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The New EMR and EMT Certification Examinations

 

Table of Contents

Important timelines and information

+ New Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT) Certification Examinations launch on April 7, 2025. 
+ State EMS office approved BLS skills competency requirements for EMR and EMT levels will continue in the current format.  
+EMR and EMT Certification Examination fees remain the same as 2024.
  • EMR - $88 per examination attempt
  • EMT - $104 per examination attempt

 

About the BLS Certification Examinations



Examination Content 

National Registry certification examinations are periodically updated to align with evolving professional roles, incorporating advances in clinical practice, research, and technology.


Test plans for the updated EMR and EMT Certification Examinations, based on the 2023 BLS Practice Analysis are now available.

 

EMR Certification Examination Test Plan

EMT Certification Examination Test Plan

New EMR Certification Examination Domain Information

Content DomainPercent of Examination
Scene Size-Up and Safety  19% - 23%
Primary Assessment 37% – 41%
Secondary Assessment 4% - 8%
Patient Treatment and Transport 20% - 24%
Operations 10% - 14%

*Note: items related to pediatric patient care will be integrated throughout the examination content. 

 

New EMT Certification Examination Domain Information

Content DomainPercent of Examination
Scene Size-Up and Safety  15% - 19%
Primary Assessment 39% – 43%
Secondary Assessment 5% - 9%
Patient Treatment and Transport 20% - 24%
Operations 10% - 14%

*Note: items related to pediatric patient care will be integrated throughout the examination content. 


 

Novel Item Classes Used in the Assessment of EMRs/EMTs 


In 2023, the National Registry introduced Technology Enhanced Items (TEIs) to its AEMT and Paramedic Certification Examinations, using interactive features to assess candidate knowledge in new ways beyond traditional multiple-choice questions. TEIs will appear in the new EMR and EMT Certification Examinations.

 

Examples of the TEIs that will now be included in all National Registry Certification Examinations are:  
Build List: Arrange the provided options in the specified order.  
Drag-and-Drop: Sort the options into the specified categories or classifications.   
Option/Check Box: Select or classify options in a table according to specified criteria.  

View TEI Types and Navigation

A tutorial at the start of the examination provides instructions for each item type, accessible anytime through the Help function.  

Sample Packet

Download EMR Sample Packet

Download EMT Sample Packet 

Explore interactive sample questions for the EMR and EMT Certification Examinations.

EMR Sample Items 

EMT Sample Items 

Frequently Asked Questions

The BLS Certification Examinations went live April 7, 2025.
The National Registry conducted a BLS practice analysis starting in 2022 to update its understanding of the skills and knowledge required for entry-level EMR and EMT roles. This analysis used multiple research methods—including EMS event documentation review, observational studies, ride-alongs, Clinician interviews, panels, and surveys—to gather comprehensive data on real-world job tasks across multiple settings. Subject matter experts (SMEs) from the EMS field provided insights into the knowledge and skills needed to perform their roles safely and effectively. These findings form the basis for examination content, ensuring each question is relevant and directly linked to job responsibilities.
The BLS Practice Analysis summary document can be found here. 
Your ATT was issued for the current version of the examination. If you do not take your examination on or before April 4, 2025, and your course eligibility remains valid, the National Registry will issue a new ATT for the updated examination on April 7, 2025.
 
Important: If your course eligibility expires before April 4 or before the standard 90-day period, your ATT deadline to test date will reflect your course eligibility expiration date.
The BLS practice analysis was conducted after the ALS practice analysis, with each analysis focused on different clinician groups: BLS on EMRs and EMTs, and ALS on AEMTs and Paramedics. While the findings had similarities, each analysis provided unique insights. The National Registry prioritized the ALS Redesign Initiative to focus on Paramedic and AEMT roles initially, then conducted a separate BLS analysis for a thorough assessment of competencies needed at each level.
The new EMR and EMT certification examinations will feature updated domain areas, with labels and organization differing from the current five-domain structure:

Current Domains:
1. Airway, Respirations, and Ventilation
2. Cardiology and Resuscitation
3. Trauma
4. Medical, Obstetrics, and Gynecology
5. Operations

New Domains:
1. Scene Size-Up and Safety
2. Primary Assessment
3. Secondary Assessment
4. Patient Treatment and Transport
5. Operations

The test structure will be as follows:
EMR  
Scene Size-Up and Safety   19% - 23%
Primary Assessment  37% – 41%
Secondary Assessment  4% - 8%
Patient Treatment and Transport  20% - 24%
Operations  10% - 14%
 
EMT  
Scene Size-Up and Safety   15% - 19%
Primary Assessment  39% – 43%
Secondary Assessment  5% - 9%
Patient Treatment and Transport  20% - 24%
Operations  10% - 14%
The psychomotor examination process for EMRs and EMTs will not change. The BLS psychomotor examination process is established and approved by each state. AEMT and NRP candidates need to have Student Minimum Competency (SMC) and the 2024 ALS redesign changes that were implemented July 1st, 2024, are only applicable to AEMTs and NRPs and do not impact EMR and EMT candidates.
No. The fee will not increase.
The new examination will be administered in the same format.
EMR
Computer Adaptive Examination Administered by Pearson VUE (testing center) or OnVUE (remotely proctored) 
90-110 Items, 30 Pilot/Unscored Items 
1-hour, 45 minutes
 
EMT
Computer Adaptive Examination Administered by Pearson VUE (testing center) or OnVUE (remotely proctored) 
70-120 Items, 10 Pilot/Unscored Items
2 hours
The new BLS Certification Examinations went live on April 7, 2025. The last date for the prior examinations was April 4, 2025.
Yes, the examinations will continue to be administered in the same way.
No, the testing and retesting process will remain the same.
We don’t expect any change in difficulty. The National Registry Board of Directors will set the passing standard after reviewing the results of a standard-setting study, which will provide a recommendation from a panel of SMEs, including BLS Clinicians, Practitioners, and Educators.
No, recertification is a separate process that takes place after initial certification.

Additional Information

Important Dates 

DATESEVENTS
December 12, 2024 NAEMSE Webinar BLS New Examination Blueprint Launch
Webinar 1
You can now view this webinar via NAEMSE's YouTube Channel. 
January 23, 2025 NAEMSE Webinar BLS New Examination Blueprint Launch
Webinar 2
You can now view this webinar via NAEMSE's YouTube Channel.