EMT-Intermediate/85 Practical Examination

The practical section of the examination process consists of four (4) skills presented in a scenario-type format to approximate the abilities of the NREMT-Intermediate/85 to function in the out-of-hospital setting.   All skills have been developed in accordance with the EMT-Basic National Standard Curriculum, the behavioral and skill objectives of the 1985 EMT-Intermediate National Standard Training Curriculum, and current AHA guidelines. The process is a formal verification of the candidate's "hands-on" abilities and knowledge, rather than a teaching, coaching, or remedial training session. The NREMT will not explain any specific errors in any performance.  Candidates are permitted to bring their own equipment for the examination, provided it is approved for testing by the National Registry Representative in attendance at the examination. All candidates are urged to review all practical examination criteria in the supplemental brochure "Performance Standards for Advanced Level Practical Examination Candidates" before attempting the examination.

All candidates must complete the practical examination in a standardized format.  All candidates must demonstrate an acceptable level of competency in each of the following skills:

1.  Patient Assessment/Management

All candidates will be required to perform a "hands-on," head-to-toe, physical assessment and voice treatment of a moulaged simulated patient for a given scenario. This skill includes:

a.   Scene Size-Up

b.   Initial Assessment/Resuscitation

c.   Focused History and Physical Examination - Rapid Trauma Assessment

d.   Detailed Physical Examination

2.  Ventilatory Management

Given a scenario of having just found an apneic adult patient with a palpable carotid pulse, the NREMT-Intermediate/85 candidate must demonstrate immediate management of the patient using simple airway maneuvers and adjuncts, bag-valve-mask device, and supplemental oxygen.  Each candidate must then choose and insert a dual lumen airway device (Combitube®, PTL® or endotracheal tube (ET).  Requirements for state licensure may mandate which of these devices may be used.

3.  Intravenous Therapy

Candidates will be required to establish a patent IV in a manikin arm in accordance with a given scenario.

4.  Random Basic Skills    

All candidates will be evaluated over one (1) of the following EMT-Basic skills tested at random.  All instruments for these skills will adhere to the National Registry EMT-Basic Practical Examination material:

a. Spinal Immobilization (Seated Patient)

b. Spinal Immobilization (Supine Patient)

c. Bleeding Control/Shock Management

NREMT-Intermediate/85 candidates are required to complete four (4) skills when taking the entire practical examination.  Grading of the practical examination is on a Pass/Fail basis.  Failure of two (2) or less skills (when taking the entire NREMT-Intermediate/85 practical) entitles the candidate to two (2) retesting opportunities of just the skill(s) failed. 

If a same-day retest is offered at the examination site, only one (1) retest attempt may be completed at that test.   Retests must be completed in an all-or-none fashion.  The NREMT cannot score or report incomplete practical attempts.  Candidates are not permitted to complete only a portion of the skills that need to be retested.  The NREMT does not mandate of guarantee same-day retest opportunities at any National Registry Advanced level practical examination site.  

Failure of any portion of the second retest attempt constitutes failure of the entire practical examination.  The candidate is then required to officially document remedial training over all skills before starting the next full attempt of the practical examination and re-examining over all four (4) skills on another date, provided all other requirements for National Registration are fulfilled.

Failure of three (3) or more skills constitutes failure of the entire practical examination. The candidate is then required to officially document remedial training over all skills before starting the next full attempt of the practical examination and re-examining over all four (4) skills on another date, provided all other requirements for National Registration are fulfilled.

The passed portion of the examination, either the written or practical, will remain valid for a twelve (12) month period from the date of the examination, provided all other requirements for National Registration are fulfilled.   Candidates not completing the failed portion of the examination within that twelve (12) month period will be required to repeat the invalid portion.

Candidates are allowed three (3) full attempts to pass the practical examination (one "full attempt" is defined as completing all four (4) skills and two retesting opportunities if so entitled).  Candidates who fail a full attempt or any portion of a second retest must submit official documentation of remedial training over all skills before starting the next full attempt of the practical examination and re-examining over all four (4) skills, provided all other requirements for National Registration are fulfilled. This official documentation must be signed by the EMT-Intermediate/85 Training Program Director or Physician Director of training/operations that verifies remedial training over all skills has occurred since the last unsuccessful attempt and the candidate has demonstrated competence in all skills. Should a candidate fail the third full and final attempt of the practical examination, the candidate must complete a new, state-approved EMT-Intermediate/85 Training Program.

Information About the Examination Process  

Candidate Checklist for Completing the Application and Exam Process

Felony Conviction Policy

Disability Accommodation Policy

Retest Information

Specialist Practical Exam Test Sheets

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