1 and December 31 will receive an initial expiration date of March 31 three years in the future. Every cycle thereafter will be for the full 2 year period commencing on April 1 and expiring March 31.

For example:

NRAEMT- Expiration Date and Recertification Cycles

Initial Certification

Initial Cycle

Following Cycles

If you successfully completed the national certification process between:

Your initial recertification cycle is:

Every cycle after your initial cycle:

  • January 1-June 30

 

Example:
Completed national certification on February 14, 2014

  • Your initial certification date-March 31, 2 years in the future

 

Example:
February 14, 2014-March 31, 2016

  • April 1-March 31 (2 years)

  

Example:
April 1, 2016-March 31, 2018
(2 years expiring on even years)

  • July 1-December 31

 

Example:
Completed national certification on July 7, 2014

  • Your initial certification date-March 31, 3 years in the future

 

Example:
July 7, 2014-March 31, 2017

  • April 1- March 31  (2 years)

 

Example:
April 1, 2017-March 31, 2019
(2 years expiring on odd years)


Lapsed Certification

If your National EMS Certification lapsed as an Advanced Emergency Medical Technician within a two year period or you are currently state licensed as an Advanced Emergency Medical Technician, you can obtain National EMS Certification by completing a state-approved Advanced Emergency Medical Technician 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 Advanced Emergency Medical Technician course and complete the cognitive and psychomotor examinations.

ADA Accommodations

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. Requests to appeal must be submitted within forty-five (45) days of receipt of notice of determination.

Responsibilities of Certified Advanced Emergency Medical Technician

Certified Advanced Emergency Medical Technicans 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 National EMS Certification solely an individual responsibility.

Advanced Emergency Medical Technician 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:

  1. Be actively working within an emergency medical service, rescue service, or patient health care facility using your AEMT 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.

  2. Complete all recertification requirements.

  3. Demonstrate continued cognitive competency through continuing education or examination.

  4. Submit your completed recertification application prior to March 31 (of the year your certification expires).

Continuing Education Option

Complete a total of 72 hours of education including:

  • Completion of a State or CECBEMS (F1, F2, F5) 36 hour refresher course or continuing education that meet both the mandatory and flexible topics (36 hours)

  • Completion of 36 hours of additional continuing EMS related education as outlined below

  • Pay the $15.00 (US funds) non-refundable processing fee at the time of submission of document

  • Maintain skills as verified by your Physician Medical Director. (Requires original or electronic signature on your recertification application validating competency of skills).

  • Obtain current CPR certification at the appropriate level.


  • All continuing education hours, to include the refresher, must be completed within the current recertification cycle. Education completed prior to the previous March 31 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 chart for detailed recertification requirements.

Exam Option

The recertification by examination option enables you to demostrate continued competence without requiring you to document your continuing education.

  • 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 by March 31 (of the year your certification expires). You will receive an abbreviated recertification application upon successful completion of the exam

  • Return the abbreviated recertification application by March 31 (of the year your certification expires) with signatures and supporting documentation

    All other recertification requirements (including felony statement, CPR certification, active affiliation/practice, verification of skills, Physician Medical Director signature, etc.) must still be met and verified.

    You may make one attempt to demonstrate continued cognitive competency by taking an examination (in lieu of documenting continuing education) within six months of your expiration date (October 1 through March 31).

Detailed Continuing Education Requirements

  1. Refresher
  2. Completion of a State or CECBEMS (F1, F2, F5) approved AEMT Refresher Course OR Continuing Education

    The AEMT refresher can be completed through two different options:

    • Traditional refresher course

      Completion of a State or CECBEMS (F1, F2, F5) AEMT refresher course.*

    • Continuing education topic hours

      AEMT refresher may be completed by continuing education** and must include both mandatory and flexible core content. See the chart below for more information.

      *A maximum number of 10 hours can be applied from Distributive Education (online, video, or magazine-based) towards this section and must be state or CECBEMS approved.

      **Some states require the traditional refresher course and will not accept continuing education hours. Please refer to your state's particular requirements.

     You may complete continuing education equivalent to a Refresher Course if one is not required by your state. You may count education received in lectures, standardized courses (such as ABLS, ACLS, EMPACT, PEPP, PALS, PHTLS, ITLS, etc.), college courses, in service training, case reviews, conferences, etc. Up to 10 hours of the refresher training can be by Distributive Education (online, video or magazine-based).

    You must ensure that you cover every topic within the four divisions of the mandatory core content.  You must also cover each of the five divisions of the flexible core content; however, you are not required to cover each topic.

    Mandatory Core Content - 18 hours total
    Airway, Breathing and Cardiology - 6 hours
    • Provide ventilatory support for a patient
    • Attempt to resuscitate a patient in cardiac arrest
    • Provide care to a patient experiencing cardiovascular compromise
    • Provide post resuscitation care to a cardiac arrest patient

     

    Medical Emergencies - 2 hours
    • Assess and provide care to a patient experiencing an allergic reaction
    • Assess a patient with possible overdose
    • Assess and provide care to a near-drowning patient
     
    Trauma - 4 hours
    • Perform a rapid trauma assessment
    • Assess a patient with a head injury
    • Assess and provide care to a patient with a suspected spinal injury
    • Provide care to a patient with a chest injury
    • Provide care to a patient with an open abdominal injury
    • Provide care to a patient with shock/hypoperfusion
     
    Obstetrics and Pediatrics - 6 hours
    • Assess and provide care to an infant or child with cardiac arrest
    • Assess and provide care to an infant or child with respiratory distress
    • Assess and provide care to an infant or child with shock/hypoperfusion
    • Assess and provide care to an infant or child with trauma
     
    Flexible Core Content - 18 hours total  
    Airway, Breathing and Cardiology - 6 hours
    • Assess and provide care for respiratory distress in an adult patient
    • Use oxygen delivery system components
    • Perform techniques to assure a patent airway
    • Assess and provide care to a patient experiencing non-traumatic chest pain discomfort
     
    Medical Emergencies - 4 hours
    • Assess and provide care to a patient with an altered mental status
    • Assess and provide care to a patient with a history of diabetes
    • Assess and provide care to a patient experiencing a seizure
    • Assess and provide care to a patient exposed to heat or cold
    • Assess and provide care to a patient experiencing a behavioral problem
    • Assess and provide care to a patient with suspected communicable disease
     
    Trauma - 1 hour
    • Provide care to a patient with a painful, swollen, deformed extremity
    • Assess and provide care to a patient with a burn injury
     
    Obstetrics and Pediatrics - 6 hours
    • Assess and provide care to an infant or child with suspected abuse or neglect
    • Assess and provide care to an infant or child with a fever
    • Assess and provide care to an obstetric patient
    • Provide care to a newborn
    • Provide care to a mother immediately following delivery of a newborn
     
    Operational Tasks - 1 hour
    • Use body mechanics when lifting and moving a patient
    • Communicate with a patient while providing care
     

  3. Additional EMS Related Continuing Education-36 hours

  4. The following are maximum hours per course that can be applied towards Additional Continuing Education hours:

    • A maximum number of 18 hours can be applied from any one topic area

    • A maximum of 16 hours can be applied from each of the following courses: ABLS, ACLS, AMLS, EMPACT, EPC, PEPP, PALS, PHTLS, ITLS, etc.

    • A maximum number of 12 hours can be applied from each of the following courses: Teaching CPR - Emergency Driving - Dispatch Training

    • A maximum number of 18 hours can be applied from Distributive Education (online, video, or magazine-based) towards this section and must be state or CECBEMS approved.

    College Courses (1 college credit = 8 CEU)

    A maximum number of 18 hours can be applied for college courses that relate to your role as an EMS professional (for example, but not limited to: anatomy, physiology, biology, chemistry, microbiology, pharmacology, psychology, sociology, statistics, etc.)

    Hours from the following courses can be applied hour for hour with no maximum: Advanced Trauma Life Support, EMS Course Instruction, and Wilderness EMS Training.

    Courses that cannot Be applied towards additional continuing education hours: Clinical Rotations, CPR, EMR course, home study programs, instructor courses, management/leadership courses, performance of duty, preceptor hours, serving as a skill examiner, and volunteer time with agencies.


  5. CPR Certification
  6. Submission of approved CPR credential for the professional rescuer. Credential must be current and valid. Verification may be in the form of an instructor's signature on the recertification application or copies of both sides of a current card.

Inactive Status

Inactive status can only be requested by NREMTs who have completed at least 6 months of EMS patient care during their first registration cycle.

Inactive status with the NREMT signifies a National Certified provider who is currently not providing patient care. Often this is misunderstood. Registrants who wish to declare inactive status must continue to meet the NREMT recertification requirements. The NREMT confirms that “inactive” EMS providers are “not working.” Therefore, inactive status is useful for administrators, educators, managers, etc., but not for those who have left EMS and also failed to maintain competency via completion of the recertification education requirements.

Inactive status is not for those unable to obtain and meet the educational requirements or those who have had limitations or revocation of a health care license.

Registrants who request inactive status at the EMR and EMT levels do not need to obtain verification of skills from their training officers. Again, these registrants must complete all refresher, continuing education and CPR requirements. These registrants are eligible to recertify via examination if they so choose. CPR certification remains a requirement even for those who pass the examination.

Registrants who request inactive status at the AEMT or Paramedic levels do not need to obtain verification of skills from their medical directors. Again, these registrants must complete all refresher, continuing education and both CPR and ACLS requirements. These registrants are eligible to recertify via examination if they so choose. CPR and ACLS remain a requirement even for those who pass the examination.

Applying for Active Status when registered as Inactive

Movement from Inactive to Active status requires the registrant to complete Section III of the re-certification requirements. Fundamentally the registrant must work with their future or current employer so that he/she is willing to verify competency of the skills found on the recertification form. In order to do this the registrant must retrieve the form from the NREMT website Click here, have the form completed and then forward it to the NREMT. No fee is required to move from inactive to active status.

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