The National Registry of Emergency Medical Technicians (NREMT) was established in 1970 in response to a suggestion of the U.S. Committee on Highway Safety. Today, the NREMT is an independent, not-for-profit agency whose job is to certify that EMTs have the knowledge and skills to do their job—to save lives and preserve health. By setting uniform national standards for training, testing, and continuing education, the NREMT helps ensure patient safety throughout the United States.
In some states, the NREMT certification process is the only licensure process for EMTs. Other states have their own testing procedures. (A list of specific certification requirements for all 50 states,Washington,D.C., Puerto Rico, and the U.S. Virgin Islands appears in Chapter 8.) Nearly all states and U.S. territories base their curriculum and tests on the U.S. Department of Transportation’s 1994 National Standard Curriculum for EMT-Basics. The NREMT exam uses the same curriculum to guide the construction of exam questions. Therefore, whether you will be taking a state test or the NREMT test, you will be learning and studying similar material. This book is based on the NREMT cognitive examination.
Minimum Requirements
To apply for national registration as an EMT-Basic with the NREMT, you must meet the following requirements:
- You must be at least 18 years old.
- You must have successfully completed a stateapproved National Standard EMT-Basic training program within the last two years.
- If your state does not require national EMT-Basic registration, you must obtain official documentation of your current state EMT-Basic certification.
- You must have successfully completed all sections of a state-approved EMT-Basic practical exam within the past 12 months. This exam must equal or exceed all the criteria established by the National Registry.
- You must complete the felony statement on the application and submit the required documentation.
- You must submit current cardiopulmonary resuscitation (CPR) credentials from either the American Heart Association or the American Red Cross.
- You must submit an acceptable application attesting to the satisfaction of the previous requirements.
- You must send a $70 nonrefundable/ nontransferable application fee (money order only). All fees must be made payable to the National Registry of Emergency Medical Technicians and submitted with the application to cover processing of the application.
- You must successfully complete the National Registry EMT-Basic cognitive examination.
How to Apply
When you have met all the requirements and are ready to take the exam, contact the NREMT to obtain an application and to find out where you can take the test in your state.Write or call the NREMT at:
National Registry of Emergency Medical Technicians
P.O. Box 29233 Columbus, OH 43229
614-888-4484
When you contact the National Registry, you will find out whether the examination is administered through your state EMT office or whether you need to make individual arrangements to take the exam.
Finally, you must submit an application to the National Registry stating that you have met all the requirements, accompanied by the registration fee. You can also fill out an NREMT application online by going to:
http://www.nremt.org/EMT Services/candidate_application.asp.
The EMT-Basic Cognitive Exam
The National Registry’s EMT-Basic cognitive examination ranges from 70 to 120 items, and the maximum time allotted to take the exam is two hours from the time it begins. The exam is administered using a computer adaptive test (CAT).With the CAT method, each question is modified to fit your abilities. For example, if you answer a question correctly, the following question will be somewhat more challenging. If you answer a question incorrectly, the following question will be a bit easier. The more questions you answer correctly, the more likely you are to end the exam early. Once you complete each section of questions, the CAT will reevaluate your ability, and as the exam continues, the program will adapt to match your skill level.
The purpose of the CAT-administered cognitive exam is to find your highest ability level. The exam is pass/fail, and in order to pass, you must meet entrylevel competency. Entry-level competency is the NREMT’s criteria for an EMT-Basic candidate, which includes being able to practice carefully and capably. The exam consists of six content areas:

For more information on the EMT-Basic cognitive exam,visit http://www.nremt.org/about/about_exams.asp.
The EMT-Basic Practical Examination
When you apply for National Registry EMT-Basic registration, you will fill out an application that consists of several sections. The application requires verification of your credentials. The verification may be in the form of your program director’s electronic signature attesting to competency in the following skills:
- Patient Assessment/Management—Trauma
- Patient Assessment/Management—Medical
- Cardiac Arrest Management/AED
- Spinal Immobilization (Seated Patient)
- Spinal Immobilization (Supine Patient)
- Bag-Valve-Mask Apneic Patient with a Pulse
- Long Bone Fracture Immobilization
- Joint Dislocation Immobilization
- Traction Splinting
- Bleeding Control/Shock Management
- Upper Airway Adjuncts and Suction
- Mouth-to-Mask with Supplemental Oxygen
- Supplemental Oxygen Administration
The National Registry EMT-Basic application also requires proof that you have successfully completed a state-approved practical examination within a 12- month period. At a minimum, the exam must evaluate your performance in the following skills. To pass the practical exam, you must meet or exceed the NREMT’s criteria in the following six areas:
- Station #1: Patient Assessment/Management— Trauma
- Station #2: Patient Assessment/Management— Medical
- Station #3: Cardiac Arrest Management/AED
- Station #4: Spinal Immobilization (seated or supine patient)
- Station #5: Bag-Valve-Mask Apneic Patient with a Pulse
- Station #6: Random Skill Station. This will consist of one of the following skills:
- Long bone immobilization
- Joint dislocation immobilization
- Traction splinting
- Bleeding control/shock management
- Upper airway adjuncts and suction
- Mouth-to-mask with supplemental oxygen
- Supplemental oxygen administration
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