The National Registry Of Emergency Medical Technicians (NREMT)

The National Registry of Emergency Medical Technicians (which shall be referred to as the NREMT from here on out) is the body or organization that manages the EMT profession. The main purpose of this organization is to ensure that the EMTs who provide care to patients at the scene of a medical emergency are competent and able to perform their jobs at a very high level of quality.

NREMT Mission Statement

According to the NREMT website, the mission statement of the registry is as follows:

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”.

In effect this is an organization that aims to monitor and control the EMT profession by maintaining records of EMTs that are allowed to practice. In addition the procedures and standards that the national registry puts into place are aimed at ensuring that the quality of EMT professionals who are allowed to practice in the field is high and that everyone falling under the control of the organization behaves appropriately.

History And Milestones

History up until the NREMT was established:NREMT

  • 1969: Highway Traffic Safety suggests that uniform standards for EMS be put into place
  • 1970: The first meeting of the Task Force in charge of achieving the above was held January 21, 1970
  • 1971: Rocco V. Morando is selected as NREMT’s founding Executive Director, first exam administered
  • 1973: The first re-certification of a Nationally Registered EMT was processed
  • 1974: Development of initial EMT training guidelines
  • 1975: Continuing education and re-certification requirements established and the National Association of Emergency Medical Technician formed
  • 1976-1977: Exams tested, curriculum was developed nationally and advanced training packages were introduced
  • 1978: The first exam is given and the he Registry becomes a member of the National Commission for Health Certifying Agencies

Most recent history and milestones:

  • 2000: The Board of Directors adopts a Strategic Plan to help guide the direction of the organization
  • 2001: The NREMT examination is used in 43 states as the primary or only means of certification
  • 2002: First increase in NREMT membership fees since 1973
  • 2003: The NREMT implements a Research Program for the betterment of NREMT programs and to contribute to the EMS community, and receives accreditation of all five levels of exams from the National Commission for Certifying Agencies, a certification accrediting agency sponsored by the National Organization for Competency Assurance.
  • 2005: The NREMT exams are now used by 46 states and territories as the sole basis for certification at one or more levels.
  • 2007: The NREMT begins the process to transition from pencil-and-paper based exams to computer based testing

General Facts

The NREMT is a non-profit organization that exists to ensure quality on the EMT profession. Before this body was established there were no certification procedures for individuals working in the emergency medical services and no standards were in place. The NREMT stepped forward to address this shortcoming. Over 1 million EMTs have been certified through this body. In order to qualify for certification as an EMT through the NREMT you need to:

  • Completing a state-approved EMS education course
  • Passing the NREMT written and practical examinations

Board Of Directors

The board of directors for the NREMT consists of 21 individuals. These individuals are experts and prominent and important figures from various segments of the emergency medical services. In addition a certain proportion of the board consists of members of the public who, too, are prominent and important figures. The high level of quality of the board of directors serves to indicate that the NREMT is dedicated to the goals expressed in its mission statement. The point of the board of directors is to ensure that the NREMT is properly governed and well organized and that all of its members are monitored and kept in check. The board of directors is:

  • Committed to public protection
  • Committed to quality patient care

Exam Development

There are five levels of certification that can be received by writing NREMT examinations. These include:

  • First Responder
  • Basic EMT
  • Intermediate/85 EMT
  • Intermediate/99 EMT
  • Paramedic

These exam questions are formalized and written by experts in the field. These tests consist of a number of different items. In order to ensure that each item on the test is of the best quality and relevant, they each take 1 year and $1000 to create. The process includes a testing phase.  According to the website of the NREMT “Each of the item banks for the five levels of certification has thousands of questions that are calibrated to entry level competency, and lead to certification that is legally defensible and psychometrically sound”.

How Entry Level Competency Is Determined

The NREMT sets the standards that determine whether or not an individual is allowed to work as an EMT. If you receive certification from the NREMT it means that you meet these requirements. However it is not the same as receiving a license to work as an EMT. Once you have received certification form the NREMT you will still be required to receive a license from your state in order to be allowed to work in that state as an EMT. You will need to go through the NREMT to receive your certification as examinations are based on practice through data obtained from the NREMT Practice Analysis. The psychomotor competency tests involved are also carefully developed and monitored.

How States Use The NREMT

There are a number of benefits for states who use the NREMT in order to certify their EMT workers. The 46 states that currently use the NREMT for this purpose have the following advantages:

  • The EMT standards are the same across these states. The states that do not use the NREMT are inconsistent with each other and those states that do, making regulation difficult and statistical analysis a problem.
  • States that you the NREMT standards can exchange EMT workers, while those that do not must develop and defend their own certification procedures. These certification procedures may not be recognized by other states, making it difficult for EMTs training there to move from state to another.

Why Re-certification Is Important

In order to continue working as an EMT in states that use the NREMT’s procedures you will need to seek re-certification every two years. The main reason for this is to ensure that the level of quality of the NREMT profession is kept high and that all employees in the profession are adhering to the same standards. To receive re-certification it is necessary to provide proof of continuing education. In addition you will have to demonstrate your competency in various areas of the EMT profession before you will be granted re-certification status by the NREMT. States that do not use NREMT procedures will also require re-certification, but the rules will differ and you will need to investigate the specific procedures required in your state.

Research Development

The NREMT has implemented a research program which exists specifically for the following purposes:

  • To improve the medical emergency services in the USA
  • To improve the functioning and procedures of the NREMT

Every year the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) is conducted. The point of this survey is to describe the employees currently working as EMTs across the country. It basically serves a statistical purpose.  This survey provides useful information regarding the makeup of the EMT profession, including:

  • Salary statistics of EMTs
  • Job satisfaction statistics of EMTs
  • Gender statistics of EMTs
  • Age statistics of EMTs
  • Work experience statistics of EMTs
  • Ethnicity statistics of EMTs

Professional Accreditation

According to the NREMT website:

The NREMT is accredited by the National Commission for Certifying Agencies (NCCA), the accreditation body of the National Organization for Competency Assurance (NOCA). The NCCA’s mission is to help ensure the health, welfare, and safety of the public through the accreditation of a variety of certification programs/organizations that assess professional competency. The NREMT is also affiliated with the Commission on the Accreditation of Allied Health Educational Programs (CAAHEP)”.

States that do not adhere to NREMT policies have to defend their own accreditation standards and these may not be recognized across the entire country.

The NREMT is a very well organized organization which is dedicated to the goals that it plans to pursue. Any EMTs who are in doubt about a procedure or policy simply need to refer to the NREMT website for clarity on the issue. In addition there are a number of resources provided to assist EMTs in their jobs and prospective EMTs in their path to becoming certified. The NREMT is the certifying agency for EMT workers and is accredited by the National Commission for Certifying Agencies (NCCA).

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