EMT Paramedic Test

EMT-Paramedic TestThe EMT-Paramedic exam requires applicants to pass both a state approved psychomotor exam, as well as a national NREMT certification exam. Under the new 2014 NHTSA guidelines, the EMT-Paramedic certification level will be referred to as simply the Paramedic certification. Potential EMT candidates applying for an EMT-Paramedic certification must meet certain requirements.  EMT-Paramedic candidates must be 18 years or older.  EMT-Paramedic candidates must also have an EMT-Basic certification at the national or state level.  Candidates must also have completed a state-approved EMT-Paramedic course.  The state EMT-paramedic course must meet or exceed the US Department of Transportation National Standard Curriculum for EMT-Paramedic.  This EMT-Paramedic state course must have been successfully completed within the previous two years.  Additionally, EMT-Paramedic candidates must hold a current CPR credential and have successfully demonstrated competence in Paramedic skills.

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NREMT EMT-Paramedic Application Steps

To apply for the EMT-Paramedic test, please follow the following steps:

  • Go to and register for an account.
  • Complete an online National Registry Application. Please note that the application includes a statement on Licensing Action and Felonies - dealing with felony convictions. If you have an existing felony conviction on your record, your application will be denied.  You are, however, allowed to appeal your application denial. 
  • Pay an application fee of $110.  The applicaon fee applies to each attempt at the cognitive exam.  The application fee can not be transferred or refunded.
  • You will receive an Authorization to Test (ATT) document, after you submit your application.  The ATT will contain complete test information and logistics, such as required identification, scheduling instructions and test center locations.

NREMT EMT-Paramedic Exam

Candidates for the EMT-Paramedic certification must pass the NREMT EMT-Paramedic cognitive test.  The EMT-Paramedic test is given via a computer and is a Computer Adaptive Test (i.e., which adapts the test based on the student’s aptitude).  The number of questions on the EMT-Paramedic exam will range from 80 to 150 based on the EMT student’s aptitude.  You will be given a maximum of 2.5 hours to complete the EMT-Paramedic exam.

The EMT-Paramedic exam will cover all portions of the curriculum, including: EMS Operations, Cardiology, Trauma, Medical, Obstetrics, Pediatrics and Airway and Breathing.  The EMT-Paramedic test is heavily focused on fundamentals and operations.

The following requirements apply to EMT Paramedic certification candidates:
 - You must be at least 18 years of age.

 - You must currently be certified at the EMT-Basic level (at either a state or national level).

 - You must have successfully completed a state certificed EMT-Paramedic course.  The EMT-Paramedic course must, at a minimum, meet the U.S. Department of Transportation (DOT) Paramedic National Standard Curriculum requirements. The course must have been completed within the past two years and verified by the Course Program Director on the NREMT web site.

EMT-Paramedic Test Outline

The EMT-Paramedic test outline is shown below.

 NREMT Paramedic Exam Question Topics   Range of Questions on NREMT-Paramedic Exam
 Airway and Breathing  14-27
 Cardiology  14-26
 Trauma  13-25
 Medical  12-23
 Obstetrics and Pediatrics  13-24
 Operations  14-25
 Total   80-150

EMT-Paramedic Psychomotor Assessment Exam

Twelve skills will be assessed in the psychomotor examination.  The skills are based on scenarios and will evaluate your abilities to perform in an out of hospital environment. The covered skills include: patient assessment-trauma, ventilatory management, cardiac management, IV and medication skills, oral station, pediatrics and basic skills such as spinal immobilization and bleeding control/shock management.

EMTs have different duties and responsibilities based on their training and certification.  An EMT's salary is often different based on their experience, training, and location. Typically, most EMTs are certified to one of five levels that are administered by NREMT, the National Registry of Emergency Medical Technicians.  The five NREMT certifications are: First Responder, EMT-Basic, EMT-Intermediate/85, EMT-Intermediate/99 and Paramedic. An effective way to pass your NREMT certification exam is to use free EMT practice tests.

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