Refresh40
EMT-Basic Refresher Course — Scenario-based adaptive learning for NREMT recertification. All 40 hours. One platform.
Open for Review — No purchase requiredIs Refresh40 right for you? This course is for currently certified EMTs who need to complete 40 NCCP hours for NREMT recertification. If you are preparing for initial certification or need remediation after failing the NREMT exam, the 14-Day EMT Remediation Course is the appropriate program.
Why This Course Works
Refresh40 mirrors the proven 40-hour NCCP recertification structure — all 5 National Component domains, the State/Local component, and the Individual component — and replaces generic content with IPM's scenario-based adaptive learning engine.
Instead of passive video watch-and-click, each module places you inside dynamic patient emergencies. The system tracks your mastery in real time using Bayesian Knowledge Tracing (BKT) and automatically adjusts question difficulty, giving harder scenarios when you're performing well and targeted remediation when you're not.
The result: EMTs who have actually practiced the clinical judgment the NREMT exam tests — not just watched someone else demonstrate it.
NCCP Hour Breakdown
National Component
Airway 1.5 · Cardiology 2.5 · Trauma 3 · Medical 7 · Operations 6
State / Local Component
Regional protocols, QI/QA, documentation, legislation
Individual Component
Gap-targeted adaptive review + 100-Q NREMT final exam
Total
40 hrsAdaptive Engine
BKT difficulty tracking
80% Mastery Gate
Per-module requirement
40-Hour Certificate
NREMT NCCP-compliant
Self-Paced
Resume anytime
Reference Model vs. Refresh40
| # | NCCP Domain | Reference Structure | Refresh40 Approach | NCCP Hrs |
|---|---|---|---|---|
| 1 | Airway, Respiration & Ventilation | Video lecture + comprehension quiz | Simulation-first · adaptive airway emergencies · BVM competency check | 1.5 |
| 2 | Cardiology & Resuscitation | Didactic slides + AED competency | Live-code simulation · ROSC branch scenarios · CAT-adjusted difficulty | 2.5 |
| 3 | Trauma | MOI videos + skill station checklists | XABCDE scenario branches · tourniquet decision gates · mass-casualty drill | 3.0 |
| 4 | Medical / Operations | Case studies per chief complaint | Adaptive AMS/ACS/stroke differentials · pharmacology decision trees | 7.0 |
| 5 | EMS Operations | ICS lecture + triage tabletop | MCI simulation with 22-patient START triage · ICS role-play | 6.0 |
| 6 | Pediatric & OB | Pediatric module + OB unit | PAT-first scenarios · weight-based dosing simulator · delivery complications | 4.0 |
| 7 | State / Local Component | State protocol review PDF | Interactive regional protocol library · QI/QA simulation | 10.0 |
| 8 | Individual / Exam Prep | Generic practice questions | BKT-personalized gap review · 100-Q CAT final exam with rationale | 10.0 |
| Total NREMT NCCP Hours | 40 | |||
Before diving into the eight modules, Katie narrates a complete course orientation. She opens with the required introduction, reviews all eight learning objectives, then reads sequentially through every module — covering what's included in each, the adaptive scenario hook, and the mastery gate. Listen here first, then begin with Module 1.
What This Orientation Covers
Required opening lines
Fixed introduction — exact required text
All 8 learning objectives
What mastery looks like after 40 hours
Modules 1–8 sequentially
Core content, adaptive scenario, assessment gate
Closing anchor
Fixed closing — exact required text
Full Lesson Plans
National Component
Module 1 — Airway, Respiration & Ventilation
Learning Objectives
- 1Reassess airway anatomy and physiology for adult, pediatric, and geriatric patients
- 2Demonstrate correct OPA/NPA sizing and placement using 2025 NAEMSP guidelines
- 3Apply BVM E-C clamp technique with two-provider coordination
- 4Identify indications for suction and select appropriate catheter type
- 5Differentiate oxygen delivery devices by FiO₂ output and clinical indication
- 6Recognize respiratory failure vs. respiratory distress using clinical signs
Core Content Topics
- Airway anatomy review: adult vs. pediatric differences (occiput, trachea angle, epiglottis)
- OPA and NPA: sizing, indications, contraindications, insertion technique
- Suctioning: rigid (Yankauer) vs. flexible catheter; duration limits; risks
- Oxygen delivery: nasal cannula, simple mask, NRB, Venturi — FiO₂ targets
- BVM ventilation: E-C clamp, one-person vs. two-person, rate and volume
- Capnography basics: waveform interpretation, ETCO₂ targets
- Pediatric airway special considerations: jaw thrust, length-based tape
- Geriatric airway: dentures, reduced respiratory reserve, medication interactions
Adaptive Scenario
Scenario: 68-year-old unresponsive male with vomit in airway. System adjusts question difficulty based on your suction sequence choices.
Assessment
10-question adaptive micro-quiz · must score 80% to advance
National Component
Module 2 — Cardiology & Resuscitation
Learning Objectives
- 1Apply 2025 AHA chain of survival to prehospital cardiac arrest management
- 2Execute high-performance CPR with correct rate, depth, recoil, and minimal interruptions
- 3Interpret AED prompts and manage shock delivery in VF/VT scenarios
- 4Recognize and differentiate STEMI presentation from NSTEMI/stable angina
- 5Manage post-ROSC care including hemodynamic monitoring and transport decision
- 6Identify special resuscitation situations: pregnancy, hypothermia, trauma arrest
Core Content Topics
- Chain of survival — 2025 update: early access, CPR, defibrillation, ALS, post-arrest
- High-performance CPR: rate 100-120/min, depth 2-2.4", full recoil, minimize pauses
- AED operation: placement, analysis phase, clearing, shock delivery
- Cardiac anatomy and arrhythmia recognition: VF, VT, asystole, PEA
- ACS continuum: stable angina → NSTEMI → STEMI; symptom patterns
- Nitroglycerin and aspirin: EMT indications, contraindications, administration
- Post-ROSC: ETCO₂-guided ventilation, avoiding hyperoxia, BP management
- Special arrest: hypothermia (rewarm before pronounce), drowning, pregnancy
Adaptive Scenario
Scenario: Witnessed VF arrest in a 55-year-old. System tracks your CPR sequence timing and adjusts complexity of post-ROSC management questions.
Assessment
10-question adaptive micro-quiz · must score 80% to advance
National Component
Module 3 — Trauma
Learning Objectives
- 1Apply XABCDE primary survey framework to all trauma patients
- 2Classify hemorrhage by class and select correct intervention per class
- 3Demonstrate tourniquet application technique and document time of application
- 4Manage chest trauma: open pneumothorax, tension pneumothorax, flail chest
- 5Apply spinal motion restriction principles using current evidence-based criteria
- 6Recognize mechanism of injury patterns predicting specific injury profiles
Core Content Topics
- XABCDE primary survey: X=eXsanguination first, ABCDE systematic approach
- Hemorrhage classes I–IV: signs, interventions (direct pressure → tourniquet → wound packing)
- Tourniquet: Combat Application Tourniquet (CAT), placement, time documentation
- Wound packing with hemostatic gauze: indications, technique
- Chest trauma: open pneumothorax (vented chest seal), tension pneumothorax (decompression by ALS)
- Flail chest: positive pressure ventilation; paradoxical movement recognition
- Head trauma: GCS scoring, Cushing triad, pupil response
- Spinal motion restriction: criteria-based (NEXUS/Canadian C-Spine), selective immobilization
- Pediatric trauma: anatomical differences, fall height thresholds
- Burn management: rule of nines, stop-drop-roll, cooling vs. covering
Adaptive Scenario
Scenario: MVC rollover with unrestrained driver. System branches scenarios based on whether you correctly identify tension pneumothorax or miss it.
Assessment
10-question adaptive micro-quiz · must score 80% to advance
National Component
Module 4 — Medical Emergencies
Learning Objectives
- 1Differentiate altered mental status etiologies using the AEIOU-TIPS mnemonic
- 2Manage diabetic emergencies: hypoglycemia vs. hyperglycemia — assessment and intervention
- 3Recognize stroke using FAST/BE-FAST and communicate last known well time
- 4Assess and manage anaphylaxis including epinephrine auto-injector use
- 5Apply SAMPLE history and OPQRST to chest pain, dyspnea, and abdominal pain
- 6Identify psychiatric emergencies and apply de-escalation principles
Core Content Topics
- Altered mental status: AEIOU-TIPS (Alcohol, Epilepsy, Insulin, Opiates, Uremia, Trauma, Infection, Psychosis, Stroke)
- Diabetic emergencies: BGL thresholds, oral glucose (conscious), positioning, transport
- Stroke: FAST/BE-FAST, time of onset, stroke center routing, field stroke scale
- Seizure: active vs. postictal care, status epilepticus, airway management
- Anaphylaxis: recognition, epinephrine auto-injector (thigh, document time), second dose
- Respiratory emergencies: asthma (SABA), COPD (controlled O₂), pulmonary edema
- Abdominal emergencies: GI bleed, ectopic pregnancy, aortic aneurysm red flags
- Toxic emergencies: overdose patterns, opioid reversal with naloxone
- Behavioral/psychiatric: safety assessment, restraint principles, excited delirium
Adaptive Scenario
Scenario: 42-year-old unresponsive with medic-alert bracelet (diabetic). System adapts based on glucose assessment choices and oral glucose eligibility decisions.
Assessment
10-question adaptive micro-quiz · must score 80% to advance
National Component
Module 5 — EMS Operations
Learning Objectives
- 1Apply scene size-up principles: safety, NOI/MOI, number of patients, additional resources
- 2Execute START triage algorithm in MCI scenarios with correct priority assignment
- 3Describe safe ambulance driving principles and pre-trip inspection checklist
- 4Identify landing zone criteria for air medical transport
- 5Apply NIMS ICS structure to MCI response and communicate within the system
- 6Manage lifting and moving: body mechanics, patient packaging, device selection
Core Content Topics
- Scene size-up: BSI/PPE, scene safety, MOI/NOI, resource needs, crowd control
- START triage: R-P-M (Respirations, Perfusion, Mental status) → Black/Red/Yellow/Green
- JumpSTART for pediatrics: modified breathing threshold (15 vs 30)
- MCI ICS: Incident Commander, Medical Group Supervisor, Treatment/Transport/Staging sectors
- Ambulance operations: pre-trip checklist, due regard, intersection safety, backing
- Air medical: LZ setup (100×100 ft), marking, radio coordination, rotor safety
- Patient movement: emergency vs. urgent vs. non-urgent moves, device selection
- Lift mechanics: power grip, wide base, keep load close, team lifts
- Hazmat awareness: recognize, isolate, deny entry — EMT does NOT enter the hot zone
- Special operations: confined space, water rescue, structural collapse awareness
Adaptive Scenario
Scenario: 8-vehicle pileup on highway — 22 patients. System tracks your triage accuracy and ICS communication decisions under time pressure.
Assessment
10-question adaptive micro-quiz · must score 80% to advance
National Component · Pediatric Requirement
Module 6 — Pediatric & OB Emergencies
Learning Objectives
- 1Apply the Pediatric Assessment Triangle (PAT) as the first assessment tool for pediatric patients
- 2Differentiate pediatric respiratory failure from distress using clinical signs
- 3Calculate weight-based drug and fluid dosing using length-based tape (Broselow)
- 4Manage neonatal resuscitation using NRP warm-stimulate-position-assess sequence
- 5Identify imminent delivery signs and assist with normal and abnormal presentations
- 6Recognize pediatric NAT (Non-Accidental Trauma) indicators and reporting obligations
Core Content Topics
- PAT: Appearance (TICLS), Work of Breathing, Circulation — first 30-second impression
- Pediatric vital sign normals by age group: neonate, infant, toddler, school-age, adolescent
- Respiratory emergencies: croup (seal bark, stridor), epiglottitis (tripod, drooling), bronchiolitis
- Febrile seizures: management, parental reassurance, transport decision
- Pediatric shock: compensated vs. decompensated; early recognition imperative
- Length-based tape (Broselow): color-coded dosing, equipment sizing
- Normal delivery: crowning, cord management, drying and stimulating, APGAR
- Abnormal presentations: breech, prolapsed cord, shoulder dystocia maneuvers
- Neonatal resuscitation: PPV indications, rate, O₂ delivery
- NAT: unexplained bruising patterns, delay in seeking care, inconsistent history
Adaptive Scenario
Scenario: 18-month-old febrile and limp — caregiver says "she just got hot." System adapts based on how you differentiate febrile seizure from sepsis.
Assessment
10-question adaptive micro-quiz · must score 80% to advance
State/Local Component
Module 7 — State/Local Component
Learning Objectives
- 1Review state-specific EMT scope of practice updates and formulary changes
- 2Apply regional mass casualty and disaster response protocols
- 3Complete local EMS protocol refresher for most common call types in your region
- 4Demonstrate knowledge of QI/QA reporting procedures per local EMS agency
- 5Identify updated state EMS legislation, HIPAA updates, and documentation standards
Core Content Topics
- State EMT scope of practice: current formulary, new additions, restrictions
- Regional EMS protocols: chest pain, stroke, STEMI, trauma center routing
- Local disaster/MCI plans: regional hospital divert, EMTALA, mutual aid
- Documentation: state-specific PCR platform, e-PCR data requirements
- QI/QA: mandatory reporting, peer review, near-miss reporting culture
- HIPAA and patient privacy in EMS: sharing information with receiving facilities
- EMS legislation updates: Naloxone distribution laws, POLST/MOLST recognition
- Cultural competency and language access: using interpreter services, consent across languages
Adaptive Scenario
Protocol scenario library: regional routing and protocol decisions for 6 simulated calls including STEMI, stroke, and polytrauma.
Assessment
10-question knowledge check · state-specific scenarios
Individual Component
Module 8 — Individual Component & NREMT Adaptive Exam Prep
Learning Objectives
- 1Apply NREMT Computer Adaptive Testing (CAT) strategy for question interpretation
- 2Identify personal knowledge gaps using BKT mastery tracking data from prior modules
- 3Practice clinical judgment under time pressure using adaptive scenario sets
- 4Review high-yield NREMT topic areas: pharmacology, consent/ethics, documentation
- 5Complete 100-question final adaptive practice examination simulating NREMT format
Core Content Topics
- NREMT CAT explained: how difficulty adapts, 70-120 item range, passing standard
- Question anatomy: clinical stem, lead-in, distractors — how to identify the "most correct" answer
- High-yield pharmacology: aspirin, nitroglycerin, epinephrine, naloxone, oral glucose, O₂
- Consent and ethics: expressed, implied, informed, refusal of care, minors, DNR/POLST
- Documentation and legal: falsification, abandonment, negligence, duty to act
- BKT gap analysis: each student receives personalized weak-concept list from prior modules
- Adaptive scenario drills: 40 branching scenarios spanning all 5 NCCP domains
- 100-question NREMT-format final exam: CAT-scored, detailed answer rationale
Adaptive Scenario
Full adaptive final exam: difficulty adjusts in real-time. Students who score < 80% receive a personalized remediation plan targeting missed concepts.
Assessment
100-question NREMT-format final exam · 80% passing standard
Ready to Recertify?
40 hours. 8 modules. One adaptive exam. Meets NREMT NCCP recertification requirements.