An EMT refresher course covers the topic areas required by the National Continued Competency Program (NCCP): airway/respiration/ventilation, cardiovascular, trauma, medical, and operations. Under the 2025 NCCP model, these five areas make up the national component, which accounts for 50 percent of your total recertification hours. The remaining hours are split between state/local and individual components.
Purchasing an NREMT package from CE Solutions allows your NREMT hours to SYNC to NREMT.
Why EMT Refresher Topics Are Structured Around the NCCP
The term "refresher course" is still used widely, but what it describes has changed.
The National Continued Competency Program (NCCP) was constructed using methodology similar to that of the American Board of Medical Specialties requirements and streamlines the recertification process into three strategic categories of continuing education: National, Local, and Individual.
That shift moved EMS continuing education away from a single block of generic hours toward a clinically grounded structure that mirrors how other healthcare professions handle ongoing competency.
Topics included in the national component reflect current trends in evidence-based medicine, scope of practice changes, and position papers from numerous associations involved with EMS research, with an additional focus on those patient presentations that have a low frequency but high criticality.
That last point matters. Your refresher is not just a review of basics. It is designed to keep you sharp on calls you may rarely run but cannot afford to mismanage.
If you are planning your CE now, start with the official NREMT National Continued Competency Program page to confirm the current model requirements before selecting courses.
The 2025 NCCP Model: What Changed for EMTs
The National Registry began implementing the 2025 NCCP Model on April 1, 2025 for EMT, AEMT, and Paramedic recertification.
If your certification expires after that date, the 2025 model applies to you.
The five broad topic domains remain the same, but how they are organized inside the national component has been updated.
The 2025 model provides more comprehensive topic areas like neurology, stroke, geriatrics, and disaster management under the umbrella of "Medical."
One of the most concrete additions is a pediatric requirement.
Under the 2025 NCCP model, at least 10 percent of the required national component credits must address pediatric care. This pediatric education is included within, not added to, the national component requirement, equaling 2 credits for EMTs.
Earlier versions of the NCCP broke each national subsection down into very specific required topics. The 2025 model loosens that structure somewhat, giving education providers more latitude in exactly how content is delivered within each domain. That flexibility does not reduce the clinical depth required. It simply allows accredited providers to build courses that reflect current evidence more accurately.
EMT Refresher Course Topics Broken Down by Component
Under the 2025 NCCP,
EMTs require a total of 40 hours, divided as: 20 hours national component, 10 hours local/state component, and 10 hours individual component.
Here is how those topic areas break down in practice.
National Component: 20 Hours (50% of Total)
Core topic areas under the national component include airway/respiration/ventilation, cardiovascular, trauma, medical, and operations.
The Utah EMS Office published the official 2025 NCCP National Component breakdown, which shows the required hour allocations per topic area by certification level. You can review that document at the Utah EMS 2025 NCCP National Component Guide as a reference for how the credits are distributed.
- Airway, Respiration, and Ventilation: BVM technique, airway adjuncts, oxygenation, ventilation management, respiratory emergencies including pediatric presentations.
- Cardiovascular: Chest pain assessment, ACS recognition, cardiac arrest management, CPR quality, AED use, and shock states.
- Trauma: Bleeding control, spinal motion restriction decisions, burns, musculoskeletal injuries, and mechanism of injury evaluation.
- Medical: Altered mental status, stroke recognition, diabetic emergencies, toxicology, anaphylaxis, OB emergencies, behavioral health, geriatric considerations, and neurological presentations.
- Operations: Scene safety, ICS, MCI response, hazmat awareness, vehicle extrication roles, and documentation.
Note that 10 percent of your total national component credits must be in pediatric content.
For EMTs, that means at least 2 of your 20 national component hours must directly address pediatric patients. Verify this requirement is met before submitting your application.
State/Local Component: 10 Hours (25% of Total)
Specific topic requirements may be defined by your specific state, region, or local agency. Examples of local content topics typically include state or local protocols, areas of specialization, or tasks that require additional focus based on QA/QI.
Common state-specific requirements include jurisprudence, infection control, EMS law updates, and local protocol changes. Check your state EMS office website or use the state-by-state requirements pages at CE Solutions to find what your state mandates for this component.
Individual Component: 10 Hours (25% of Total)
The individual component is the most flexible portion of your recertification. You choose topic areas relevant to your practice, your agency, or skill gaps you have identified.
Choosing a CAPCE-accredited provider protects you from completing CE hours that do not count toward NREMT recertification or state licensure renewal.
That protection matters here especially, since providers sometimes use this component to complete courses from less-vetted sources.
Purchasing an NREMT package from CE Solutions allows your NREMT hours to SYNC to NREMT.
How to Choose Courses That Cover the Right EMT Refresher Topics
Knowing the topic list is not enough. The course you pick must be accepted by the NREMT or your state EMS office.
All education submitted for NREMT recertification must be CAPCE-accredited or accepted by a state EMS office, and all education must be directly related to EMS patient care.
CAPCE has become aware of various continuing education providers who falsely represent that they are accredited by CAPCE. You can verify any provider's status directly through the CAPCE official website.
That verification step takes two minutes and can save you from completing hours that are rejected at renewal. Visit capce.org to confirm a provider's accreditation status before enrolling.
For a deeper look at how credit hours are calculated and tracked across a full two-year cycle, see the CE Solutions guide on EMT continuing education hours.
Practical Steps to Build Your EMT Refresher Plan
- Confirm your NREMT certification expiration date and which NCCP model applies to your cycle.
- Check your state EMS office for any mandatory state/local topics that must be completed before you can apply for renewal.
- Choose a CAPCE-accredited provider and verify their accreditation directly on the CAPCE website.
- Select national component courses that cover all five topic domains and include the required pediatric content.
- Use your individual component hours for areas that strengthen your practice, such as geriatric care, behavioral health, or mass casualty response.
- Purchasing an NREMT package from CE Solutions allows your NREMT hours to SYNC to NREMT.
Frequently Asked Questions
Are EMT refresher course topics the same in every state?
The national component topics are consistent across all states because they are set by the NREMT. The state/local component topics vary. Your state EMS office or medical director determines what must be covered in that 25-percent slice. Always check your state's requirements separately from the NREMT requirements.
Can I complete my EMT refresher course topics entirely online?
Most national and individual component hours can be completed through CAPCE-accredited online courses. Some states require hands-on skills verification or specific in-person components for the state/local portion. Check your state EMS office requirements before assuming a fully online path is available to you.
What happens if I complete hours in the wrong topic area?
Hours submitted under the wrong NCCP category may be rejected by the NREMT, leaving gaps in your application. Review the official NREMT recertification page and your provider's course labeling carefully. If a course is labeled by your CAPCE-accredited provider under a specific topic domain, that label carries weight when you submit your transcript.
Purchasing an NREMT package from CE Solutions allows your NREMT hours to SYNC to NREMT.
CE Solutions has delivered CAPCE-accredited EMS continuing education to EMRs, EMTs, AEMTs, and Paramedics since 1997. If you are ready to complete your required EMT refresher course topics with courses that are accepted by the NREMT and state EMS offices, create your free CE Solutions account and get started today.
