National Registry of EMTs

Emergency Medical Responder

Emergency Medical Responders provide immediate lifesaving care to critical patients who access the emergency medical services system. EMRs have the knowledge and skills necessary to provide immediate lifesaving interventions while awaiting additional EMS resources to arrive. EMRs also provide assistance to higher-level personnel at the scene of emergencies and during transport. Emergency Medical Responders are a vital part of the comprehensive EMS response. Under medical oversight, Emergency Medical Responders perform basic interventions with minimal equipment.
[From the: National EMS Scope of Practice Model]

How to become a Nationally Certified Emergency Medical Responder?

Individuals applying for Emergency Medical Responder certification must meet the following requirements:

  1. Successful completion of a state-approved Emergency Medical Responder (EMR) course that meets or exceeds the National Emergency Medical Services Education Standards for the Emergency Medical Responder.
    • Candidates must have completed the course within the past two years and the course Program Director must verify successful course completion on the NREMT website.
    • If the Emergency Medical Responder (EMR) completed an initial educational program more than two years ago, and the candidate is currently state licensed at the EMR level, the candidate must document successful completion of a state-approved EMR refresher course or 12 hours of equivalent continuing education topic hours within the past two years.
    • If the candidate is not currently state licensed as an EMR and it has been more than two years from the completion of an approved EMR course, the candidate must complete a new state-approved EMR course prior to applying for National Certification.
  2. Have a current CPR-BLS for Healthcare Providers or equivalent credential.
  3. completion of a state-approved Emergency Medical Responder (EMR) psychomotor exam.
    • Some states integrate the EMR psychomotor exam into the EMR course. Candidates should contact their State EMS Office or course instructor for guidance on their local psychomotor exam requirements.
  4. Successful completion of the EMR Cognitive Exam

Application Process

  • Create an account/login profile on this website.
  • Submit a NREMT application and answer all questions truthfully.
  • The NREMT may deny certification or take other appropriate actions in regards to applicants for certification or recertification when a criminal conviction has occurred.
  • Pay the application fee of $75.00 (US funds). The application fee is non-transferable and non-refundable. This fee is charged for each attempt of the cognitive examination.
  • Candidates will receive an electronic Authorization to Test (ATT) once you are eligible for the exam. The electronic ATT contains scheduling instructions and important details concerning proper identification required at testing centers. You can find the ATT in the 'Check Application Status' page.

Certification Process

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 up to a twelve (12) month period, provided all other requirements for NREMR certification are met.

The Cognitive Exam Apply For A Cognitive Exam

The NREMT Emergency Medical Responder (EMR) cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the Emergency Medical Responder (EMR) exam will range from 90 to 110, and 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; 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, candidates 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.

We strongly encourage candidates to review the following information:

EMR Cognitive Exam Test Plan

Based on the most recent practice analysis, the NREMT Board approves a cognitive exam test plan. A test plan is a blue-print that tells the computer testing software how to build a candidate's exam. The table below indicates what percent of the test will focus on each topic area.

Content Area Percent of Exam Adult / Pediatric Mix
Airway, Respiration & Ventilation 18%-22% 85% Adult; 15% Pediatric
Cardiology & Resuscitation 20%-24% 85% Adult; 15% Pediatric
Trauma 15%-19% 85% Adult; 15% Pediatric
Medical; Obstetrics & Gyn 27%-31% 85% Adult; 15% Pediatric
EMS Ops 11%-15% N/A

Cognitive Exam Retest Information

If a candidate is not successful in passing the cognitive exam, the NREMT will provide a candidate feedback on their performance. Candidates may apply to retest 15 days after the 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

Emergency Medical Responder psychomotor examinations are not scheduled by the NREMT. All EMR psychomotor exams are administered by either the State EMS Office or at the training institution (with approval and oversight provided by the State EMS Office). EMR course instructors should provide candidates information regarding this examination.

All Nationally Certified Emergency Medical Responders are required to demonstrate proficiency on the following skills:

Expiration Dates

Initial expiration dates are determined by the date the candidate successfully completes the entire national certification process (cognitive and psychomotor exams). EMR candidates completing the national certification process between the January 1 and June 30 will receive an expiration date of September 30 two years in the future. Individuals successfully completing the national certification process between July 1 and December 31 will receive an expiration date of September 30 three years in the future.

Expiration Dates

Initial Certification

Initial Cycle

If you successfully completed the national certification process between: Your initial certification date will be September 30
January 01-June 30 2 years in the future
July 1-December 31 3 years in the future

How do I recertify?

Detailed information about the recertification process for Emergency Medical Responders is on the EMR Recertification Page.

Lapsed EMR Certification

Lapsed 0-24 Months

If the EMR did not meet all recertification requirements by the expiration date, the National EMS certification is considered to be lapsed. If the certification lapsed less than two years, or you are currently state licensed as an Emergency Medical Responder (EMR), you can regain National EMS Certification by completing the cognitive and psychomotor examinations.

To obtain authorization to test, lapsed EMRs must demonstrate proof of education requirements. The following methods are acceptable:

  • Complete a Traditional State Approved EMR Refresher
  • State approved continuing education equal to the EMR Refresher
  • If the EMR was licensed in a NCCP state, completion of the National Component meets the requirement

Lapsed More Than 2 Years

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.

Frequently Asked Questions

Responsibilities of Nationally Certified EMS Personnel

Certified Emergency Medical Responders (EMRs) must notify the NREMT within 30 days regarding the following matters:

  • change in mailing address (the best way to update a mailing address is by editing the user profile page)
  • any criminal 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.

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.

Americans with Disabilities Act

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.

Cognitive Exam
Exam Type: Computer Adaptive
Questions: 90-110
Time Limit: 1 hour, 45 min
EMR Info
Cognitive Exam Fee: $75
(Per exam attempt)
Renewal Fee: $10
Late Fee: $50 Renewal Fee
Age: Any Age