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Certified First Responder
Document Number: 340
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 (CFR), 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
CFRs. 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 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 CFR 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) is the final module and is 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 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. |
Sources for More Information
For more information please visit:
http://www.nremt.org/EMTServices/reg_1st_history.asp
http://en.wikipedia.org/wiki/Certified_first_responder
http://www.rescue1.us/1st_responder.htm
http://www.firstrespondertraining.com/
http://www.nhtsa.dot.gov/people/injury/ems/pub/frnsc.pdf
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Please Note: The information contained in this publication
is intended for general information purposes only. This publication is
not a substitute for review of the applicable government regulations
and standards, and should not be construed as legal advice or opinion.
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