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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]
AEMT Certification Handbook
Recertification Information
- Current National Registry certification or state license at the EMT level, or a higher
- Successful completion of a state-approved Advanced EMT course that meets or exceeds the National Emergency Medical Services Education Standards for the Advanced EMT.
- 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.
- Have a current CPR-BLS for 'Healthcare Provider' or equivalent credential.
- Successful completion of the National Registry cognitive (knowledge) and psychomotor (skills) exams.
- Passed portions of the cognitive and psychomotor exam remain valid for 24 months. For candidates with a course completion date prior to November 1, 2018, passed portions of each examination are valid for 12 months. Provided all other entry requirements are met.
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 $136 (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 Registered EMS Personnel
Registered 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.
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
Apply For A Cognitive ExamThe 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 | Percent of Exam | Adult / Pediatric Mix |
|---|---|---|
| Airway, Respiration & Ventilation | 18%-22% | 85% Adult; 15% Pediatric |
| Cardiology & Resuscitation | 21%-25% | 85% Adult; 15% Pediatric |
| Trauma | 14%-18% | 85% Adult; 15% Pediatric |
| Medical; Obstetrics & Gynecology | 26%-30% | 85% Adult; 15% Pediatric |
| EMS Operations | 11%-15% | 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:
- Traditional refresher course: Completion of a State or CAPCE(F1, F2, F5) approved 36 hour AEMT refresher course.
- NCCR 25 hours of continuing education: Completion of the 25 hour National Competency Component from the NCCP model.
- 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
Find A Psychomotor ExamThe 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 DevicePediatric Respiratory Compromise
Candidates are evaluated over the following two 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, BVM device, and supplemental oxygen, followed by the placement of a supraglottic airway device.
- 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 BVM ventilations as the patient progresses from respiratory distress to respiratory failure.
Cardiac Arrest Management/AED
Cardiac Arrest ManagementCandidates 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 - BolusIntravenous Bolus Medications
Intravenous Therapy: Candidates are required to establish a patent IV in a manikin arm in accordance with a given scenario.
Intravenous Bolus Medications: Candidates must administer an IV bolus of medication in accordance with a given scenario.
Pediatric Intraosseous Infusion Skills
Pediatric Intraosseous InfusionCandidates 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.)
Random EMT Skills
Long Bone ImmobilizationJoint Immobilization
Bleeding Control/Shock Management
Each candidate will be evaluated on one of the following randomly selected EMT skills.
Psychomotor Exam Retest Information
Advanced EMT candidates are allowed two 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 or less skills when taking a full attempt of the psychomotor examination. Candidates are eligible for two retest attempts of the four or less skills failed. If offered, only one retest attempt may be completed on the same day. Failure of any skill on the second retest attempt constitutes complete failure of the entire psychomotor examination. Candidates who fail five or more skills have failed the entire psychomotor examination.
Candidates who fail a full attempt or any portion of a second retest attempt must submit official documentation of remedial training over all skills before starting the next full attempt of the psychomotor examination and re-examining over all nine skills, provided all other requirements for National Certification are fulfilled.
This official documentation must be signed by a Program Director, Training Officer, or Medical Director that verifies remedial training over all skills has occurred since the last unsuccessful attempt and the candidate has demonstrated competence in all skills.
Documentation may be emailed to support@nremt.org.
Should a candidate fail the second full and final attempt of the psychomotor examination, the candidate must complete a new, state approved Advanced EMT Training Program.
- Passed portions of the psychomotor examination 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.
Initial expiration dates are determined by the date the candidate successfully completes the entire national certification process (cognitive and psychomotor exams). EMT, AEMT, and Paramedic candidates completing the national certification process between the January 1 and June 30 will receive an expiration date of March 31 two years in the future. Individuals successfully completing the national certification process between July 1 and December 31 will receive an expiration date of March 31 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 March 31 | |
| January 01-June 30 | 2 years in the future | |
| July 1-December 31 | 3 years in the future | |
Lapsed 0-24 Months
Entry requirements for a currently state licensed AEMT can be found above (first bullet in the Notes section).
Reentry into the National Registry may be granted to those who previously held, but do not currently hold, a state AEMT license or a National AEMT Certification provided the candidate completes:
- 50 hours of continuing education that meets all requirements of the 2016 National Continued Competency Program within the past two years
- The National Registry Advanced Emergency Medical Technician (AEMT) Computer-Based (Cognitive) and Skills-Based (Psychomotor) Examinations
- And holds current CPR-BLS for 'Healthcare Provider' or equivalent credential
Lapsed More Than 2 Years
Reentry into the National Registry may be granted to those who previously held, but do not currently hold, a state AEMT license or a National AEMT Certification provided the candidate completes:
- 50 hours of continuing education that meets all requirements of the 2016 National Continued Competency Program within the past two years
- The National Registry Advanced Emergency Medical Technician (AEMT) Computer-Based (Cognitive) and Skills-Based (Psychomotor) Examinations
- And holds current CPR-BLS for 'Healthcare Provider' or equivalent credential
To become a certified Emergency Medical Technician, you first need to complete the EMT cognitive exam. This is a knowledge based test that measures your understanding of the fundamental principles and practices of working as an EMT.
How Do I Register for the EMT Exam?
In order to register for the test, you first need to submit an application and be approved to test. Approval depends on meeting the following criteria:
- Be 18 years of age or older
- Have completed an approved EMT training course that meets the National Emergency Medical Services Education standards
- Have your current CPR-BLS credential for “Healthcare Provider”
Be prepared to pay the $80 exam fee when you submit this application because you will not receive your Authorization To Test (ATT) until that fee is paid. And you cannot schedule your exam until you receive your ATT.
Once you have received your ATT, you have to schedule your exam for a date within the next 90 days. The exam is offered on a continuous basis and testing centers are located across the United States so you will be able to choose a date and location that are most convenient for you. However, to ensure that there are still appointments available on your preferred date, make sure you schedule as soon as possible.
How Many Questions Are On the NREMT Test?
The total number of questions you see on the test depends on your performance. It is a computer adaptive test that continually assesses your performance with each response you give. Once the computer is able to make a confident decision about your score, it will automatically stop the exam.
Basically, what this means is that you could end up answering as few as 70 questions or as many as 120 questions. The actual number depends on your performance. If you are consistently answering questions correctly and keeping your average score above a certain threshold, the computer will stop the exam and notify you that you have passed. If, however, you are consistently answering questions incorrectly and staying below a certain threshold, the test will stop and you will be notified that you did not pass.
You will have a maximum of two hours to complete the exam. Since you can’t be sure exactly how many questions you will answer, it is best to prepare as if you will be answering all 120. That means you should spend an average of one minute on any given question.
What Will I Be Tested On?
The exam questions will fall under five different content areas. Each of the questions is aimed at measuring not just your understanding of the information but your ability to apply it in realistic, on the job scenarios. The content areas are as follows:
- Airway, Respiration, and Ventilation – 18%-22% of the questions
- Cardiology and Resuscitation – 20%-24% of the questions
- Trauma – 14%-18% of the questions
- Medical, Obstetrics, and Gynecology – 27%-31% of the questions
- EMS Operations – 10%-14% of the questions
Critical Care Paramedic Practice Test
Questions will not appear in any particular order. The content areas will be mixed together and the actual balance of questions you see will depend on exactly how many questions you end up getting on the test.
When Will I Find Out If I Passed?
As mentioned above, the test will automatically stop once the computer can make a confident assessment about whether or not you have achieved a passing score. So you will know immediately after the test. However, passing the cognitive exam is not the only thing you need to do to become a certified EMT.
After passing the cognitive exam, you will next need to take a psychomotor exam. This is a practical test where you will demonstrate your ability to perform various emergency and medical procedures. After successfully completing both of these tests, you will qualify for certification.
How Much Time Should I Spend Preparing for this Exam?
You should definitely spend at least a couple of weeks preparing for this exam. The more you study, the more likely you will be able to pass without having to answer all 120 questions!
The best way to prepare for a test like the EMT cognitive exam is to use effective study aids like the Mometrix Study Guide and Mometrix Flashcards. These tools will provide with a clear and comprehensive overview of the material for all five content areas. The explanations are written in clear, easy-to-understand language by a team of experts who know this exam inside and out.
On top of that review, these tools will also provide you with lots of practice questions that will get you ready for exactly the kind of questions you are going to see on test day. Plus, the flashcards are portable so you can squeeze in extra study sessions on the go!
EMT Practice Questions
Watch this video on YouTube
EMT Study Guide
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