EMS Certification
EMS certification statute and rules
- Vermont Emergency Medical Services Statute (24 V.S.A.)
- Vermont Emergency Medical Services Rules
PDF version or HTML version
Certification Information
- EMT-B Information
- EMT-I Information
- Paramedic Information
- Information about certification reciprocity from other states
- Frequently Asked Questions
EMT - B Certification Information
Initial Certification
To become and Emergency Medical Technician - Basic (EMT-B), an individual must:
- be at least 18 years old.
- be sponsored by a licensed ambulance or first responder service, or show evidence of other appropriate involvement in the delivery of emergency medical treatment.
- complete an EMT-B course approved by the Department of Health.
- pass the Vermont written and practical certification examinations.
Initial Training
All EMT-B training must be received from a Department -approved training program. All programs must meet the content and objectives of the Department of Transportation's 1994 national standard EMT-B curriculum. The curriculum includes at least 110 hours of didactic training and five patient assessments in a clinical setting. Some districts also have prerequisites that go beyond minimum state requirements. To find out the schedule of courses near you, contact the training coordinator for the EMs district in which you are located.
Skills Allowed
- Taking and recording vital signs.
- Basic airway management.
- Managing soft tissue injuries..
- Oropharyngeal and nasopharyngeal airways.
- Splinting bone and joint injuries.
- Pharyngeal suctioning.
- Pneumatice anti-shock garment (PASG).
- Managing medical emergencies.
- Administration of oxygen.
- Emergency childbirth.
- Mask and nasal cannula.
- CPR and obstructed airway maneuvers for infant, child and adult.
- Use of bag-valve-mask device.
- Administration of oral glucose and activated charcoal.
- Automated defibrillation.
- Assisting in adminstration of nitroglycerin, prescribed inhaler and epinephrine auto-injector.
Recertification
EMT-B certification lasts two years. To recertify, a person must, during the previous certification period:
- Complete a Department-approved EMT-B refresher course or an equivalent program of continuing education as detailed on the Department's EMT-B recertification form.
- Continue involvement with the delivery of emergency medical treatment.
- Successfully complete a Department-approved EMT-B written examination and skill verification.
- Apply on forms available from the Department to receive the new certification.
Extension Certification
The Department of Health may extend a certification for up to six months, provided the applicant is able to document appropriate additional continuing education during the extension period. Any person wishing an extension must apply to the Department in writing prior to expiration of the certification. Extensions are not granted automatically and there is no grace period. Extensions are granted to applicants who are unable to take the recertification exam because of illness, injury or lack of an examination site in the area of the states near the applicant. Insufficient continuing education is not a valid reason for an extension.
Written Examination for Intial Certification
The Department of Health administers the written EMT-B examination of the National Registry of EMT's in accordance with the requirements and policies of the Registry. The exam has 150 multiple choice questions. Each question is referenced to the national standard curriculum and at least two EMT texts, but exam questions are NOT based on any one textbook. The passing score is 70 percent. Each candidate is allowed three attempts to pass the exam. The written examination is scored only after the candidate has passed the practical examination.
Upon passing the written and practical examinations, new candidates will automatically receive a Nationally Registered EMT-Basic certification in addition to their Vermont card. A candidate is not required to be Nationally Registered to be certified in Vermont. Questions on the exam are distributed in the following manner:
| Topic | Number of Questions per Topic |
|---|---|
| Patient Assessment | 24–30 |
| Airway and Breathing | 24–30 |
| Circulation | 22–28 |
| Musculoskeletal, Behavioral, Neurological and Environmental | 21–27 |
| Children and Ob/Gyn | 19–25 |
| EMS Systems, Ethical, Legal, Comm/Documentation | 21–27 |
| Safety and Triage/Transportation |
Practical Examination for Initial Certification
The practical examination is designed and administered by the Department. There are eleven stations, five of which must be passed.
- Trauma assessment and management
- Medical assessment and oxygen therapy
- Cardiac arrest management
- Spine immobilization - seated or supine patient
- Random skill:
- Immobilization of long bone injury
- Immobilization of joint injury
- Immobilization with traction splint
- Bleeding control and shock management
- Upper airway adjuncts and suction
- Cardiopulmonary resuscitation
- Medication administration
Performance criteria for the stations are available from service training officers, EMT instructors and the EMS office. Each candidate gets three attempts to pass the pratical exam. A current list of practical exam locations and times may be accessed by selecting here.
Reinstatement of Expired Certification
A person who loses EMT certification for less than one year may regain certification by completing the recertification requirements described previously. A person who losed EMT certification for more than one year but less than three years may regain certification by completing an approved refresher course, continuing involvement with the delivery of emergency medical treatment and passing an approved EMT-B written examination and skill verification. A person who has lost EMT certification more than three years ago must meet all the requirements of a new EMT.
Recognition of Licenses and Certifications from Other States
The Department may issue a Vermont EMT-B certificate for one to two years to a person who holds valid credentials entitling him/her to practice as an EMT-B in a state or province which meets or exceeds the content and objectives of the national standard curriculum for EMT-B's and which imposes a written and practical exam as a condition of those credentials, provided the applicant:
- submits the application form available from the Department.
- has not been previously certified in Vermont as an EMT.
- is affiliated with a Vermont licensed ambulance or first responder service.
To renew a certification obtained this way, an EMT-B must meet all recertification requirements for EMT's. The EMS office does not extend certifications obtained in this way. Vermont EMS does not have a list of states which meet the requirements above because states frequently change their requirements. The training of each applicant is verified with the EMS office of the state in which the applicant was originally certified or licensed. This typically takes four to six weeks. Reciprocity forms may be requested by selecting here.
EMT-I Certification Information
Initial Certification
To become an Emergency Medical Techinician-Intermediate (EMT-I), an individual must:
- be at least 18 years old.
- be sponsored by an ambulance or first responder service licensed to provide emergency treatment at or above the intermediate level, or be affiliated with a medical facility that requires the person to hold this level of certification.
- hold current certification as a Vermont EMT.
- complete an EMT-Intermediate course approved by the Department of Health.
- pass the Vermont EMT-Intermediate written and practical certification examinations.
Initial Training
EMT-Intermediate training must be received from a Department-approved training program. All programs must meet the content and objectives of the relevant sections of the Department of Transportation's national standard paramedic curriculum. The curriculum includes at least the following amount of training in these areas:
| Didactic | 63 hours |
|---|---|
| Clinical | 20 hours |
| Total | 83 hours |
To find out the schedule of courses near you, contact the training coordinator for the EMS district in which you are located. Some districts also have prerequisites that go beyond minimum state requirements. The EMS office can supply the phone number of the nearsest district training coordinator.
Skills Allowed
- Taking and recording vital signs.
- Managing soft tissue injuries.
- Basic airway management.
- Splinting bone and joint injuries.
- Oropharyngeal and nasopharyngeal airways.
- Treating shock with pneumatic anti-shock garment (PASG).
- Pharyngeal suctioning.
- Managing medical emergencies.
- Administration of oxygen.
- Mask and nasal cannula.
- Use of bag-valve-mask device.
- Advanced airway management.
- Emergency childbirth.
- Esophageal obturator airways.
- CPR and obstructed airway manuevers for infant, child and adult.
- Establish and monitor peripheral IV (including saline locks).
- Administer medications upon verbal order.
- Infuse crystalloid solutions.
- Administer epinephrine 1:1000.
- Collect blood samples.
- Administer 50% dextrose.
- Administer naloxone.
Recertification
EMT-I certification is valid for one year. To recertify as an EMT-I, a person must:
- complete the specified number of hours of continuing education in a combination of mandatory and optional subjects as detailed on the Department's EMT-I recertification form.
- continue to hold certification as a Vermont EMT.
- maintain sponsorship by a service at the EMT-Intermediate level or above.
- apply on forms available from the Department to receive the new certification.
Advanced EMT's are not routinely required to take the Vermont written and practical examinations for the recertification at the advanced level. A district medical advisor or district board may, however, request that an individual be examined by the Department for verification of continuing competency.
Reinstatement of Expired Certification
A person who loses EMT-I certification for less than six months as a result of not completing the EMT-I recertification process described above may regain certification by accruing the type and amount of continuing education that would have been requiredd during all time since the issuance of the last certificate and meeting all other recertification requirements. A person who loses EMT-I certification for more than six months must meet all requirements of a new EMT-I unless the district medical advisor and district board petition the Department for some other course of action.
Written Certification Examination
The written certification examination is administered by the Department. It has 100 multiple choice questions. Each question is referenced to the curriculum. Questions are NOT based on any one text book. The passing score is 80 percent. Each candidate is allowed three attempts to pass the exam.
Questions are distributed in the following manner:
- Roles and responsibilities - 5 %
- Human systems and patient assessment - 15%
- Respirations and ventilation - 15%
- Airway management - 10%
- Circulation and fluids - 10%
- Intravenous therapy - 10%
- Shock and resuscitation - 15%
- Pharmacology - 20%
Practical Examination
The practical examination is designed and administered by the Department. There are three stations, each of which must be passed:
- Patient assessment and advanced management.
- Intermediate airway management.
- Intravenous therapy and medication administration.
Performance criteria for the stations are available from service training officers, EMT instructors and the EMS office. Each candidate gets three attempts to pass the practical exam.
Recognition of Licenses and Certifications from Other States
Advanced EMTs certified or licensed in other states who wish to obtain Vermont EMT-I certification will be considered by the Department on a case by case basis. The necessary conditions for obtaining EMT-I certification are that the person:
- apply on forms available from the Department.
- satisfy the Department that he is able to operate within the protocols established for the EMS district where he is located.
- show affiliation with a licensed ambulance or first responder service or medical facility providing treatment at or above the EMT-I level.
- pass the EMT-I written and practical examinations.
The Department will also consider whether the applicant's training is equivalent to Vermont's. The training of each applicant is verified with the EMS office of the state in which the applicant was originally certified or licensed. This typically takes four to six weeks. To renew a certification obtained in this way, an EMT-I must meet all conditions imposed on other EMT-I's.
EMT-Paramedic Certification Information
Initial Certification
To become an Emergency Medical Technician-Paramedic (EMT-P), an individual must:
- be at least 18 years old.
- be sponsored by an ambulance or first responder service licensed to provide emergency treatment at the Paramedic level, or be affiliated with a medical facility that requires the person to hold this level of certification.
- complete an EMT-Paramedic course acceptable to the Department of Health. If the course takes place in Vermont, it must be approved by the Department.
- pass the National Registry EMT-Paramedic written and practical. examinations and be registered as an EMT-Paramedic with the National Registry of EMTs.
- apply for certification on forms available from the Department of Health.
Initial Training
EMT-Paramedic training must be received from a training program acceptable to the Department. All programs must meet the content and objectives of the Department of Transportation's national standard paramedic curriculum. Vermont currently has no paramedic training programs. To find out where nearby courses are offered, contact the Department of Health's EMS office.
Skills Allowed
- Taking and recording vital signs.
- Managing soft tissue injuries.
- Basic airway management.
- Splinting bone and joint injuries.
- Oropharyngeal and nasopharyngeal airways.
- Treating shock with pneumatic anti-shock garment.
- Pharyngeal suctioning.
- Interpreting cardiac dysrhythmias.
- Administering oxygen.
- Infusing crystalloid solutions.
- Mask and nasal cannula.
- Collecting blood samples.
- Using bag-valve-mask devices.
- Emergency childbirth.
- Advanced airway management.
- Establishing and monitoring peripheral and esophageal obturator airways.
- Central intravenous lines.
- Endotracheal intubation and suctioning.
- Chest decompression.
- CPR and obstructed airway maneuvers for infant, child and adult.
- Cricothyrotomy.
- Administering medications and other treatments.
- Defibrillation and synchronized cardioversion, described in the national standard EMT-Paramedic curriculum.
Recertification
EMT-P certification is valid for two years. To recertify as an EMT-P, a person must:
- Re-register as an EMT-Paramedic with the National Registry of EMTs.
- Maintain sponsorship by a service licensed at the EMT-Paramedic level.
- Fulfill any other EMS District standards for continuing education and local testing.
- Apply on forms available from the Department to receive the new certification.
Reinstatement of Expired Certification
A person who loses EMT-P certification may regain certification by re-registering with the National Registry as an EMT-P and completing the process for initial Vermont certification.
Written and Practical Certification Examinations
The written and practical certification examinations are administered by the National Registry of EMT's. Refer to National Registry materials for information about the format and structure of the examinations.
Recognition of Licenses and Certifications from Other States
An EMT-Paramedic certified or licensed in another state who wishes to obtain Vermont EMT-P certification must become a Nationally Registered EMT-Paramedic and go through the process for initial Vermont certification.
Certification Frequently Asked Questions
When does my certification expire?
Your certification expires on the last day of the month printed on your card.
When am I due to take the recertification exam?
You are due to take the recertification exam when your certification expires. EMT certifications good for two years. This means you will submit your CE and take the recertification exam every two years.
How do I recertify?
A month or two before your certification is due to expire, the EMS Office will send you a notice listing the exams scheduled in the near future. You will also receive a certification exam application, which you need to complete and return with your completed CE form. If you do not have a CE form, call the EMS Office or download one from the documents page
What is the recert exam like?
The recertification exam (also called the refresher exam) is based on the 1996 national standard EMT-B refresher curriculum. You can obtain the curriculum free of charge at the National Highway Traffic Safety Administration’s web site. The written exam has 120 multiple choice questions. The practical exam has three stations that combine many skills into three realistic scenarios. An applicant is allowed three attempts on both the written and practical certification exams, if necessary.
How can I prepare for the recertification exam?
To prepare for the written exam, you should review the learning objectives from the refresher course or the EMT-B course, consider taking a practice exam (available from EMS publishers) and brush up on areas you are rusty in by reading continuing education articles and EMT texts. To prepare for the practical exam, you should review the learning objectives from the refresher course or the EMT-B course, go over the performance criteria for the stations and practice your skills.
Which form should I complete to recertify?
Use the form that came with your card. You should have received a Continuing Education form that requires 24 hours of EMT-Basic CE and 10 hours of EMT-Intermediate CE. The 24 required hours of EMT-Basic CE can be obtained either through continuing education or through an approved EMT-B refresher course. To obtain a CE form simply call the EMS Office or download one from the documents page.
What is a refresher course?
A refresher course is an educational program approved by the Department of Health. It follows the national standard EMT-B refresher curriculum and reviews topics from the EMT-Basic course. The minimum course length is 24 hours, sixteen of which must be in certain areas. This allows the course coordinator at least eight hours to go over areas where students need more practice. The eight hours of elective can cover anything in the EMT-B curriculum. This would include, for example, splinting, medical emergencies and rapid extrication, but not rope rescue or EKG rhythm recognition.
Do I have to attend a refresher course?
Vermont does not require you to complete a refresher course if you are renewing your certification within a year of its expiration. The National Registry, however, requires a refresher course to renew a National Registry card. An EMT who does not complete a refresher course needs to get continuing education that meets the content and objectives of a refresher course. This means squad training officers should plan their training sessions so that all of the content and objectives of the refresher course are covered at least every two years.
Since most squads meet at least once a month to train and since only 24 hours are required, it should be relatively easy to accomplish this. Some training officers have already planned to cover the refresher material every year instead of every two years. This should make it easier for members who have to miss an occasional training session.
How can I take a refresher course?
If you wish to take a refresher course, you should approach either an EMT instructor or your district training coordinator to find out when courses will take place near you.
If I get CE instead of attending a refresher course, do I have to get a certain number of credits through a certified instructor-coordinator?
No. The instructions on the new CE form specify that at least ten hours of CE must be taught by a certified instructor-coordinator (IC). When the forms were printed, the EMS Office anticipated getting a new computer database that would allow the Department of Health to certify ICs. That database does not exist yet, so the Department is not certifying ICs yet. Only after ICs are certified and there are sufficient ICs around the state will this requirement be enforced.
I want to test with other people on my squad. Can I test at a different time?
Yes. You can recertify up to twelve months early without losing any time. For example, suppose you are due to recertify in June 2004. Your district is planning to hold a recert exam in January, not June. If you recertify in January, you will get a new EMT card that expires in June 2006, not January 2001. You can also request an extension of your EMT certification by submitting a completed extension request form (available from the EMS Office) your certification expires. EMS cannot grant extensions for certifications that are already expired.
An extension gives you six more months to take the recertification exam. If you are an EMT-I, be sure to submit your EMT-I CE with the extension request to keep your EMT-I certification current. The Department of Health does not grant extensions for the purpose of gaining additional CE, to those who have failed the recertification exam or to EMTs who gained Vermont certification through reciprocity.
How much credit do I get toward EMT-B recertification for completing an EMT-Intermediate course?
Completion of an EMT-Intermediate course entitles you to claim the six hours of CE required for the preparatory, airway and patient assessment areas of Section II.
If I become an EMT-Intermediate, what will my EMT-I expiration date be?
Your EMT-I expiration date will be the same as your EMT-B expiration date. If this gives you less than two years of EMT-I certification, the amount of CE you need to recertify will be prorated. For example, if you passed the EMT exam on May 15, 2003 and became an EMT-I on November 15, 2003, your new card will show both your EMT-B and EMT-I certifications expiring May 31, 2005. Because you received only three-fourths of the usual certification period of two years, you will need to submit only three-fourths of the usual CE required for EMT-I renewal.
How can I regain my EMT certification if it has expired?
An EMT-B whose certification lapsed for less than one year can get reinstated simply by completing the recertification requirements that were due previously. A former EMT-B whose certification expired more than one year but less than three years ago needs to complete a refresher course and pass the refresher exam. Someone whose certification expired more than three years ago must complete an EMT-B course and pass the certification exam.
My squad covers towns in both Vermont and New Hampshire, so I maintain EMT certification in both states. Do I have to take both states’ recert exams?
No. Vermont EMS will accept a renewed National Registry card as evidence of completing equivalent education and testing. National Registry renewal requirements are described below. Since New Hampshire requires an EMT to have a National Registry card, this should make recertification much easier for EMTs who maintain certification in both states. Providers in this situation must still meet the other recertification requirements of Vermont-based EMTs such as affiliation with a Vermont licensed service and completing a recertification exam.
How can I become a Nationally Registered EMT?
The answer to this question depends on when you became an EMT and when you last took the recertification exam.
If you are a Vermont EMT who completed the course and passed the National Registry exam within the last twelve months but did not get National Registration, send the letter and the check to the National Registry now.
If you are a Vermont EMT who recertified and passed the Vermont recertification exam within the last twelve months, you need to complete an EMT-B refresher course (or transition course) and pass the National Registry written exam. Contact the EMS Office to find out when the exam will be given locally and how to register for it.
If you are a Vermont EMT who passed the Vermont recertification exam more than twelve months ago, you need to complete an EMT-B refresher course, pass the Vermont practical exam and then pass the National Registry written exam. This means you can take the National Registry written exam any time in the twelve months after you pass the Vermont refresher exam. Contact the EMS Office to find out when the exam will be given locally and how to register for it.
How do I renew my National Registry card?
The National Registry sends reregistration materials in November to all those whose cards expire the following March.
In the reregistration materials is a form you need to complete which asks for information about the refresher course you took and the 48 additional hours of CE the Registry requires. EMTs reregistering in 1999 may substitute an EMT-B transition course for a refresher course. Since Vermont does not require recertifying EMTs to take a refresher course, the Registry will accept from Vermont residents 24 hours of CE that meet the content and objectives of a refresher course in lieu of a formal refresher program. You will also need to submit the reregistration fee and a copy of your new Vermont EMT card (or early notification letter).
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