Pre-Hospital Emergency Care Responder & Practitioner Fact Sheet

Pre-hospital emergency care can be given by someone within the community, by those trained as responders, or by ambulance personnel who have trained to become registered practitioners. This fact sheet has been compiled to outline the training and education, as well as the roles and responsibilities, of pre-hospital emergency care Responders and Practitioners.

Responder

Cardiac First Response (CFR)

A Cardiac First Responder has completed PHECCs standard of education and training in Cardiac First Response (CFR) at the levels of CFR responder or CFR practitioner. The standard outlines the care management of major life-threatening emergencies, including heart attack, cardiac arrest, foreign body airway obstruction and stroke and includes Aspirin administration. The CFR+ standard is designed, as an extra module to the CFR responder level course, for specific groups with a paediatric AED requirement. Its aim is to enable course participants to develop competency in AED use, including paediatric pads where available, on a child. The practitioner level CFR course is aimed at healthcare professionals/ practitioners and includes additional skills such as oxygen use, pulse checks and two-rescuer CPR.

Emergency First Response (EFR)

An Emergency First Responder (EFR) is a Cardiac First Responder who has in addition completed a 5-day course designed for persons working as a non-transporting pre-hospital Responder. The EFR is trained to recognise and assess common life-threatening and common serious medical conditions. The CPGs authorise the EFR to administer oxygen and assist patients with the selfadministration of prescribed Salbutamol, GTN and Glucose gel medications. For the trauma patient the EFRs scope of practice extends to manual stabilisation of the cervical spine and collar application. Log rolling, placing a patient on a long board or use of an extrication device is under direct supervision of a PHECC-registered practitioner except in some circumstances outlined in the CPG where special authorisation takes effect.

Occupational First Aid (OFA)

The Occupational First Aider is trained according to the Health and Safety Authority and FETAC (Level 5) standard and is specific to the provision of first aid in a place of work in compliance with the Health and Welfare at Work (General Application) Regulations (S.I. No. 299 of 2007). The Occupational First Aider is trained to provide treatment for a minor injury and preserving life or minimising the consequences of injury or illness until handover to an appropriate healthcare professional/practitioner. PHECCs CFR standard is a core unit in the OFA standard though it is uncertified. However, the OFA standard is recognised by PHECC as level 2 on the PHECC prehospital training continuum and is consequently given recognition for entry to CFR Instructor and EFR courses. For more information from the Health and Safety Authority visit www.hsa.ie/eng/.

PTO

Practitioner

Emergency Medical Technician (EMT)

An Emergency Medical Technician is a registered practitioner who has completed PHECCs Standard of Education & Training at EMT level. Practitioners at this level are authorised to provide a range of medications by CPG and registered medical practitioner instructions. For example, Entonox and Paracetamol for pain relief, Salbutamol for asthma and Adrenaline IM for anaphylaxis. This is the minimum clinical level that is recommended to provide care and transport of an ill or injured patient and builds substantially on the skills of the EFR. The duration of education and training is five weeks and is designed to provide the EMT with the knowledge and skills for working primarily in patient transport services and in supporting the pre-hospital response to patients accessing the 999/112 emergency medical services. The EMT can work for the HSE National Ambulance Service; Dublin Fire Brigade; fire, rescue and auxiliary services; and voluntary or private ambulance services. The National Qualification in Emergency Medical Technology (NQEMT) at EMT level is awarded to successful candidates.

Paramedic (P)
A Paramedic is a registered practitioner who has completed PHECCs standard of education and training at Paramedic level. This is the minimum clinical level that is recommended to provide care & transport of an ill or injured patient following a 999/112 call. The Paramedic is principally engaged in assessing patients needs, making informed clinical decisions, planning and administering procedures and medications and monitoring patient responses both on scene and during transport. Skills such as supraglottic airway use and 12-lead ECG interpretation are examples of the Paramedics scope of practice. Authorisation to administer medication is by CPG and registered medical practitioner instructions and includes Glucagon IM for hypoglycaemia and Naloxone IM for narcotic overdose. The Paramedic can work for the HSE National Ambulance Service; Dublin Fire Brigade; fire, rescue and auxiliary services; and voluntary or private ambulance services. The education and training for Paramedics consists of 28 weeks theory, supervised clinical practice on emergency ambulance vehicles and healthcare service placements as well as one year Internship. The NQEMT at Paramedic level is awarded to successful candidates.

Advanced Paramedic (AP)

An Advanced Paramedic is a registered practitioner with experience as a Paramedic. The AP standard of education and training prepares graduates for their role as clinical leaders and expert practitioners in the field of pre-hospital emergency care. Their deployment in the HSE varies from region to region; nonetheless their role has been designed to contribute to a reduction in the morbidity and mortality of patients experiencing life-threatening events pre-hospital. Such significant advances in this area are the roll out of pre-hospital thrombolysis in 2009 and airway management skill of needle cricothyrotomy. There is no direct entry to this course of training and candidates are experienced Paramedics principally employed by the HSE National Ambulance Service and Dublin Fire Brigade. The standard builds substantially on the Paramedic standard and currently requires fourteen weeks theory and clinical practice; six weeks in-hospital and a further six weeks on emergency response vehicles with supervision. One year of AP Internship is soon to be added to the AP Standard. The NQEMT at AP level is awarded to successful candidates.

MinimumtrainingrequiredtobecomeaPHECCcertifiedResponderorPractitioner
CardiacFirst Responder
68Hours/1Day classroomlearning

Occupational FirstAider*
3daysclassroomlearning toincludePHECCCFR Standard

EmergencyFirst Responder
30hours/5days classroomlearning

Emergency Medical Technician

Paramedic
270hours/9weeks +19weeksInternship inclusiveof1week TraumaLifeSupport Course

Advanced Paramedic
35weeks 16weeksDistance Learning 12weeksClinical taught/placements 7weeksInternship

CertificationAssessmentDuration

MultipleChoice ShortWrittenAnswers Questions(20for Responders/25for Practicalskillsassessment Practitioners) *OFAtrainingisoverseenby theHSA.TheOFAAAis Practicalskills appointedbytheHSAtocarry assessment outtheassessmentand registrationofOccupational FirstAidInstructors.PHECCs CFRStandardistaughtaspart ofthecourse.

120hours/4weeks classroomlearning +1weekwork Completionofthe placement PHECCCFRcourseis prerequisiteforentryto EFRcourses 40MultipleChoice After4Weeks Questions training: 100Multiple Practicalskills ChoiceQuestions assessment 8OSCEskills assessment(4 Primaryand4 Secondaryskills)

After9weeks training: 100Multiple ChoiceQuestions 6PrimaryOSCE skillsassessment After19weeks training: 6ShortWritten Answers 8SecondaryOSCE

CombinedMultiple ChoiceQuestions/ ShortAnswerPaper Continuous assessmentinc.OSCE skillsassessment

Panelassessment

Retentiontraining everyyear& recertification everytwoyears

Recertificationevery2years Pleasecontactwww.ofaaa.ie forfurtherinformationon OccupationalFirstAidCourses

Retentiontrainingevery year&recertification every3years

Maintainingand updating competencies 2daysperyear

12monthsPostGrad Internship: 3competency assessments Maintainingand updating competencies 2weeksperyear

12monthsPostGrad Internship 3competency assessments Maintainingand updating competencies 2weeksperyear

IMPORTANTPleasenotethedurationsquotedaretheminimum.PleaseseethePHECC2007TrainingandEducationStandardforfulldetails.