First responders in the United States
[edit] History of
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謡hich 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.
[edit] 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]
[edit] 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.
Emergency medical oxygen is a common supplementary skill that may be added in accordance with the 1995
DOT First Responder:National Standard Curriculum guidelines
[5] or under the authority of EMS agencies or training providers such as the American Red Cross. Other supplementary skills at this level can include the taking of vital signs including manual blood pressures, advanced splinting and the use of the Automated External Defibrillator (
AED).
[6]
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.
[edit] Rescue
The
National Fire Protection Association regulations 1006
[7] and 1670
[8] 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 rescues, etc., are Medical First Responders, Emergency Medical Technicians, or
Paramedics, as most every rescue has a patient involved.
[edit] 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.
[edit] 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: