EMT Refresher Courses: What They Cover and When You’re Required to Take One

EMT certification is not a one-time achievement. Emergency Medical Technicians must consistently maintain clinical readiness, stay current with evolving medical guidelines, and meet state and NREMT continuing education requirements. EMT Refresher Courses play a core role in that process. Whether you are actively working as an EMT on an ambulance or returning after an inactive period, understanding refresher course content and renewal timelines is essential for staying certified.

This guide breaks down what EMT refresher courses include, how states define mandatory renewal training, the NREMT recertification structure, CE hour requirements, and how refresher programs differ by provider. You’ll also find links to long-form EMT education resources and preparation courses designed to strengthen your foundational knowledge before taking a refresher.

What Are EMT Refresher Courses?

EMT Refresher Courses provide updated education and skills verification for certified EMTs. They are not designed to reteach the entire EMT curriculum, but instead to:

• Reinforce foundational knowledge

• Update students on new treatment protocols

• Revalidate psychomotor skills

• Maintain NREMT and state certification compliance

• Prepare providers for real-world patient care

  
  

Most refresher courses combine didactic material, case-based learning, skills stations, and scenario assessments. States vary in what they require, but the purpose is consistent: to ensure EMTs remain up to date on their knowledge, competent with their skills, and aligned with current standards of care.

When Are EMT Refresher Courses Required? (NREMT and State Timelines)

NREMT Recertification Every Two Years

The National Registry requires EMTs to recertify every two years. To do this, EMTs can complete:

• The NCCP Refresher Course

• Continuing education hours

• Psychomotor skill verification

• Required paperwork and fees

  
  

Check out https://nremt.org/EMT/Recertification for more information on NREMT guidelines.

If an EMT does not meet the deadline, options may include entry-to-practice exams, remediation, or reinstatement requirements.

State EMS Office Requirements

Some states follow NREMT timelines exactly, while others set their own CE and refresher rules. You may need a refresher:

• Every two years (most states)

• Every three years (a few states)

• When transitioning between states

• After certification lapses

• When returning from inactive or expired status

  
  

Even if NREMT accepts CE-only renewal, your state may still mandate a structured refresher course.

Employer or Agency Requirements

Fire departments, private EMS agencies, and hospitals often require refresher courses beyond state minimums.

What Do EMT Refresher Courses Cover? (Refresher Course Content Breakdown)

While course content varies slightly by provider, all refresher programs address the essential domains of emergency medical care.

Airway, Respiration, and Ventilation

• Airway anatomy review

• BVM operation

• Airway adjuncts

• Oxygen therapy

• Suctioning

• Pediatric airway considerations

  
  

Cardiology and Resuscitation

• Cardiac assessment

• CPR updates

• AED operations

• Special populations in cardiac emergencies

  
  

Trauma Assessment and Management

• Patient assessment

• Bleeding control

• Shock management

• Chest, abdominal, and musculoskeletal trauma

  
  

Medical and Obstetric Emergencies

• Diabetic emergencies

• Poisoning and overdose

• Stroke identification

• Asthma and allergic reactions

• OB emergencies

• Pediatric emergencies

  
  

EMS Operations

• Scene safety

• PPE

• Incident command

• Vehicle operations

• Mass-casualty response

  
  

The NCCP model ensures that refresher course content remains nationally consistent. The difference lies in format (online vs in-person), hours, and how states require skills to be validated.

How Long Is an EMT Refresher Course? Required Continuing Education Hours

The NREMT National Continued Competency Program (NCCP) requires:

Total Hours Required for EMTs

NREMT EMT renewal requires 40 hours, divided into:

• 20 hours: National Component

• 10 hours: Local/State Component

• 10 hours: Individual Component

  
  

State-Specific Hour Requirements

Some states modify hour expectations. Examples:

• Some states require more hours to meet state CE rules

• Some require specific in-person skills days

• Some allow online CE for all components

• Others restrict distributive (fully online) education

  
  

Check both NREMT and your State EMS Office to ensure you meet every requirement.

State-by-State Differences: When a Refresher Course Is Mandatory

States define refresher training differently. Common cases in which states require a refresher include:

Lapsed or Expired Certification

Many states require EMTs to complete a refresher before retesting or reinstating certification.

Returning from Inactive Status

Inactive EMTs often need refresher training before re-entering service.

Reciprocity and State Transfers

If you move states, you may be required to complete a refresher to match local requirements.

Skill Deficiencies or Training Gaps

Some medical directors mandate refresher courses for EMTs who need remediation or additional skill development.

Agency Policy Requirements

Agencies may require annual skills verification even if NREMT does not.

Online vs. In-Person EMT Refresher Courses: Which Does Your State Accept?

While NREMT accepts online cognitive CE, skills verification must be documented either:

• In person, or

• Virtually, if the state allows it

  
  

States Commonly Accepting Online Didactic Refresher Courses

At the time of this writing:

• California

• Florida

• Texas

• Arizona

• Nevada

• Virginia

• Pennsylvania

• Washington

• Oregon

  
  

States Allowing Virtual Skills Verification

This varies by year and provider. Always verify requirements before enrolling.

Why EMTs Struggle With Refresher Courses (And How to Prepare)

Many EMTs worry about refreshers because they don’t feel confident in their core knowledge. This is especially common among providers who have:

• Been away from EMS for several years

• Worked in low-call-volume agencies

• Struggled in EMT school

  
  

Never mastered anatomy, physiology, or assessment fundamentals

EMT Training and EMT Preparation Courses

Are you in need of a full EMT course? How about an EMT Preparation course? Our Prep course covers many foundational subjects  which can be helpful if you’ve been out of the field for a while and are re-entering EMS. It can also help if you’ve let your cert expire and have to retake the entire EMT course all over again.  It will rebuild much of your foundational knowledge on the basic sciences and subjects you probably struggled to understand when you went through EMT training the first time. 

• EMT Prep Course: https://mike-s-school-3d2c.thinkific.com/courses/emt-prep

• Accelerated EMT Course: https://www.emteat.com/accelerated-emt-course

• Hybrid Online EMT Course: https://www.emteat.com/hybrid-online-emt-course

FAQs About EMT Refresher Courses

1. What is included in EMT Refresher Courses?

A full EMT Refresher course will include review of basic sciences, updates for local and national guidelines, a review of  trauma management, airway skills, cardiac updates, medical emergencies, and operations content. 

2. How often do I need an EMT refresher?

NREMT requires renewal every two years.

3. How many hours is an EMT refresher?

NREMT’s NCCP model requires 40 hours. Some states require only 24 and others may require 36. Check your local guidelines to make sure you meet the requirements. 

4. Are online refresher courses accepted in my state?

Most states accept online didactic courses if the program offering the course is accredited/approved; some states also require in-person skills verification.

5. What if my EMT certification expires?

You may need a refresher, additional CE hours, and possibly retaking the NREMT exam depending on how long your cert has been expired.

6. Do refresher courses include hands-on skills?

Yes, if required by your state or provider. You also need to renew your BLS CPR cert. Some may allow virtual skills verification.

7. Can I use CE hours instead of a refresher course?

NREMT often allows CE-only renewal, but some states still mandate a formal refresher.

8. Do I need a refresher if I move to a new state?

Possibly. Reciprocity rules vary so check out the requirements of the state you are moving to.

EMT Refresher Courses ensure you stay current, confident, and compliant with state and NREMT standards. Whether you’re refreshing expired skills, renewing certification, or preparing for a return to EMS, the right refresher can make all the difference.

Visit https://www.emteat.com to explore training options for a full EMT course or an EMT Preparation courses.

Have questions? Call 310-295-0271 to speak with our team. We’re here to help you stay certified and ready for the field.