How Clinical Guidelines Impact the National Registry

November 12, 2020

The American Heart Association (AHA) recently updated CPR guidelines with an emphasis on recovery, especially after sudden cardiac arrest. The 400+ updates also address overdoses, new technology and an effort to increase awareness of the importance of high-quality bystander CPR.

For the AHA, this comprehensive update builds on focused annual guideline updates, adopted for continuous evidence review since 2015. Similarly, the National Registry’s examinations are constantly undergoing review, updates and changes to best reflect the current practice in EMS. That means monitoring clinical guidelines from the AHA, American College of Emergency Physicians (ACEP), the Centers for Disease Control and Prevention, the American College of Surgeons and many, many more.

When updates are released from any of these organizations, National Registry program managers immediately go through the updates to make sure there is nothing on the current examinations that is in direct conflict.

The content review begins a process of identifying and removing any conflicting content. That is followed by a broader sweep of the National Registry’s item bank to remove any content that may conflict with any new or updated guidelines. At the same time, the National Registry uses practicing EMS providers, educators, and medical directors to develop new content and items. These items will ultimately make their way to the Cognitive and Psychomotor examinations after extensive review.

“New content takes time to develop – as long as 6 to 12 months,” said Dr. Gregory M. Applegate, chief science officer for the National Registry. “The time window is important because it gives EMS programs time to begin incorporating the new guidelines into their curriculum and students time to learn the new material prior to encountering it on a National Registry examination.”

The National Registry also must be aware of guidelines which may conflict with one another. As a result, the National Registry is working with the Prehosptial Guidelines Consortium on methods to better align published evidence-based guidelines with National Registry standards.


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Shane Cartmill
Communications & Marketing Manager