The Bain report has identified two types of first responder operations.
First on the scene Co Responders” where the fire service arrives at the scene first where there is an injured or seriously ill patient. They should have the necessary skills and equipment to provide effective treatment and support for the patient until the paramedics arrives.
First Responders, this usually refers to community schemes run by the Ambulance service utilising people from communities or specialist organisations based within the community.
Co-Responders – This refers to schemes where a Fire & Rescue Service and the Ambulance Service work in partnership to provide an effective, rapid response to immediately life threatening medical emergencies. Specifically in locations where the Fire Service will be able to get to the call more quickly.
The following questions and answers are based on at least 10 years operational experience in 3 Services all of which are fully supported and endorsed by the FRSA.
1. Are first or Co-Responders Paramedics?
- No, First/Co Responders are trained in basic first aid, oxygen therapy and the use of an automatic defibrillator.
- The level of training will depend on the requirements of the local Ambulance Service.
- Basic first aid skills delivered quickly and effectively save lives every day.
- Frequently the arrival of competent responders at the home of a patient with a very serious illness can calm the whole situation down and ensures that the patient receives effective and appropriate treatment until more advanced medical assistance arrives.
- Some responders are trained and equipped with Entonox, which is very effective at relieving pain; again this is of huge benefit to the patient.
2. Why do we need first or Co-Responders?
- If a person has an obstructed airway, they will die in less than 5 minutes, simply protecting the airway of a seriously ill patient will save lives
- A defibrillator is most effective if used within 4 minutes of a cardiac arrest, after 8 minutes have elapsed there is only a very small chance of a successful outcome for the patient. May groups and organisations are going to have to work effectively together to improve the speed and availability of defibrillatory shocks
- Delivering a rapid effective attendance to life threatening calls by a single service is virtually impossible, even in an ideal world it could not be guaranteed.
- To save lives in our communities, everyone who is able to provide assistance is needed to help improve the outcome for people with an immediately life threatening medical condition.
- In rural areas this is more important because of the greater travel times involved and the delays caused by summer traffic and winter weather conditions.
3. Why use firefighters as First/Co-Responders?
- Firefighters make good responders because they are already trained emergency service professionals.
- Unlike community or “lay” responders firefighters can be sent to nearly all types of calls received by the Ambulance Service.
- Fire Co-Responders are able to respond with blue lights and sirens.
4. Will carrying out Co-Responder duties undermine the Ambulance Service?
- Definitely not, Co-Responders are just one type of responder currently in use by Ambulance Services across the UK
- Ambulance Services are actively recruiting responders from all walks of life, leisure centre staff, lifeguards; voluntary aid societies, postmistresses and publicans are all playing a vital role in saving lives in our communities.
- Your local Ambulance Service will have to be fully involved with a responder scheme.
5. Will participation in a Co-Responder scheme upset our local paramedics?
- Most paramedics will support Fire Service involvement in responder schemes.
- A comment that is often made by paramedics is “If a responder is on scene giving life saving treatment I get a chance to use all my skills and equipment for the benefit of the patient”.
- Involvement in a responder scheme means working very closely with local paramedics, this improves liaison and leads to greater understanding of each services needs at an incident.
- This greater understanding leads to improved co-operation and greater teamwork; this improves the quality of service we offer to the patient.
6. Will attendance at a Co-Responder call affect fire cover?
- There are many operational methods of carrying out first responder schemes, some involve turning out with a fire appliance, and others involve the use of a second vehicle.
- Use of a fire appliance will obviously have an effect on fire cover, however as fire calls reduce, the use of a fire appliance to save a life will be seen as best value.
- The use of a second vehicle will help to ensure that fire cover is maintained this option often provides a more rapid response.
- Many fire stations have never saved a life, some have saved a few, thankfully these incidents are few and far between, Co-Responders save between 5 and 10 lives per scheme, per year, every year!
7. What training will we need?
- Training will depend on the requirements of the local Ambulance Service and the existing skill level of the firefighters.
- Training can be delivered in as little as two days or as much as two weeks.
- Training is always appropriate to the expected call types and equipment deployed.
- On-going refresher training and re-certification will be required at intervals decided depending on workload and experience.
8. What sort of calls would we be sent to?
- Calls will vary enormously, anything from a very tiny baby up to a very elderly person.
- Calls involve dealing with trauma, breathing difficulties, unexplained collapses, chest pain, and cardiac arrests.
- The problem must be immediately life threatening for the responders to be mobilised.
- Calls involving violence will not usually be passed through to responders.
- Responders are often sent to seriously ill patients that are still conscious and breathing, the early application of oxygen in these cases saves many lives.
- Full back up and advice will always be available from Ambulance control.
- Fire Service responders are usually mobilised to all person injured RTCs. This solves the old problem of delayed call outs to serious road crashes.
9. Are defibrillators difficult to use?
- No – they are very easy to use, they are fully automatic and have voice prompts to ensure that the correct protocols are followed.
- They will not deliver a shock unless it is needed, even if the wrong buttons are pressed.
- They are self-checking and will not operate if they are faulty.
10. Are defibrillators dangerous?
- No – they defibrillators are very safe; they will not deliver a shock to anyone if they do not need it.
- The protocols developed for the use of an automatic defibrillator will ensure that the operator is protected as well.
- The patient will effectively be dead, as the defibrillator will only deliver a shock if the patient’s heart has stopped.
11. What are the benefits of participating in a Co-Responder scheme?
- Increased public awareness of the value of the service we provide.
- Improved public image of Crew, Station and Service.
- More lives saved in our communities, often-family members and friends.
- Enormous benefit to seriously ill members of our communities.
- Increased community awareness improves recruitment.
- Increased call volume means more money and improved retention of staff.
- Increased call volume makes providing cover more worthwhile.
- Stations operating a Co-Responder service will be very difficult to close or downgrade.
12. What if we get involved in a complaint – who will cover us?
- The Ambulance Trust responsible for the scheme will provide full and complete cover for Co-Responders who will be acting as agents for the Trust.
- Most Services insurers will cover responders as long as all protocols are followed and equipment is used in accordance with proper procedures.
- The FRSA will provide comprehensive help, support and representation for any members involved in problems relating to Co-Responder duties.
13. How do we start a responder scheme?
- Ask your Fire Service to approach the Ambulance Service to see if there is a need for a scheme in your stations area.
- You may have to raise fund to supply equipment.
- The British Heart Foundation may be able to help with a grant for the purchase of a defibrillator.
- Your local GPs may be able to offer help and advice.
14. How many calls will we be expected to attend?
- This will depend on the area you cover; typically stations attend between 60 and 120 calls per year, although some stations can be significantly busier.
- Workload can depend on seasonal variations such influxes of tourists’ etc.
15. What happens if we are not successful and the patient dies?
- Sometimes there is nothing that can be done, rarely; some calls can be unpleasant.
- Even if there is an unsuccessful result, the simple fact that responders arrived and carried out the correct procedures helps family and friends cope with the situation and its aftermath.
- Both the Service and the Ambulance Service will always make debriefing of responders and counselling available.
16. What will happen if we do not get involved?
- The Ambulance Service will be forced to look elsewhere.
- Some Police Services are already training officers as first responders.
- You will probably find a community scheme is established.
- Local businesses, leisure centres, pubs, post offices and village shops are all used very successfully as locations for “lay responder” schemes.
- These “lay responder” schemes work very well, if one has been established it would then be difficult for a local fire station to establish its own.
- There are already instances of this happening.