Background: Given the large number of palliative patients cared for by the emergency services, education and training in palliative care topics are playing an increasingly important role. To support decision-making in an emergency setting a palliative or emergency card has been introduced in many cities., Objectives: To assess the success of educational interventions and the effect of the palliative or emergency card, a questionnaire was developed and validated to determine palliative knowledge and palliative self-efficacy expectations in the emergency services., Materials and Methods: A Delphi process was applied for development and content validation. Factor analysis was used for construct validation. Criterion validity was assessed with the help of 22 nurses specially trained in palliative care. Reliability was determined using Cronbach's alpha as a measure of internal consistency., Results: In all, 291 of 750 paramedics participated in the voluntary survey. After completion of the Delphi process, there was consensus that the important topics of pain, dyspnea, sedation, end-of-life care, euthanasia, and legal aspects were covered in the questionnaire. Factor analysis was in favor of a six-factor solution. Criterion validation revealed a significant difference in palliative knowledge between palliative care nurses (M Rang 289.73) and paramedics (M Rang 146.97, U = 281.000, r = 0.40, p < 0.001). Cronbach's alpha was 0.70 for the knowledge questions and 0.82 for the palliative care self-efficacy expectancy subscale., Conclusions: The Paramedic Palliative Care Test (PARPACT) is a validated measurement tool for testing educational interventions in paramedicine., (© 2021. The Author(s).)