Certified first responder

A portion of the accident scene for Ansbach, Germany incident response exercise for U.S. and German emergency responders, October 2007.

A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. They have more skill than someone who is trained in basic first aid but they are not a substitute for advanced medical care rendered by emergency medical technicians, emergency physicians, nurses, or paramedics. The term "certified first responder" is not to be confused with "first responder", which is a generic term referring to the first medically trained responder to arrive on scene (police, fire, EMS).

Certified First Responders in Canada

Many options are available in order to become a certified First Responder in Canada. Courses are offered by many sources including the Canadian Red Cross, and St. John Ambulance, and the Department of National Defence. Certified First Responder courses in Canada are separated into either "First Responder" or "Emergency Medical Responder" level courses. However, before the people can take either the First Responder or the EMR course, they are required to complete "Standard First Aid", which is about 24 hours long. "First Responder" level courses are usually 40 hours in length (though St. John Ambulance offers a truncated 24 hour course) and is considered the minimum level of training for crews providing medical standby at events, as well as for employment with some private stable transport companies that provide inter-hospital transfer for patients in need of a bed, but are stable and do not require advanced medical care. "Emergency Medical Responder" level courses meet the Paramedic Association of Canada's National Occupational Competency Profile, and those who receive certification at this level can work for Emergency Medical Services in some provinces.

First Responders from St. John Ambulance and fire departments assist paramedics during an exercise outside Thunder Bay, Ontario, Canada

Examples

The Canadian Ski Patrol System, St. John Ambulance Patient Care Divisions, Volunteer Fire Departments, Campus Response Teams, and the Canadian Coast Guard all provide Certified First Responder level emergency medical care, in some cases as a support to existing services, and in others as the primary emergency response organization.

Limitations on Certified First Responders

While all Certified First Responders in Canada and america are covered under Good Samaritan laws in jurisdictions where they are enacted, in some cases they have a Duty to Act. Certified First Responders who are providing medical coverage to events (such as St. John Ambulance's Patient Care Divisions), as well as those who are employed by Volunteer Fire Departments, Campus Response Teams, and others who are required to perform Emergency Medical Response as part of their duties all have a Duty to Act. While Certified First Responders in general are not required to render aid to injured/ill persons, those who work in the aforementioned areas can be accused of and prosecuted for negligence if they fail to respond when notified of a medical emergency, if their care does not meet the standard to which they were trained, or their care exceeds their scope of practice and cause harm to the paitent. As with all medically trained and certified persons, Certified First Responders are immune to successful prosecution if assistance was given in good faith up to, and not beyond, the limits of certification and training.

First responders in France

Main article: Certified First Responder in France

In France, the pre-hospital care is either performed by first responders from the fire department (sapeurs-pompiers, most emergency situations) or from a private ambulance company (relative emergency at home), or by a medical team that includes a physician, a nurse and an ambulance technician (called "SMUR"). The intermediate scale, the firefighter nurse (infirmier sapeur-pompier, ISP), is only a recent evolution and is performed by nurses specially trained acting with emergency protocols; these nurses are the French equivalent of paramedics. The first responders are thus the most frequent answer to emergency calls. In addition, in France there exists a network of first responder associations. These CFR volunteers are allowed to supervise massive outside meetings, student fests, etcetera. These volunteers have followed the same special rescuer training as firefighters (PSE 1 & PSE 2, at all 70 hours of training).

First responders in the United Kingdom

In the United Kingdom, most statutory NHS ambulance services deploy paid first responders who drive dedicated "Rapid Response Vehicles" (RRVs). These are typically estate cars, MPVs or 4x4s, are liveried with high-visibility ambulance markings, and fitted with blue flashing lights and sirens. These vehicles are generally single-crewed, by an Emergency Medical Technician, Paramedic, or Emergency Care Practitioner. This differs from most ambulances in the UK, which usually have two crew members.

Community First Responder Schemes

Main article: Community First Responder

Scottish Ambulance Service "First Responder" vehicle

A Community First Responder Scheme is made up of groups of volunteers who, within the community in which they live or work, have been trained to attend emergency calls received by the NHS (National Health Service) Ambulance Service, providing potentially life-saving treatment and first aid until an emergency ambulance arrives.

The Welsh Ambulance Services NHS Trust, when looking at the locations for Responder Groups, take the following into consideration:

• Towns or villages where it is challenging for an emergency ambulance to arrive at scene within 8 minutes – this is usually in the more rural areas of the county.

• The total number of calls received within these locations must be significant enough for training to take place, ensuring motivation of the group members and that their contribution would have a valued, significant effect on patients.

• Responders are members of the community who are trained to use Automated external defibrillator, Oxygen and other lifesaving equipment to assist ambulance crews, and maintain patient stability whilst professional crews are in attendance. Responders have no special dispensation to break the rules of the road whilst attending calls. The only exception to this is in the case of CFR groups which have been given specially liveried cars and response vehicles which include blue lights. Under the Road Traffic Act and various other UK traffic law, correct and permitted use of Blue Lights on a vehicle allows the driver to cross solid white lines to overtake, and to treat a red light as a 'Give Way' sign. Out of all the Ambulance trusts in the UK, a handful have CFR schemes with dedicated cars, and most of these are not given blue lights.

First responders in the United States

History

The U.S. Department of Transportation (D.O.T.) recognized a gap between the typical eight hours training required for providing advanced first aid (as taught by the Red Cross) and the 180 hours typical of an EMT-Basic program. Also, some rural communities could not afford the comprehensive training and highly experienced instructors required for a full EMT-Basic course. The First Responder training program began in 1979 as an outgrowth of the "Crash Injury Management" course.

In 1995 the D.O.T. issued a manual for an intermediate level of training called "First Responder." This training can be completed in forty to sixty hours. Importantly, this training can be conducted by an EMT-Basic with some field experience—which is a resource available "in-house" for many volunteer fire departments who do not have the resources for full EMT training. The first responder training is intended to fill the gap between First Aid and EMT-Basic.

The American Red Cross conducts a course titled "Emergency Response" that fits this definition.

Scope of Practice

Emergency responders are tested during a training exercise.

First Responders in the US can support Emergency Medical Technicians and Paramedics, provide basic first aid for soft tissue and bone injuries and assist in childbirth. They are also trained in packaging, moving and transporting patients.[1]

First responder skills and limitations

Lifesaving skills in the first responder course include recognizing unsafe scenarios and hazardous materials emergencies, protection from blood borne pathogens, controlling bleeding, applying splints, conducting a primary life-saving patient assessment, in-line spinal stabilization and transport, and calling for more advanced medical help. First responders are allowed to administer oxygen under an EMT basic or higher only. First Responders can serve as secondary providers with some volunteer EMS services. A certified first responder can be seen either as an advanced first aid provider, or as a limited provider of emergency medical care when more advanced providers are not yet on scene or available. First responders also serve as triage

Rescue

The National Fire Protection Association regulations 1006 and 1670 state that all "rescuers" must have medical training to perform any technical rescue operation, including cutting the vehicle itself during an extrication. Therefore, in most all rescue environments, whether it is an EMS Department or Fire Department that runs the rescue, the actual rescuers who cut the vehicle and run the extrication scene or perform any rescue such as rope, low angle, etc, are Medical First Responders, Emergency Medical Technicians, or Paramedics, as most every rescue has a patient involved.

Traditional first responders

The first responder training is considered a bare minimum for emergency service workers who may be sent out in response to a call for help and is almost always required for professional firefighters, such as the FDNY, who require valid CFR-D (Certified First Responder-Defibrillation) certification for all firefighters. The first responder level of emergency medical training is also often required for police officers.

Non-traditional first responders

Many people who do not fall into the earlier mentioned categories seek out or receive Certified First Responder training through their employment because they are likely to be first on the scene of a medical emergency, or because they work far from medical help.

Some of these non-traditional first responders include:

• Park rangers
• Utility workers
• Teachers, childcare workers, and school bus drivers
• Designated industrial workers in a large facility (industrial plant) or at a remote site (fish-packing plant, commercial vessel, oil rig)
• Police Officers
• Security guards
• Bodyguards
• General aviation pilots and commercial flight attendants
• Sports coaches and Athletic trainers
• Hunting and fishing guides
• Search and rescue personnel
• Campus Responders
• Lifeguards/Ski Patrollers
• Camp counsellors

See also

• Outdoor Emergency Care
• Combat Lifesaver
• Rescue Squad
• Extrication
• Triage
• list of French organisations training first responders (associations and administrations)

External links

• IAEA-WHO Manual for first responders to a radiological emergency
• EMT City, large online community for EMTs and Paramedics
• British Red Cross First Responders
• National Website for Community First Responders (Currently rolling out across the UK)