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"The National Registry of Emergency Medical Technicians"(NREMT) registers emergency medical services providers from across the nation. The NREMT is a non-profit, non-governmental, stand alone agency led by a Board of Directors. The Board of Directors consists of members from National Emergency Medical Services (EMS) organizations and of those with expertise in EMS systems.
The National Registry develops a system of registration and re-registration based upon data when available and the general agreement of the board when data is absent. The Registry began in 1970 and has examined over 750,000 Emergency Medical Technicians (EMT's) in this country since then. Currently there are approximately 155,000 EMT's who have met the NREMT requirements. The NREMT registers EMS providers at four levels: First Responder, EMT-Basic, EMT-Intermediate and EMT-Paramedic.
Registration is given to EMT's who meet current entry requirements, including passing written and performance examinations. Registration continues when the registrant completes his/her required education and experience requirements and forwards the required applications to the NREMT. This is done on a bi-annual basis.
The NREMT's registration services are part of the licensure process for EMT's in 39 states. The Registry works closely or directly with State Offices of EMS in all 50 states to accomplish their mission.The most important functions of the NREMT are examination development and administration. The NREMT takes great effort to assure examinations are fair both to the public and to the student taking the exam. The NREMT stresses cost effectiveness, mission direction and information in development of policies, procedures, and methods. The Registry takes very seriously it's responsibility to help protect the public by identifying EMS providers who can safely and effectively practice.
"First Responder Registration Entry Requirements"
All individuals applying for First Responder registration must meet the following
requirements to be eligible for national registration.1. Successfully complete, within the last two years, an approved National Standard First Responder education program, as developed and put into operation by the U. S. Department of Transportation.
2. Individuals are required to have successfully completed (within the last two years) all sections of an approved First Responder practical examination that equals or exceeds the criteria established by the U. S. Department of Transportation, First Responder Final Practical Skills Exam, including One and Two Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway.
3. A registration fee of $15.00 (money order or institutional check), payable to the National Registry of Emergency Medical Technicians, must be submitted with the application. This fee covers the cost of all printed material, examination, postage, data processing, reporting of results, a wallet card, certificate, Registry First Responder emblem and newsletters.
4. Successfully complete the above requirements and the National Registry First Responder written examination.
"Requirements EMT-Basic Registration Entry"
Individuals applying for EMT-Basic registration must meet the following requirements to be eligible for the national registration as an EMT-Basic.
1. Each applicant must be 18 years of age or older.
2. Successfully complete, within the last two years, a state-approved National Standard EMT-Basic training program, as developed and put into operation by the U.S. Department of Transportation.
3. In states not mandating National Registry EMT-Basic certification, individual's must include documentation (card or certificate) showing current state certification at the EMT-Basic level.
4. All individuals are required to have successfully complete within the past twelve months all sections of a state-approved EMT-Basic practical examination that equals or exceeds the established criteria of the National Registry.
5. Truthfully complete the felony statement on the application and submit the documentation if necessary.
6. Submission of current CPR credentials (either American Heart Association or American Red Cross). Verification may be in the form of an instructor signature or copies of both sides of a current card affixed to the appropriate space on the back of the National Registry EMT-Basic application.
7. Submission of an acceptable application attesting to the satisfaction of the above requirements.
8. A registration fee of $15.00 (money order only), payable to the National Registry of Emergency Medical Technicians, must be submitted with the application. This fee covers the cost of all printed material, examination administration, postage, data processing, and reporting of examination results. The fee will be refunded if an application is not accepted. The fee will not be refunded if the application is accepted and entered into data processing.
9. Successfully complete the above requirements and the National Registry EMT-Basic written examination.
"EMT-Intermediate Level"
In 1979 responding to requests from the field and with the direction from NREMT's Board of Directors, fifty state EMS offices were surveyed for their views on the establishment of a national certification level for IV/EOA, Cardiac/EOA and Trauma/EOA. Of the forty states responding, 70% favored IV/EOA, 55% Cardiac/EOA, and 25% Trauma/EOA.
In November 1979, with this information, the Registry's Board of Directors voted to establish an Intermediate certification level by the mid-1980's. It was to be based on the National Standard Curriculum's behavioral objectives included in Modules 1 through 3, plus EOA. The level certified competency in four skill areas. 1. Trauma patient assessment. 2. IV therapy. 3. Esophageal obturator airway and 4. The anti-shock garment.
At the January 1980 meeting of the Registry's Standards and Examination Committee, the first draft of the EMT-Intermediate examination was reviewed and policies and procedures for implementing certification were discussed.
In April 1980, recommendations for the mode and method of examination were finalized. This initial examination was first tested in Lafayette, Louisiana and Burlington, Vermont. This testing resulted in revisions, which were presented to the Standards and Examination Committee. Certification policies and procedures were then approved at the June 1980, NREMT Board of Directors meeting. National EMT-Intermediate Board Certification was first offered in the summer of 1980.
In 1982, the EMT-Intermediate certification level was re-evaluated and it was decided there was a need for a stand-alone examination. The NREMT Board of Directors approved the EMT-Intermediate examination, in June 1982. It included a 150-item written format and a four-station practical.
In early 1983, testing to reassess EMT-Basic skills and test newly acquired EMT-Intermediate skills was put into effect.
In 1986, the U.S. Department of Transportation issued the National Standard EMT-Intermediate Training Program Curriculum. The National Registry then developed an examination based on the objectives of this new curriculum. The examination changed the number of items in the Basic Section from 80 to 70 and increased the number of Intermediate items from 70 to 80. The examination was put into effect nationally in December 1986.
In 1991, an Intermediate writing committee met to revise and add items to the
Intermediate item bank. The items were trial tested across the country and a Standard Setting meeting was held. The new and revised items were placed within the examination in early 1992.In 1992, in conjunction with the EMT-Paramedic practical examination, a revised EMT-Intermediate examination was put into effect. A new scannable report form was developed and computer programs were written to score the new examination. The computer tracking of results allows the NREMT to provide statistics on practical examination performance.
1993, the EMS Education and Practice Blueprint changed the extent of practice for EMT-Intermediates. Reaching general agreement nationally, the Blueprint serves as a guide to development of curriculum.
EMT-Intermediate is currently undergoing revision. It is under contract by the National Highway Traffic Safety Administration, to the Center for Emergency Medicine of Western Pennsylvania. Changes in EMT-Intermediate are expected in response to revisions within this level of care.
"EMT-Paramedic Level"
On February 21, 1978, the first National Registry EMT-Paramedic examination was given. The examination was based on the behavioral and skill objectives in the U.S. Department of Transportation's National Standard EMT-Paramedic 15 module Curriculum.
Based on the National Curriculum, the National Registry contracted with the University of Kansas Medical Center, Emergency Medical Training Program, to develop the appropriate written and practical examinations for National Registration as an EMT-Paramedic. Before being used nationwide, the examinations were pre-tested in the Denver, Kansas City and Chicago areas.
The EMT-Paramedic examination provides the cornerstone for sound verification of Advanced Life Support programs nationally. It also provides sound medical/legal standards against which EMT-Paramedics can be evaluated. The examination acts as a workable instrument to confirm the skills and competencies necessary to deliver quality Advanced Life Support patient care.
Several main factors influence the failure rate experienced by EMT-Paramedic candidates. They include inadequate continuing education, length of time lapsed since graduation, failure of many paramedic training programs to closely follow the National Curriculum, and over estimation of the abilities of individual EMT-Paramedic students by themselves or their Medical Directors.
National Registry EMT-Paramedic Board Registration requires each individual to exhibit a high performance level in the skills and competencies necessary for the delivery of quality care to the victim of unexpected illness and injury.
In 1987, the National Registry revised the EMT-Paramedic examination based upon a newly released six divisional EMT-Paramedic Training Curriculum developed by the U.S. Department of Transportation. The examination was written by twenty item writers selected from across the United States. They had backgrounds as street paramedics, educators, nurses and physicians. All items were pre-tested at 20 sites throughout the country. Items were then reviewed by a Standard Setting Committee, which consisted of street level paramedics, nurses, and physicians and then put into national use. The first examination using the objectives of the six-division curriculum was available on July 1, 1987.EMT-Paramedic examinations are revised on a regular basis.
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This article is not intended to be used as a factually up to date paper, only as an overview of the highlights of the National Registry of Emergency Medical Technicians.
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