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History of the NREMT

It has been nearly four decades since President Lyndon Johnson's Committee on Highway Traffic Safety recommended the creation of a national certification agency to establish uniform standards for training and examination of personnel active in the delivery of emergency ambulance service. The result of this recommendation was the inception of the National Registry of Emergency Medical Technicians (NREMT) in 1970.

Since that time, pre-hospital emergency medical care has continually evolved and improved. The EMT has been acknowledged as a bonafide member of the health care team. Excellent training programs have been developed and a vital focus has been placed on continuing education. National standards have been established. Ambulance equipment essentials have been set.† National accreditation of paramedic programs has been achieved, and professional associations for the EMT have been organized.

Through every change, the NREMT has remained steadfast in upholding its mission to provide a valid, uniform process to assess the knowledge and skills required for competent practice required by professionals throughout their careers and by maintaining a registry of certification status.

The organization has done what was necessary to establish, implement and maintain uniform requirements for the certification and recertification of emergency medical technicians. The NREMT has also been involved in numerous national projects and its staff participates on major national committees, playing an active part in the ever-continuing process of improving standards of emergency medical services.

Click on the decades below to read about the milestones in the NREMTís history.


President Lyndon Johnson's Committee on Highway Traffic Safety recommends the creation of a national certification agency to establish uniform standards for training and examination of personnel active in the delivery of emergency ambulance service. This resulted in the appointment of a Task Force by the American Medical Association's Commission on EMS to study the feasibility of a National Registry for EMTs. The Task Force was headed by Oscar P. Hampton, Jr., M.D., a physician recognized for his pioneering work with the American College of Surgeonsí Committee on Trauma.


Representatives of organizations actively involved in emergency medical service attend the first meeting of the Task Force on January 21, 1970. Organizations invited to participate were:

  • Ambulance Association of America

  • International Association of Fire Chiefs

  • International Rescue and First Aid Association

  • National Ambulance and Medical Services Association

  • National Forest Service

  • National Funeral Directors Association

  • National Park Service

  • National Safety Council

  • National Ski Patrol

  • American Heart Association

  • International Association of Chiefs of Police

The Task Force met only three times to draft bylaws, determine the composition of the Board, discuss funding, and tackle a myriad of other concerns inherent in the birth of the new certifying agency.

On June 4, 1970, the Task Force was dissolved and was immediately reconvened as the first meeting of the Board of Directors of the National Registry of Emergency Medical Technicians. Roddy A. Brandes of the Ambulance Association of America was elected the Board's first Chairman.


Rocco V. Morando is selected as NREMT's founding Executive Director.

The first basic NREMT-Ambulance exam is administered simultaneously to 1,520 ambulance personnel at 51 test sites throughout the U.S. This event marked the beginning of National Board Certification for the nation's Emergency Medical Technicians.


The first recertification of a Nationally Registered EMT is processed.


The NREMT calls a meeting of national EMT-Paramedic leaders and educators to develop initial guidelines for the national EMT-Paramedic curriculum.


Continuing education requirements for recertification are established for EMT-Ambulance and EMT-Non Ambulance personnel.

The NREMT is instrumental in the formation of the National Association of Emergency Medical Technicians.

A brief prepared by the NREMT is reviewed and accepted by the American Medical Association's Committee on Health Manpower, resulting in the addition of EMT-Paramedic to the list of approved health occupations and the subsequent Council of Allied Health Education and Accreditation (C.A.H.E.A.) procedure.


The NREMT contracts with the University of Kansas to develop and pilot test written and practical examinations for the EMT-Paramedic.

National curriculum for paramedic training is developed in conjunction with leading EMS agencies and the University of Pittsburgh.

A multi-media, audiovisual teaching package is produced by the NREMT to train examiners in the administration of an objective practical performance examination for the EMT-Ambulance.


The First NREMT-Paramedic exam is given in Minneapolis, MN.

The Registry becomes a member of the National Commission for Health Certifying Agencies.


Continuing education requirements for recertification are established for EMT-Paramedics.

As a member of the C.A.H.E.A. Joint Review Committee, the Registry helps to develop essentials and guidelines for the accreditation of educational training sites for the EMT-Paramedic.

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Guidelines and examination for the EMT-Intermediate are developed.

The NREMT breaks ground on a new headquarters at 6610 Busch Boulevard in Columbus, Ohio, to house the growing organization.

The first NREMT-Intermediate exam is given in Jackson, Mississippi.


The NREMTís new headquarters were dedicated on June 23.


For the first time, two versions of the EMT-Ambulance exam are introduced, reducing the possibility of exam compromise.


Free-standing EMT-Intermediate written and practical examinations are developed and implemented.


The NREMT exams are now used by 24 states and territories as the sole basis for certification at one or more levels. An additional 15 states and territories accept NREMT exams in lieu of their state examinations, at one or more levels.

The NREMT becomes an active participant in a research project conducted by the National Council of State EMS Training Coordinators to collect data and determine the need for standards and guidelines for the EMT-Defibrillator level of care.


The NREMT incorporates all new standards of the American Heart Association into the examinations at all three levels of certification.

The U.S. Department of Defense develops and disseminates Directive No. 6000.10 on Emergency Medical Services which states, "All EMS health care personnel working in an emergency care area shall have current certification in Basic Life Support. Technicians or hospital corpsman working in EMS and/or assigned to ambulance duty shall have a minimum of EMT-A certification from the National Registry of EMTs."


The NREMT adopts examination blueprint changes to meet the newly released National Standard EMT-Intermediate and EMT-Paramedic Curricula as developed and promulgated by the U.S. Department of Transportation.

The NREMT begins to include appropriate questions related to criminal convictions on all applications for initial certification and recertification.

New examinations are written and used at the EMT-Intermediate level according to the U.S. Department of Transportationís EMT-Intermediate curriculum.


NREMT Executive Director Rocco V. Morando retires but continues his service as Executive Consultant to the Board of Directors.

The NREMT headquarter building is renamed the Rocco V. Morando Building.

The NREMT accepts its 300,000th EMT-Ambulance application.


William E. Brown, Jr., RN, MS, CEN, NREMT-P assumes the position of Executive Director.

All branches of the U.S. military begin to comply with the Department of Defense Directive requiring National Registration for EMTs in the military.

A new category, EMT-Basic, is established, combining EMT-Ambulance and EMT-Non-Ambulance.

The National Association of State Emergency Medical Services Directors replaces the International Association of Chiefs of Police on the Board of Directors.

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The NREMT participate in the revision of the U.S. Department of Transportationís EMT-Basic curriculum.


The NREMT implements a scientifically developed policy to accommodate candidates with learning disabilities in accordance with the Americans with Disabilities Act.

The Board of Directors approves funding for a National EMT Training Blueprint project and study design for a knowledge and skills retention study.


The NREMT endorsed the EMS Education and Practice Blueprint.

The NREMT votes to support the Commission on Accreditation of Allied Health Education Programs, which replaced the American Medical Associations Committee on Allied Health Accreditation as the sponsoring body for accreditation.


The NREMT conducts a Practice Analysis study to determine key areas required for practice. All exams are updated based on the data obtained from this study.


The NREMT installs a new computer system which improves communications with state offices

The NREMT begins registration of First Responders.

The NREMT works with the Center for Emergency Medicine of Western Pennsylvania on revision of the EMT-Intermediate and EMT-Paramedic curricula.


The NREMT Board approves formation of the Longitudinal EMT Attribute Demographic Study (LEADS) project committee to learn more about the important issues facing EMS personnel and to help identify the critical issues affecting the profession.


The NREMT Mission Statement is adopted -- To certify and register Emergency Medical Services Professionals throughout their careers by a valid and uniform process to assess the knowledge and skills for competent practice.

The NREMT adopts the EMT-Intermediate/99 level and retains Registry certification of the EMT-Intermediate/85 until completion of the EMS Education Agenda for the Future process has been completed.

The LEADS committee completes first survey and snapshot on EMS education.

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The Board of Directors adopts a Strategic Plan to help guide the direction of the organization.

The LEADS committee completes second survey and snapshot on EMS work life.


The NREMT exams are now used by 43 states and territories as the sole basis for certification at one or more levels.

The LEADS committee completes third survey and snapshot on EMS compensation.


The NREMT increases fees for the first time since 1973.

The LEADS committee completes fourth survey and snapshot on EMS driving safety and health risk.


The NREMT implements a Research Program for the betterment of NREMT programs and to contribute to the EMS community.

The NREMT receives accreditation of all five levels of exams from the National Commission for Certifying Agencies, a certification accrediting agency sponsored by the National Organization for Competency Assurance.

The LEADS committee completes fifth survey and a post 9/11 survey.


The LEADS committee completes sixth survey and snapshot on ambulance safety.


The NREMT exams are now used by 46 states and territories as the sole basis for certification at one or more levels.

The NREMT begins the process to transition from pencil-and-paper based exams to computer based testing in January 2007.

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