Table of Contents
| ► IMPORTANT TIMELINES AND INFORMATION |
| ► ABOUT THE EXAMINATIONS |
| ► NOVEL ITEM CLASSES USED IN THE ASSESSMENT OF EMRS/EMTS |
| ► FREQUENTLY ASKED QUESTIONS |
| ► ADDITIONAL INFORMATION |
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.
|
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 Domain | Percent 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% |
New EMT Certification Examination Domain Information
| Content Domain | Percent 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% |
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
When will the new BLS (EMR and EMT) Certification Examinations go live?
The BLS Certification Examinations went live April 7, 2025.
Why is the National Registry making this change?
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.
The BLS Practice Analysis summary document can be found here.
Why is my Authorization to test (ATT) valid for less than 90 days?
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.
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.
Why didn’t you make this change at the same time as the new ALS examinations?
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.
How will the new EMR and EMT Certification Examinations be different from the current ones?
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:
Each test question aligns with the specific tasks EMRs and EMTs are expected to perform within each domain. The knowledge measured in the current domains is now integrated into the primary responsibilities outlined in the new domains, based on feedback from SMEs. For instance, the emphasis on the Primary Assessment domain highlights the critical skill of conducting thorough patient assessments, such as evaluating the airway.
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% |
Each test question aligns with the specific tasks EMRs and EMTs are expected to perform within each domain. The knowledge measured in the current domains is now integrated into the primary responsibilities outlined in the new domains, based on feedback from SMEs. For instance, the emphasis on the Primary Assessment domain highlights the critical skill of conducting thorough patient assessments, such as evaluating the airway.
Why is there still a psychomotor examination for BLS, but not for ALS?
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.
Will the cost of the new examination increase?
No. The fee will not increase.
How many questions will be on the new examination?
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 |
What is the final date to take the current BLS Certification Examination?
The new BLS Certification Examinations went live on April 7, 2025. The last date for the prior examinations was April 4, 2025.
Will the new examinations still be administered by Pearson VUE and remote proctored (OnVUE)?
Yes, the examinations will continue to be administered in the same way.
Will the number attempts permitted change with the new examinations?
No, the testing and retesting process will remain the same.
Will the changes make it easier or harder to gain National Registry certification?
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.
Will this affect recertification?
No, recertification is a separate process that takes place after initial certification.
Additional Information
Important Dates
| DATES | EVENTS |
| 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. |