National Registry of Emergency Medical Technicians

The National Registry of Emergency Medical Technicians (The Registry) serves as the nation's emergency medical services certification organization. Created in 1970, The Registry is an independent, non-governmental, non-profit organization, headquartered in Columbus, Ohio. The mission of The Registry is to protect the public through national certification based on uniform standards for training and examination of EMS personnel. It exists as a way to unify EMS personnel across the United States in a uniform and standardized level of competency. By providing a National EMS Certification, the NREMT issues a validated and legally defensible attestation of competency.[1]

NREMT LOGO

History

The Registry was established in 1970 in response to a recommendation from President Lyndon Johnson's Committee on Highway Traffic Safety that a national certifying agency for Emergency Medical Technicians be created in order to establish and standardize training requirements.[2]

Mission Statement: To serve as the National EMS Certification Organization by providing a valid, uniform process to assess the knowledge and skills required for competent practice by EMS professionals throughout their careers and by maintaining a registry of certification status.

Vision Statement: Improve patient care by being the global leader in Certification for the EMS profession.

Standards

Most states use or require National Registry testing for some level of state certification.[2][3][4] The Registry recognizes four levels of EMS: EMR, EMT, EMT-Advanced, and Paramedic (some states and agencies may have additional certifications such as Critical Care Paramedic, Flight Paramedic, and Community Paramedic).[3] Registry certification at an EMT Intermediate level may or may not be sufficient for some state EMT-I requirements.[5] The paramedic and EMT-Advanced levels require an additional psychomotor component. The paramedic component also contains a twenty-minute out-of-hospital module in which the paramedic candidate must be able to show proficiency and meet required objectives during a simulated medical emergency scenario. Paramedic is the highest level of certification offered by the NREMT as well as the United States.

National Certification Levels

Nationally Registered Paramedic (NRP)

Highest level of certification through the The Registry. This represents the highest level of national certification. Paramedics are considered Advanced Life Support (ALS) and can administer a range of medication, as well as perform advanced electrical and invasive surgical interventions (please see Paramedics for a full list of skills.) In the United States, NRP Paramedics typically consist of a one-year program or two year associate degree program consisting of over 1800 hours of didactic and clinical education focusing on acute emergency stabilization and prehospital care.

Nationally Registered Advanced Emergency Medical Technician (NRAEMT)

Intermediate National Standard Curriculum as defined by the Department of Transportation - National Highway Traffic Safety Administration (NHTSA)[6] This level can also provide certain drug therapies.

Nationally Registered Emergency Medical Technician (NREMT)

This level of certification provides Basic Life Support (BLS). Provides 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.

Nationally Registered Emergency Medical Responder (NREMR)

Provides 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, although in certain states are allowed to work alongside one or more EMTs on an ambulance crew, acting as a driver and assisting the EMTs with patient care.

Testing

National EMS Certification cognitive examinations are high-stakes, computer-based examinations.[7] The EMR, EMT and Paramedic exams are computer based adaptive (CBT), while the Advanced-EMT is a computer based linear exam. The NREMT-P, or NREMT Paramedic exam, consists of a psychomotor skills test in addition to the CBT exam (which are taken on separate days). The psychomotor skills test is based on real-life or realistic scenarios and utilizes the NREMT ALS format and NREMT protocols.

Renewal

The Registry encourages all EMS personnel to maintain national certification. Recertification encourages providers to remain current in EMS knowledge and maintain proficiency. Recertification requirements increase confidence in the public, employers, and other stakeholders as to the competence of an individual and gives recognized credibility across the nation.

To learn more about The National Registry's recertification process, click here.  

Reciprocity and Statistics

As of 2019, there are 12,005 EMRs, 262,754 EMTs, 16,554 AEMTs, and 103,518 Paramedics (EMT-Ps) registered by the NREMT. 46 states require the NREMT for initial state paramedic licensure and 45 states for initial state EMT licensure.

While the purpose of NREMT is reciprocity so that an EMT has the same level of training and standards as an EMT from another state, not all states have adopted the NREMT model. Since states have widely differing protocols and governing bodies this may explain why certain states have yet to adopt the NREMT's vision of a unified, nation-wide EMS system.

Currently, 12 states do not offer reciprocity for EMT-Bs, 19 do not offer reciprocity for EMT-Is, and 12 do not offer reciprocity for EMT-Ps.[1] To become certified in a non-reciprocal state, NREMT EMS personnel may be required to additional training, a refresher course(s), a practical exam, and/or a written exam. Some states require an NREMT that is applying for interstate reciprocity to have a sponsor such as a Mobile Intensive Care Sponsor (MICU) in New Jersey or Mobile Intensive Care Training Program in Connecticut.

See also

References
  1. "National Registry of EMTs". National Registry of EMTs. Retrieved 2019-07-11.
  2. NREMT History
  3. Emergency Medical Technician from US Bureau of Labor Statistics
  4. "Emergency Medical Technicians" from University of Missouri, St. Louis
  5. Colorado EMT requirement overview
  6. DOT Standards for EMT-I
  7. Kyung, Tyek Han (17 August 2018). "Conducting simulation studies for computerized adaptive testing using SimulCAT: an instructional piece". Educational Evaluation for Health Professionals. 15: 20. doi:10.3352/jeehp.2018.15.20. PMC 6194482. PMID 30114899.
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