First responder

• Anatomy or system affected: All

Definition: The initial person(s) to arrive on the scene of an emergency, trained in the rescue and prehospital care of individuals involved in or affected by an emergency. As a certified role, it has been largely supplanted by the Emergency Medical Responder position in the United States, but may still be used as a general term.

History of the Role

The description of the First Responder role has evolved over the years as the level of emergency response in the United States has matured. In 1979, an effort was made to improve the Emergency Crash Response Program to include more comprehensive and structured prehospital care. The program to train First Responders expanded on the eight-hour program for teaching advanced first aid techniques, first proposed by the American Red Cross, to a more comprehensive program yet still below the level of an emergency medical technician (EMT) basic certification. Subsequently, as the need for First Responders increased, in 1995 the US Department of Transportation (DOT) took a closer look at the role and developed guidelines for the certification of the First Responder in the United States. This program matured to a forty- to sixty-hour instructional program to recruit individuals to respond to their community emergency needs.

The emergency crises that resulted from the collapse of the World Trade Center provided even more dimension to the details expected from the First Responder position. For the first time in American history, legislation was signed into law providing financial support for those First Responders affected by the September 11, 2001, terrorist attacks (the James L. Zadroga 9/11 Health and Compensation Act). From 2004 to 2006, the National Association of State EMS Officials and other groups began to transition from the term First Responder to the term Emergency Medical Responder, as determined by the "National EMS Scope of Practice Model." These guidelines also increased the ability of these practitioners in patient care, such as the use of oxygen, automated external defibrillators (AEDs), and splints.

Science and Profession

First Responders provide rescue and prehospital care to individuals acutely ill/injured or in need of emergency transport from an emergency situation or catastrophic event in the community they serve. Those First Responders who have been previously trained can provide emergency care to individuals in need of immediate response/help. However, First Responders are usually trained to elicit the help of more emergency/medically trained personnel such as EMTs or paramedics as soon as feasibly possible. This may also include the help of the fire department, law enforcement, and other medical services, and professionals in these fields almost always undergo First Responder training themselves along with any higher level certifications. First Responders are trained to recognize the emergency, medical situation, or emergent environment of a circumstance and coordinate or manage the emergency care or safe evacuation of the person in need. This is why so many facets of emergency services may be utilized/employed in emergency management.

In addition to professions traditionally trained as First Responders, such as firefighters and police officers, other specialized jobs may often require, expect, or benefit from First Responder training. This may be due to extreme circumstances of the working environment, a high likelihood of encountering emergencies on the job, or a remote work location away from other medical professionals. Examples of such First Responders include ski patrollers, park rangers, SCUBA divers, and other outdoor professions, as well as teachers, athletics coaches, camp counselors, and airport workers.

Perspective and Prospects

Positions under the general description of a First Responder provide a dynamic and exciting field of study. It is a field that is open to many individuals regardless of academic preparation. Few areas offer more opportunity to serve the community they live in, in a way that uniquely fits the individual's ability and skills. There are typically opportunities to become certified in this area through local community groups. These programs may be organized and provided by the local fire department/police department or, as in New York City, the Office of Emergency Management (OEM). The need for the services of First Responders continues to grow with the threat of ongoing climate change, catastrophic emergencies, and terrorist activities. Public safety and health crises, such as the COVID-19 pandemic and the ongoing opioid crisis in the United States, have also significantly impacted first responders, leading to new challenges and safety protocols, as well as increased training in the management of overdoses and related emergencies. Recruitment continues to be a challenge for all communities and developing agencies that can address the responsibility to oversee the dynamics of these ongoing programs.

Bibliography

Coleman, Justine. "First Responders' Resilience Masks a Mounting Mental Health Toll." The Hill, 27 Oct. 2021, thehill.com/homenews/news/577822-first-responders-resilience-masks-a-mounting-mental-health-toll/. Accessed 10 Mar. 2025.

"Emergency Medical Responder (EMR)." Global Emergency Medical Registry, www.gemr.org/emr/. Accessed 10 Mar. 2025.

"First Responders Group." US Department of Homeland Security, 1 Aug. 2024, www.dhs.gov/archive/science-and-technology/first-responders-group. Accessed 10 Mar. 2025.

Hamilton, Glenn C., et al. Emergency Medicine: An Approach to Clinical Problem Solving. 2nd ed. Saunders, 2003.

"Training and Education." FEMA, 27 Nov. 2024, www.fema.gov/emergency-managers/national-preparedness/training. Accessed 10 Mar. 2025.