EMT and Paramedic Refresher -NREMT 60 Hours
EMT and Paramedic Refresher Courses
Accredited by CAPCE and NREMT
An EMT Refresher and a Paramedic Refresher are specialized continuing education programs that help EMS professionals (Emergency Medical Technicians and Paramedics) renew their certification, maintain clinical competency, and stay updated with the latest standards of care.
They’re required by the National Registry of Emergency Medical Technicians (NREMT) and most state EMS agencies every 2 years to keep certification current.
1. EMT Refresher Course
Purpose
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Ensures EMTs (basic-level providers) remain skilled in basic life support (BLS) and prehospital emergency care.
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Covers updated guidelines from the American Heart Association (AHA) and state/national EMS protocols.
Typical Content
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Airway, Breathing & Ventilation: Oxygen administration, airway adjuncts, BVM, suctioning.
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Cardiology & Resuscitation: CPR, AED use, cardiac arrest management.
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Medical Emergencies: Diabetic emergencies, allergic reactions, seizures, strokes.
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Trauma Care: Bleeding control, splinting, shock management, spinal immobilization.
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Special Populations: Pediatric, geriatric, and obstetric care.
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Operations: EMS safety, mass casualty incidents, hazardous materials awareness.
Hours
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Usually 20–40 hours total, depending on state requirements.
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Can be classroom, hybrid, or fully online (with in-person skills check-off).
2. Paramedic Refresher Course
Purpose
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Designed for advanced-level providers (ALS) with expanded responsibilities.
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Ensures paramedics stay competent in advanced procedures and up-to-date with evolving science.
Typical Content
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Advanced Airway Management: Intubation, supraglottic devices, capnography.
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Cardiology: Advanced ECG interpretation, cardiac pharmacology, defibrillation, synchronized cardioversion, transcutaneous pacing.
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Pharmacology: Medication calculations, IV/IO access, drug administration updates.
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Medical & Trauma Emergencies: Advanced pathophysiology, differential diagnosis, critical care management.
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Special Populations: Neonatal resuscitation, pediatrics, geriatrics, obstetrics, psychiatric and behavioral emergencies.
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Operations: Critical care transport, disaster response, EMS leadership roles.
Hours
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Usually 30–60 hours (NREMT minimums apply through the NCCP model).
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Often includes hands-on advanced skills labs, case scenarios, and simulations.
3. National Continued Competency Program (NCCP) Model
Both EMTs and Paramedics now follow the NCCP framework for recertification:
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National Component: Core content updated every 4 years by NREMT (covers changes in guidelines and evidence).
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Local/State Component: Determined by state or regional EMS authority.
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Individual Component: Elective hours chosen by the provider (conferences, CE courses, specialty training).
4. Outcomes
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On completion, providers receive documentation to submit to NREMT or their state EMS office.
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Ensures continued clinical competency, legal compliance, and patient safety.
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An EMT Refresher focuses on basic prehospital emergency skills (BLS level).
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A Paramedic Refresher covers advanced life support skills, pharmacology, cardiology, and critical care interventions.
EMT vs. Paramedic Refresher Course Outline (Side-by-Side)
Format: 3-day program (approx. 24 hours for EMT, 30 hours for Paramedic)
Structure: Core updates, skills labs, and scenarios following the NREMT NCCP model
Day 1 – Airway & Cardiac Emergencies
| Time | EMT Refresher | Paramedic Refresher |
|---|---|---|
| 08:00 – 09:00 | Orientation, NREMT/NCCP updates, BLS review | Orientation, NCCP updates, ALS scope & advanced changes |
| 09:00 – 10:00 | Airway basics: OPA/NPA, suctioning, BVM, oxygen | Advanced airway: ET intubation, supraglottic devices, capnography |
| 10:00 – 11:00 | Ventilation/Respiratory emergencies (asthma, COPD) | Ventilation/Respiratory failure & advanced management (CPAP, BiPAP, RSI overview) |
| 11:00 – 12:00 | CPR & AED skills (AHA updates) | ACLS algorithms, defibrillation, synchronized cardioversion |
| 12:00 – 13:00 | Lunch | Lunch |
| 13:00 – 14:00 | Cardiac emergencies overview (angina, MI, CHF) | 12-lead ECG interpretation & STEMI recognition |
| 14:00 – 15:00 | Chest pain scenarios (team-based practice) | Cardiac pharmacology: antiarrhythmics, vasopressors, ACS meds |
| 15:00 – 16:00 | Skills check-offs (airway, CPR/AED) | Skills lab: pacing, defibrillation, cardioversion |
| 16:00 – 17:00 | Documentation & patient handoff | Advanced cardiac case studies |
Day 2 – Trauma & Medical Emergencies
| Time | EMT Refresher | Paramedic Refresher |
|---|---|---|
| 08:00 – 09:00 | Trauma assessment review | Advanced trauma life support principles |
| 09:00 – 10:00 | Bleeding/shock control, splinting, spinal care | IV/IO access, fluid resuscitation, blood products |
| 10:00 – 11:00 | Medical emergencies (diabetic, seizure, stroke) | Advanced medical: sepsis, endocrine crises, toxicology |
| 11:00 – 12:00 | Allergic reactions & anaphylaxis (EpiPen, O2) | Advanced airway in anaphylaxis, anaphylactic shock management with IV/IO meds |
| 12:00 – 13:00 | Lunch | Lunch |
| 13:00 – 14:00 | OB/GYN emergencies (childbirth, postpartum bleeding) | Advanced OB/pediatric resuscitation, NRP integration |
| 14:00 – 15:00 | Pediatric emergencies (fever, seizures, respiratory distress) | Pediatric advanced airway, PALS algorithms, intraosseous access |
| 15:00 – 16:00 | Skills practice: splinting, bleeding control, epi admin | Skills lab: IV/IO, medication calculation, advanced airway |
| 16:00 – 17:00 | Team trauma scenarios | Complex trauma simulation (multi-system trauma, ALS interventions) |
Day 3 – Operations & Integrated Scenarios
| Time | EMT Refresher | Paramedic Refresher |
|---|---|---|
| 08:00 – 09:00 | EMS operations: safety, MCI triage, hazmat awareness | Advanced operations: ICS roles, critical care transport, disaster response |
| 09:00 – 10:00 | Special populations: geriatrics, psych emergencies | Special populations: geriatrics, behavioral crisis, sedation protocols |
| 10:00 – 11:00 | Ambulance operations & safety | Advanced EMS leadership, documentation for ALS calls |
| 11:00 – 12:00 | Legal & ethical considerations | Legal, ethical, and advanced clinical decision-making |
| 12:00 – 13:00 | Lunch | Lunch |
| 13:00 – 14:00 | Skills mega-checkoff (airway, CPR, trauma, medical) | Skills mega-checkoff (airway, IV/IO, ACLS/PALS, trauma, meds) |
| 14:00 – 15:00 | Scenario-based practice (team EMS calls) | Advanced integrated simulations (cardiac arrest, sepsis, trauma+cardiac) |
| 15:00 – 16:00 | Documentation, handoff reports | Advanced case reviews, critical thinking drills |
| 16:00 – 17:00 | Written exam & course wrap-up | Written exam & capstone ALS scenario |
Key Differences
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EMT Refresher: Focuses on basic life support skills, shorter course, less pharmacology.
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Paramedic Refresher: Adds advanced airway, cardiology, pharmacology, IV/IO, and ALS scenarios; requires more hours.
National Registry Board Makes Distributive Education Waiver Permanent
Board Approves Additional Resolutions
COLUMBUS, Ohio – The National Registry of Emergency Medical Technician’s Board of Directors announced that 22-Resolution-06, or the permanent removal of limits on Distributive Education, is approved following the 60-Day Comment Period. This resolution, which goes into effect on September 30, 2022, applies to all requirements for continuing education, including recertification, state license and re-entry eligibility requirements, and refresher training after three failed examinations.All EMTs, AEMTs and Paramedics due to recertify on March 31, 2023, and beyond, and EMRs due to recertify on September 30, 2023, and beyond, will have no limits on Distributive Education (or online continuing education). The removal of limits now allows all four levels of providers to accomplish continuing education online through any state-accepted or CAPCE-accredited program. Of course, in-person continuing education will continue to be accepted, too.
“The limits on distributive education were initially waived due to the unique circumstances of the COVID-19 Pandemic. Simply put, classrooms were not open or available,” said Bill Seifarth, the National Registry’s chief executive officer and executive director. “It became clear throughout the pandemic that many stakeholders wanted to retain the option for online education permanently.”