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Certified First Responder

Quick Tips #340

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Background

The term first responder is commonly used to describe the first medically trained person to arrive at the scene of an accident or other incident. The term is also used when referring to a certified first responder. A certified first responder (CFR) may very well be the first on scene, but has a more than basic knowledge of first aid that can be used to perform patient assessment and intervention and also assists EMS providers.

In 1979, the US Department of Transportation (US DOT) recognized a gap between basic first aid and EMT level training. Basic first aid as taught by the Red Cross is covered by 8 hours of training. Basic EMT level training is 110 hours. There are three other levels of EMT training: EMT Intermediate 85 (200-400hrs), EMT Intermediate 99 (200-400 hrs), and EMT Paramedic (1000 hrs). Certified first responders fill the training gap. To become a certified first responder, one must complete 40-60 hours of first aid training. The training involves seven modules that have been established by a curriculum development group of medical personnel and educators. The curriculum was developed to create a training system that allows for evaluation of the students as they acquire new skills as well as testing the medical concepts regarding human physiology and anatomy. They included input from emergency medical personnel, physicians and test groups of certified first responders. The curriculum for certified first responders can vary by state. Training is often added to respond to patient care issues that arise from field experience and concerns that may have been left out of the core curriculum.

The Seven Core Modules:

Module 1) Covers the basic concepts and concerns of a certified first responder. The roles and responsibilities of first responders are discussed, including an overview of the EMS system. Stress management in critical situations, personal protective equipment and scene safety are covered, as well as the legal and ethical issues a first responder may encounter (such as consent, refusal of treatment and duty to act, confidentiality and crime scenes). Also included in the first module is an overview of body systems, anatomy, physiology, body mechanics and lifting and carrying techniques.

Module 2) Covers airway anatomy and physiology, how to maintain an open airway, pulmonary resuscitation and the differences in adults and children. This module also includes a practical lab of the techniques discussed regarding barrier devices, suction equipment, airways and the removal of foreign objects from an airway.

Module 3) Trains the certified first responder in patient and scene assessment. This includes evaluating a scene for possible hazards and determining the quantity of patients and the need for additional help. Students also will learn to assess the nature of the injury or illness by determining responsiveness, assessing the airway, breathing and circulation.

Module 4) Cardio pulmonary resuscitation (CPR). This covers the current American Heart Association standard for CPR and allows for practicing the concepts and skills regarding chest compressions for adults, children and infants.

Module 5) Covers what is commonly referred to as first aid. This module covers recognition and management of general medical complaints, seizures, altered mental status, environmental emergencies, behavioral emergencies, psychological crisis and typical patient situations. A review of the cardiovascular system is covered to prepare for internal and external bleeding first aid, as well as soft tissue injuries and burns. Dressing and bandaging wounds is also taught here. The final portion of module five is musculoskeletal injuries, and includes head and spinal injuries.

Module 6) Covers children and childbirth. Information is presented in two parts. The first covers the physiological and anatomical changes that occur during pregnancy and demonstrates child delivery and newborn care. The second part presents the differences between children and infants and their common medical and trauma conditions.

Module 7) Final module. A review of the knowledge needed to function as a first responder and an overview of extrication and rescue operations, hazardous material, mass casualty situations and basic triage.

Certified first responder training is available through most technical colleges as well as some independent training services. Being a certified first responder has become a requirement for many law enforcement agencies and other emergency personnel. There are also a growing number of first responders in other fields. Teachers, lifeguards, utility workers, bus drivers, hunting and fishing guides and flight attendants are among the growing list of certified first responders.

When the 40 to 60 hours of training are complete, certification lasts for two years. Some time before two years expires a training update course of 16 hours is required to maintain certification. The requirements for reinstatement vary. Below is an excerpt from the National Registry of Emergency Medical Technicians website dictating the various procedures and time frames.

Lapsed Registration

To be reinstated once the First Responder National Registration has lapsed, the candidate must:

If lapsed within a two-year period, successfully complete a First Responder Refresher program, submit a new application and fee, successfully complete the National Registry cognitive examination and a practical examination that equals or exceeds the criteria established by the U.S. Department of Transportation: First Responder Final Practical Skills Exam, Appendix "H"; including One and Two Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway.

If lapsed beyond a two-year period and state licensure/certification has been maintained, successfully complete a USDOT First Responder Refresher program, submit a new application and fee, successfully complete the National Registry cognitive examination and a practical examination that equals or exceeds the criteria established by the U.S. Department of Transportation: First Responder Final Practical Skills Exam; Appendix "H"; including One and Two Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway.

If lapsed beyond a two-year period and state licensure/certification has not been maintained, successfully complete another entire First Responder Education program, submit a new application and fee; successfully complete the National Registry cognitive examination and a practical examination that equals or exceeds the criteria established by the U.S. Department of Transportation: First Responder Final Practical Skills Exam, Appendix "H"; including One and Two Person CPR, Infant CPR and Unresponsive Adult Obstructed Airway. All states are free to make changes as they see fit. Contact your state health department or other applicable agency for details regarding changes for your location.

Commonly Asked Questions
Q.   What is the requirement for update emergency responder training?
A.   This answer may vary by state, for example in Wisconsin there is a minimum of 16 hours although schools are adding the advanced skills modules so the hours for refresher currently are 34-36.
 
Q.   What is the initial requirement? Is it 40 hours? Or 60?
A.   Most states are including the advanced skills modules and CPR certification - thus providing about a 72 hour class. States can vary in hours required.
 
Q.   Do you have to have a medical background in order to become a certified first responder?
A.   No, you should take an approved medical first responder course.
 
Q.   Is there an age limit to be a licensed certified first responder?
A.   This may vary by state; the minimum age is 18.
 
Q.   Do testing requirements for emergency responders vary by state?
A.   Yes.

 

Source

For more information please visit:

http://www.nremt.org/
http://en.wikipedia.org/wiki/Certified_first_responder
http://www.nhtsa.dot.gov/people/injury/ems/pub/frnsc.pdf

(Rev. 1/2012)

 

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