Emergency Medical Technicians (EMT)

Emergency Medical Technicians provide out of hospital emergency medical care and transportation for critical and emergent patients who access the emergency medical services (EMS) system. EMTs have the basic knowledge and skills necessary to stabilize and safely transport patients ranging from non-emergency and routine medical transports to life threatening emergencies. Emergency Medical Technicians function as part of a comprehensive EMS response system, under medical oversight. Emergency Medical Technicians perform interventions with the basic equipment typically found on an ambulance. Emergency Medical Technicians are a critical link between the scene of an emergency and the health care system. 

Certification Process

 

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

  1. 18 years of age or older

  2. Successful completion of a state-approved Emergency Medical Technician (EMT) course that meets or exceeds the National Emergency Medical Services Education Standards for the Emergency Medical Technician.

    • Candidates must have completed the course within the past two years and the course Program Director must verify successful course completion on the National Registry website.

  3. Have a current CPR-BLS for "Healthcare Provider" or equivalent credential.

  4. Successful completion of the National Registry cognitive (knowledge) and a state approved psychomotor (skills) exams.

    • Passed portions of each examination (cognitive and psychomotor) remain valid for 24 months. This policy is effective for candidates with a course completion date on or after November 1, 2018. For candidates with a course completion date prior to November 1, 2018, passed portions of each examination is valid for 12 months.

Notes

  • If the initial Emergency Medical Technician (EMT) educational program was completed more than two years ago, and the candidate is currently state licensed at the EMT level, the candidate must document successful completion of a state-approved EMT refresher course or 24 hours of equivalent continuing education topic hours within the past two years.

  • If the candidate is not currently state licensed as an EMT and it has been more than two years from the completion of an approved EMT course, the candidate must complete a new state-approved EMT course prior to applying for National Certification.

Application Process

  • Create an account/login profile on this website.

  • Submit a National Registry application and answer all questions truthfully.

  • The National Registry may deny certification or take other appropriate actions in regards to applicants for certification or re-certification when a criminal conviction has occurred.

  • Pay the application fee of $80 (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.

 

Responsibilities of Nationally Certified EMS Personnel

 

Certified Emergency Medical Technicians (EMTs) must notify the National Registry 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 National Registry considers the individual to be solely responsible for their certification.

 

Disciplinary Policy and Rights of Appeal 

 

The National Registry has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the National Registry Disciplinary Policy and Rights of Appeal can be found here

 

Americans with Disabilities Act

 

The National Registry 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 National Registry Accommodations Disability Policy can be found here.

 

The Cognitive Exam

 

The National Registry Emergency Medical Technician (EMT) cognitive exam is a computer adaptive test (CAT). The number of items a candidate can expect on the EMT exam will range from 70 to 120. Each exam will have between 60 to 110 ‘live’ items that count toward the final score. The exam will also have 10 pilot questions that do not affect the final score. The maximum amount of time given to complete the exam is 2 hours.

 

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:

 

 

EMT Cognitive Exam Test Plan

 

Based on the most recent practice analysis, the National Registry 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

  • Airway, Respiration & Ventilation 

  • Cardiology & Resuscitation 

  • Trauma 

  • Medical; Obstetrics & Gynecology 

  • EMS Operations 

Percent of Exam

  • 18%-22% 

  • 20%-24% 

  • 14%-18%

  • 27%-31% 

  • 10%-14%

Adult / Pediatric Mix

  • 85% Adult; 15% Pediatric

  • 85% Adult; 15% Pediatric

  • 85% Adult; 15% Pediatric

  • 85% Adult; 15% Pediatric

  • N/A

Cognitive Exam Retest Information

 

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

 

Candidates are given a total of six opportunities to pass the EMT cognitive examination, provided all other requirements for National EMS Certification are met. After three attempts, candidates must submit official documentation verifying completion of remedial training. Remedial training must be completed by a state approved instructor or an approved CAPCE course. After remedial training is complete, the candidate is given three additional attempts to pass the EMT cognitive exam, provided all other requirements for National Certification are met. Candidates who fail to pass after a total of six attempts are required to repeat the entire EMT course.

 

Remedial Training Requirements

 

The EMT remedial training requirement can be satisfied through three different options:

  1. Traditional Refresher Course: Completion of a State or CAPCE(F1, F2, F5) approved 24 hour EMT refresher course.

  2. NCCR 20 hours of continuing education: Completion of the 20 hour National Competency Component from the NCCP model.

  3. Continuing education topic hours: EMT remedial may be completed by continuing education* and must include the topics and hours listed here under Traditional Model.

Note: Some states require the traditional refresher course and will not accept continuing education hours. Please refer to your state's particular requirements. A maximum number of 10 hours can be applied from Distributive Education towards this section and must be state or CAPCE approved.

The Psychomotor Exam 

 

Throughout your Emergency Medical Technician (EMT) educational program you must demonstrate competence in a wide range of emergency care skills. Your instructor must attest that you have demonstrated competence in the following skills during your course: patient assessment/management of a trauma patient, patient assessment/management of a medical patient, cardiac arrest management/AED, bag-valve-mask ventilation of an apneic patient, spinal immobilization (both seated and supine patient), long bone fracture immobilization, joint dislocation immobilization, traction splinting, bleeding control/shock management, upper airway adjuncts and suction, mouth-to-mouth ventilation with supplemental oxygen, and supplemental oxygen administration to a breathing patient. 

 

You must also successfully complete a state-approved Emergency Medical Technician (EMT) psychomotor examination. Speak with your instructor or State EMS Office about the format and logistics of completing a state-approved Emergency Medical Technician (EMT) psychomotor exam. 

 

Emergency Medical Technician psychomotor examinations are not administered by the National Registry. All EMT 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). EMT course instructors should provide candidates information regarding this examination.

 

The following performance checklists are a guide for the verification of required skills. The State EMS Office or training institution may use different forms.

 

Patient Assessment / Management - Trauma 

Patient Assessment / Management - Medical 

BVM Ventilation of an Apneic Adult Patient 

Oxygen Administration by Non-Rebreather Mask 

Spinal Immobilization (Seated Patient) 

Spinal Immobilization (Supine Patient) 

Bleeding Control / Shock Management 

Cardiac Arrest Management / AED 

Joint Immobilization 

Long Bone Immobilization 

Advanced Emergency Medical Technicians (AEMT)

The primary focus of the Advanced Emergency Medical Technician is to provide basic and limited advanced emergency medical care and transportation for critical and emergent patients who access the emergency medical system. This individual possesses the basic knowledge and skills necessary to provide patient care and transportation. Advanced Emergency Medical Technicians function as part of a comprehensive EMS response, under medical oversight. Advanced Emergency Medical Technicians perform interventions with the basic and advanced equipment typically found on an ambulance. The Advanced Emergency Medical Technician is a link from the scene to the emergency health care system. 

[From the: National EMS Scope of Practice Model]

Certification Process

 

Individuals applying for the Advanced-Emergency Medical Technician national certification must meet the following requirements:

  1. 18 years of age or older

  2. Current National Registry certification (NREMT) or state license at the EMT level, or a higher

  3. Successful completion of a state-approved Advanced Emergency Medical Technician (AEMT) course that meets or exceeds the National Emergency Medical Services Education Standards for the Advanced Emergency Medical Technician.

    • Candidates must have completed the course within the past two years and the course Program Director must verify successful course completion on the National Registry website. 

  4. Have a current CPR-BLS for "Healthcare Provider" or equivalent credential.

  5. Successful completion of the National Registry cognitive (knowledge) and psychomotor (skills) exams.

    • Passed portions of each examination (cognitive and psychomotor) remain valid for 24 months. This policy is effective for candidates with a course completion date on or after November 1, 2018. For candidates with a course completion date prior to November 1, 2018, passed portions of each examination is valid for 12 months.

Notes

  • If the initial Advanced Emergency Medical Technician (AEMT) educational program was completed more than two years ago, and the candidate is currently state licensed at the AEMT level, the candidate must document successful completion of a state-approved AEMT refresher course or 36 hours of equivalent continuing education topic hours within the past two years.

  • If the candidate is not currently state licensed as an AEMT and it has been more than two years from the completion of an approved AEMT course, the candidate must complete a new state-approved AEMT course prior to applying for National Certification.

 

Application Process

  • Create an account/login profile on this website.

  • Submit a National Registry application and answer all questions truthfully.

  • The National Registry 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 $115 (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.

 

Responsibilities of Nationally Certified EMS Personnel

 

Certified Advanced Emergency Medical Technicians (EMTs) must notify the National Registry 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 National Registry considers the individual to be solely responsible for their certification.

 

Disciplinary Policy and Rights of Appeal

 

The National Registry has disciplinary procedures, rights of appeal and due process within its policies. Complete information about the National Registry Disciplinary Policy and Rights of Appeal can be found here.

 

Americans with Disabilities Act

 

The National Registry 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 National Registry Accommodations Disability Policy can be found here.

 

The Cognitive Exam

 

The National Registry Advanced Emergency Medical Technician (EMT) cognitive exam is a linear computer based test (CBT). Each candidate will answer 135 questions (items). Each exam will have 100 ‘live’ items that count toward the final score. The exam will also have 35 pilot questions that do not affect the final score. The maximum amount of time given to complete the exam is 2 hours and 15 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:

Advanced EMT Cognitive Exam Test Plan

 

Based on the most recent practice analysis, the National Registry 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 

  • Airway, Respiration & Ventilation 

  • Cardiology & Resuscitation 

  • Trauma 

  • Medical; Obstetrics & Gynecology

  • EMS Operations

 Percent of Exam

  • 18%-22%

  • 21%-25%

  • 14%-18%

  • 26%-30%

  • 11%-15%

 Adult / Pediatric Mix

  • 85% Adult; 15% Pediatric

  •  85% Adult; 15% Pediatric

  • 85% Adult; 15% Pediatric

  •  85% Adult; 15% Pediatric

  •  N/A

Cognitive Exam Retest Information

 

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

 

Candidates are given a total of six opportunities to pass the Advanced EMT cognitive examination, provided all other requirements for National EMS Certification are met. After three attempts, candidates must submit official documentation verifying completion of remedial training. Remedial training must be completed by a state approved instructor or an approved CAPCE course. After remedial training is complete, the candidate is given three additional attempts to pass the Advanced EMT cognitive exam, provided all other requirements for National Certification are met. Candidates who fail to pass after a total of six attempts are required to repeat the entire Advanced EMT course.

 

Remedial Training Requirements

 

The Advanced EMT remedial training requirement can be satisfied through three different options:

  1. Traditional refresher course: Completion of a State or CAPCE(F1, F2, F5) approved 36 hour AEMT refresher course.

  2. NCCR 25 hours of continuing education: Completion of the 25 hour National Competency Component from the NCCP model.

  3. Continuing education topic hours: Advanced EMT remedial may be completed by continuing education* and must include the topics and hours listed here under Traditional Model.

Note: Some states require the traditional refresher course and will not accept continuing education hours. Please refer to your state's particular requirements. A maximum number of 10 hours can be applied from Distributive Education towards this section and must be state or CAPCE approved.

The Psychomotor Exam

 

The Advanced EMT psychomotor examination consists of ten skills presented in a scenario-type format. All skills have been developed in accordance with the U.S. Department of Transportation National EMS Education Standards (EMT and/or AEMT), the American Heart Association Guidelines for CPR and ECC, and the U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Trauma Triage Protocol.

 

The psychomotor examination process is a formal verification of the candidate's "hands-on" abilities and knowledge. Apart from Pass or Fail, candidates are not provided with specific feedback regarding their exam performance.

 

Advanced Emergency Medical Technicians are required to demonstrate proficiency on the following skills:

 

Patient Assessment-Trauma

 

Patient Assessment - Trauma 

 

Candidates are required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a simulated patient for a given scenario, including:

  • Scene Size-Up

  • Initial Assessment/Resuscitation

  • Focused History and Physical Examination - Rapid Trauma Assessment

  • Detailed Physical Examination

Patient Assessment-Medical

 

Patient Assessment - Medical 

 

Candidates are required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a simulated patient for a given scenario, including:

  • Scene Size-Up

  • Initial Assessment/Resuscitation

  • Focused History and Physical Examination - Rapid Trauma Assessment

  • On-Going Assessment

Ventilatory Management

 

Supraglottic Airway Device 

Pediatric Respiratory Compromise 

 

Candidates are evaluated over the following two (2) ventilatory management scenarios:

  • Apneic Adult

Given a scenario of having just found an apneic adult patient with a palpable carotid pulse, candidates must demonstrate immediate management of the patient using simple airway maneuvers and adjuncts, bag-valve-mask device, and supplemental oxygen, followed by the placement of a supraglottic airway device (King®,Combitube®, etc.).

  • Pediatric Respiratory Compromise

Given a scenario with an infant in respiratory distress, candidates must demonstrate immediate management of the patient using simple airway maneuvers, adjuncts, and supplemental oxygen. You will then be required to demonstrate bag-valve-mask ventilation as the patient progresses from respiratory distress to respiratory failure.

 

Cardiac Arrest Management/AED

 

Cardiac Arrest Management 

 

Candidates will be evaluated on their ability to manage a cardiac arrest situation the proper use of an AED and 1-rescuer CPR.

 

IV and Medication Skills

 

Intravenous Therapy- Bolus

 

Intravenous Therapy: Candidates are required to establish a patent IV in a manikin arm in accordance with a given scenario. 

Intravenous Bolus Medications: After establishing a patient IV line, candidates must administer an IV bolus of medication in accordance with a given scenario.

 

Pediatric Intraosseous Infusion Skills

 

Pediatric Intraosseous Infusion 

 

Candidates are required to establish an intraosseous line in a pediatric IO manikin. (Manual insertion with a Jamshidi® needle or battery-powered drill-type devices are permitted.)

 

Spinal Immobilization (Supine Patient)

 

Spinal Immobilization - Supine 

 

Candidates are required to immobilize an adult patient who is found supine with a suspected unstable spine using a long spine immobilization device. An EMT assistant will be provided, but the candidate is responsible for communicating with and directing the EMT assistant.

 

Random EMT Skills

 

Each candidate will be evaluated on one of the following randomly selected EMT skills.

 

Psychomotor Exam Retest Information

 

Advanced Emergency Medical Technician candidates are allowed two (2) full attempts to pass the psychomotor examination (one "full attempt" is defined as completing all skills and two retesting opportunities if so entitled).

 

Candidates are eligible to retest four (4) or less skills when taking a full attempt of the psychomotor examination. Candidates are eligible for two (2) retest attempts of the four (4) or less skills failed for no more than twenty four(24) months from the date of the examination, provided they meet all other current requirements for National EMS Certification. If offered, only one (1) retest attempt may be completed on the same day. Candidates not completing the failed portion of the examination within that twenty four(24) month period will be required to repeat the invalid portion. Failure of any skill on the second retest attempt constitutes complete failure of the entire psychomotor examination. Candidates who fail five (5) or more skills have failed the entire psychomotor examination. Candidates who fail the entire psychomotor examination must submit official documentation of remedial education before attempting the entire psychomotor examination (all ten [10] skills) on their second and final attempt of the psychomotor examination. Passed National Registry examination results are valid for up to twenty four(24) months from the date of the examination, provided all other “Entry Requirements” of the National Registry are met.

 

Should a candidate fail the second full and final attempt of the psychomotor examination, the candidate must complete a new, state approved Advanced Emergency Medical Technician Training Program.

© 2018 by Rhode Island Community Training Center

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