Certified first responder

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

While all Certified First Responders in Canada are covered under Good Samaritan laws[2] in jurisdictions where they are enacted, in some cases they have a Duty To Act for example, Ontario. Certified First Responders who are providing medical coverage to events (such as Red Cross, St. John Ambulance's Patient Care Divisions and private event medical companies), 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.[3] 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 causes harm to the patient.[2] 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.

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.
• Community first responders are members of the community who are trained to use an automated external defibrillator, give oxygen, and use other pieces of 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. Under the Road Traffic Act and various other UK traffic law, correct and permitted use of Blue Lights on a vehicle does not allow the driver to cross solid white lines to overtake, but does allow the driver 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 these are not given blue lights as CFR's do not undergo blue light training.

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 twenty-four 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 Emergency Medical Technician.

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

In the US the term "Emergency Medical Responder" has largely replaced the term "Certified First Responder" or "Medical First Responder" beginning in 2012.[5] "Emergency Medical Responder" or "EMR" is an EMS certification level recognized by the National Registry of Emergency Medical Technicians.[6]

By 2015, most states recognize the level of Emergency Medical Responder.

Emergency responders are tested during a training exercise.

First Responders in the US can either provide initial emergency care first on the scene (police/fire department/search and rescue) or support Emergency Medical Technicians and Paramedics. The skills allowed at this level are very similar to an EMT's including bleeding control, positive pressure ventilation with a bag valve mask, oral airway, nasal airway, supplemental oxygen administration, suctioning, cardio-pulmonary resuscitation (CPR), use of an automated external defibrillator (AED), manual stabilization of fractures, and assisting in the administration of basic medications such as epinephrine auto-injectors, oral glucose, and inhalers. They are also trained in packaging, moving and transporting patients.[7]

First Responders can serve as secondary providers with some volunteer EMS services. An Emergency Medical Responder can be seen either as an advanced first aid provider, or as a limited provider of emergency medical care when more advanced providers have not yet arrived or are not available.

Skillwise, a certified first responder in the US is often trained and allowed to do most of what an emergency medical technician is allowed to. Some exceptions in some jurisdictions include insertion of King airways or combi-tubes, traction splinting, and administration of nebulized albuterol.

The National Fire Protection Association standards 1006[8] and 1670[9] 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 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 rescues or swift water rescue, etc., are Emergency Medical Responders, Emergency Medical Technicians, or Paramedics, as most every rescue has a patient involved.

The first responder training is considered a bare minimum for emergency service workers who may be sent out in response to an emergency call. It is almost always required for professional and volunteer firefighters. For example, all firefighters of the New York City Fire Department require a valid CFR-D (Certified First Responder - Defibrillation) certification. The first responder level of emergency medical training is also often required for police officers, rescue squad personnel, and search and rescue personnel. Many first responders have location specific training such as water rescue or mountain rescue and must take advanced courses to be certified (i.e. lifeguard).

Many people who do not fall into the earlier mentioned categories seek out or receive this type of training 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:

• SCUBA Divers
• 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)
• Security Officers
• Emergency management personnel
• Search and rescue personnel
• Campus Responders and campus police
• Lifeguards
• Ski Patrollers
• Community Emergency Response Team (CERT) members (varies by jurisdiction)
• Stage Managers