Emergency medical responder

The U.S. Department of Transportation (DOT) recognized a gap between the typical eight hours training required for providing basic 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 course. The First Responder training program began in 1979 as an outgrowth of the "Crash Injury Management" course.

In 1995 the DOT 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 which do not have the resources or funds to conduct 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.

"Emergency Medical Responder" or "EMR" [2] is an EMS certification level recognized by the National Registry of Emergency Medical Technicians.[3]

EMR patch of the NREMT

The term "emergency medical responder" is used loosely in many states, with "first responder" and "medical first responder" still being common terms.

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

Emergency responders are tested during a training exercise.

Emergency Medical Responders (EMR) in the United States provide initial emergency care first on the scene (police/fire department/search and rescue) and support Emergency Medical Technicians and Paramedics when they arrive. The skills allowed at this level include taking vital signs, bleeding control, positive pressure ventilation with a bag valve mask, oropharyngeal airway, supplemental oxygen administration, oral suctioning, cardio-pulmonary resuscitation (CPR), use of an automated external defibrillator (AED), splinting, and assisting in the administration of basic medications such as epinephrine auto-injectors and oral glucose. They are also trained in packaging, moving and transporting patients. Due to the opioid epidemic,[4] EMRs in certain states or regions are also trained and allowed to give Naloxone[5] and utilize supraglottic airways.

These are the minimum skills recommendations put forth by the National Highway Traffic Safety Administration and endorsed by the National Registry of Emergency Medical Technicians.[6] Each State, region, and agencies may add to or deduct from this list as they see medically fit.

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. Skills that Emergency Medical Responders are commonly not allowed to perform (that EMTs are) include insertion of traction splinting, administration of nebulized albuterol, administration of ASA, pulse oximetry, glucometry, or insertion of supraglottic airways. However, certain regions and states (such as Wisconsin) or medical directors may allow them to assist in or actually perform these skills.

The National Fire Protection Association standards 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 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.

Emergency Medical Responder training is considered a bare minimum for emergency service workers who may be sent out in response to an emergency call. It is typically required for firefighters. The Emergency Medical Responder level of medical training is also often required for police officers and search and rescue personnel. Many Emergency Medical Responders have location specific training such as water rescue or mountain rescue and must take advanced courses to be certified (i.e. lifeguard, ski patrol).

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 other Emergency Medical Responders include:

• Firefighters
• campus police
• Lifeguards
• Ski patrollers
• Park rangers
• Event first aid staff
• Security guards
• Emergency management personnel
• HAZMAT personnel
• Community Emergency Response Team (CERT) members
• Disaster relief personnel
• Street medics
• Athletic trainers
• SCUBA divers
• Bodyguards
• Designated industrial or corporate workers in a large facility (industrial plant or large office building) or at a remote site (oil rig, fish-packing plant, commercial vessel) (i.e. "Medical Emergency Response Team (MERT) Scheme)
• General aviation pilots and commercial flight attendants