Figuring out the level a support you need can be a bit of a mind field, hopefully this guide can tell you the main differences between First Aiders, First Responders, Ambulance Technicians (EMT), Paramedics and Doctors.
Advanced First Aiders
Advanced First Aiders can either work as part of a First Aid only crew or as part of a bigger multidisciplinary team.
Introduction to Advanced First Aider
Advanced First Aiders can recognise, assess and where possible treat critically ill or injured patients or request additional resources if required.
What skills do they have?
All Advanced First Aiders are trained in first aid with additional skills. They can carry out a patient assessment to determine the injury or illness. In addition, they can provide basic life support which includes CPR and defibrillation. Their additional training allows them to carry out correct patient, manual handling, and infection control techniques and as well as perform some basic observations on the patient such as blood pressure, blood sugar level and oxygen level monitoring. They are all trained to administer autoinjectors for the treatment for anaphylaxis.
How can they work for you?
Depending on the size of the event there may be only two Advanced First Aider on site or there may be many working as part of a multidisciplinary team. Whatever the size of the event the Advanced First Aider will typically be the first unit to a casualty.
If working at a smaller event such as a fun day where there may only be one crew of two Advanced First Aiders on site, the crew will either treat the patient at the scene if possible or stabilise and call in support externally.
First Responders
First Responders have a higher level of qualification than a First Aider and are experienced in pre-hospital care.
Introduction to First Responders
First Responders are trained to assess the situation, providing immediate first aid if needed and establish the patient’s previous medical history. Sometimes they can be a very vital second pair of hands to an ambulance crew when they arrive.
What skills do they have?
A member of staff who holds a minimum of a 5-day course in either First Response Emergency Care (FREC) or First Person on Scene (FPOS). They are trained to assess a situation, provide immediate first aid, and establish the patient’s previous medical history. They have all the skills a first aider has but has more knowledge in medical and trauma emergencies, caring for the critically ill patient before further care arrives and can administer oxygen as well as basic airway adjuncts. This grade is similar to that of community first responders.
The role of a First Responder is to provide immediate, lifesaving, medical care before the arrival of further medical help. This will include performing skills/ procedures such as:
• Placing a casualty into the recovery position
• Performing Cardiopulmonary resuscitation (CPR)
• Using an automated external defibrillator (AED)
• Stopping bleeding
• Stabilising a fractured limb
• Checking and testing all stock/ emergency medical equipment
• Carrying out event Risk Assessment to gauge event’s emergency medical provision needs
• Liaise with event organisers to implement satisfactory Emergency medical resources to cover event
• Manage the incident and ensure the continuing safety of themselves, bystanders, and the casualty
• Assess casualties and find out the nature & cause of their injuries
• Arrange for further medical help or other emergency services to attend (e.g., the fire service)
• If trained, prioritise casualties based upon medical need
• Provide appropriate first aid treatment as trained
• Take detailed notes/ monitor/ observe casualties for signs of deterioration or improvement of condition
• Complete detailed records/ reports as required
• Provide a handover to emergency services on arrival
How can they work for you?
A First Responder is a good choice for many events. The skills and knowledge of the crew and a fully equipped ambulance provides ambulance care for your event visitors and crew. This resource may be the only unit on site if that is indicated in the risk assessment.
A First Responder is also a great addition to the multidisciplinary team for events, such as music concerts, triathlon etc.
Ambulance Technicians (EMT)
Emergency Medical Technicians have a broad knowledge and skill set, offering excellent support to Advanced First Aiders and First Responders while working autonomously in a range of areas. Additionally, they can undertake emergency “blue light” and routine patient transfers. All of this makes them an excellent choice for event ambulance work.
Introduction to Emergency Medical Technician
The scope of practice for Emergency Medical Technicians is varied and broader than Advanced First Aiders and First Responders. They have sound knowledge and skill set to manage emergency situations, such as cardiac arrest, heart attacks, diabetic emergencies etc. They are able to assess and manage casualties, while at the same time recognising if additional resources are required. They may solely manage the patient and take them to the hospital. This unit can transport patients, including those categorised as needing urgent and time-critical transfer. Emergency Medical Technician crews may be the only units on site, or they may be part of a bigger multidisciplinary team.
Emergency Medical Technicians can work autonomously, providing assessment and care to casualties, whose condition ranges from minor to life-threatening. Their training and upskilling also allow them to recognise when casualties need interventions that are outside of their practice and to request support in a timely manner. As well as dealing with life-threatening emergencies, such as asthma and diabetic emergencies, they can manage many casualties at the event, treating with a range of over the counter, pharmacy only medications and some prescription medications. In addition to this, they can also provide a more advanced level of care, assisted using more advanced observations and monitoring.
For patients experiencing a cardiac event, medications such as aspirin or GTN may be given, following an assessment of the patient, including their blood pressure and a 12 lead ECG. An unconscious diabetic patient will have their blood glucose levels checked. If appropriate the Emergency Medical Technicians can give them an injection of a medicine called Glucagon to treat them for hypoglycaemia and hopefully to aid their recovery.
A patient experiencing an asthma attack may require additional medication to their own inhalers. Emergency Medical Technicians can assist by giving prescription-only medications, via a nebuliser to relieve the patient’s breathing difficulty. Depending on the patient’s medical presentation/condition many event visitors will be able to return to the event.
In order to provide the best patient/casualty care, we understand that effective communication is essential. Emergency Medical Technicians are trained to use a range of communication techniques to enable them to bypass any barriers to communication. This included phone applications for translation, use of the NHS multilingual phrase book and flashcards.
How can they work for you?
They can be deployed to an event that does not require a large team but where the risk assessment has identified the need for a broader and higher skill set than Advanced First Aiders or First Responder. For example, the activities, demographics etc all indicate higher risks than should be solely attended by Advanced First Aiders.
Emergency Medical Technicians will be part of an ambulance crew. The ambulance will be equipped with a range of monitoring, diagnostic, moving & handling, and treatment options. This enables us to provide the best level of patient care. This unit can transfer patients to the hospital.
At large, busy events, such as music festivals, rugby or football, there may be a multidisciplinary team. The Emergency Medical Technician crew plays a vital role within this, providing support for casualties, who need additional prehospital care, while at the same time, working closely with paramedics to ensure the safety and welfare of your event visitors.
Paramedics
In order to practice Paramedics must be registered with the Health & Care Professions Council (HCPC), who set out regulations that must be followed to allow the paramedic to remain on the register. In the prehospital settings, Paramedics will often be the clinical lead and make autonomous decisions to provide advanced patient care.
Introduction to Paramedics
Paramedics are highly skilled and educated individuals. In order to practice, they must meet the standards required to register with The Health and Care Professions Council (HCPC). Paramedics must then re-register every two years. They follow regulations laid down by the HCPC, such as keeping their skills and knowledge up to date. Portfolios, with evidence, must be kept and made available for inspection.
Paramedics will often be the lead or senior medic in attendance when someone becomes injured or unwell. Their role includes assessing and treating patients. They must decide where a patient needs to go, such as; to a specialist hospital unit, be referred to their GP or if they can remain at home to care for themselves. The decisions they make influence outcomes for patients, the role, therefore, carries the burden of responsibility.
A single Paramedic will work as part of a multidisciplinary team to provide additional expertise and medical support within the event medical centre. They will always remain on site but may respond to a casualty in situ if requested for guidance, for example prior to moving a patient. In order to provide excellent patient care, we do not provide lone medics.
A Paramedic will be partnered on an ambulance with an Emergency Medical Technician. This team is highly skilled and able to respond, assess, stabilise, and treat the seriously ill or injured patients. All ambulances are fully equipped, and the crew trained and prepared to deal with life-threatening emergencies. The paramedic will decide on the best care pathway for the patient, arrange for an air ambulance to be called or transfer to specialist hospital units, rather than send everyone to the Emergency Department. This unit can transfer patients on blue lights who are deemed to be time critical or requiring urgent care.
What skills do they have?
Paramedics have advanced and up to date clinical skills, such as Advanced Life Support (ALS) and of course have all the appropriate kit. They have an ever-increasing drugs kit, which enables them to provide medications to patients, experiencing a range of illnesses and injuries. In addition, they have sophisticated monitoring and diagnostic equipment. For example, when attending a patient who is experiencing a cardiac event, the paramedic can carry out a 12 lead ECG, which can be wirelessly transferred to a cardiologist in order to decide the most appropriate hospital for that patient.
Paramedics are trained to use a range of communication techniques to enable them to bypass any barriers to communication. This included phone applications for translation, use of the NHS multilingual phrase book and flashcards.
How can they work for you?
As part of a multidisciplinary team, a paramedic can be based in the event medical centre. This is especially helpful where there are large numbers of visitors and where risks may be high. For example, at music festivals where alcohol and recreational drugs often result in casualties, sporting events with rival crowds e.g. football or events where the likelihood of injury and the severity could be serious. This may include motorsports or contact sports such as boxing.
When working within the team to provide additional support and guidance to all of the other clinical grades. Their wider knowledge and skill set will support team decisions on care for all patients. For example, a more junior grade of staff may need to send a patient to the hospital, that could be managed within the medical centre. With the assistance of a paramedic, this may not be required. There are several benefits to this approach. Firstly, patients who can be cared for at the medical centre may be able to return to the event once they are fully recovered. Your event visitors do not have to make their own way back to the event on hospital discharge. By having a paramedic on site this reduces the impact on local NHS resources. This will offer reassurance and be viewed in a positive light when applying for future licenses for your event.
Frontline Paramedic ambulance units will provide a high level of prehospital care to your event visitors or staff, should it be required. The Paramedic & Emergency Medical Technician partnership allows not only for ongoing care but an assessment that may rule out the need for emergency transfer of the patient.
Doctor
Doctors with a range of specialities, such as sports medicine work as part of a multidisciplinary events team.
Introduction to Doctors
The addition of doctors to some events teams brings a broader scope of patient assessment and treatment for your event visitors and crew. The need to have a doctor present will be identified through the event medical risk assessment, the governing body of a sport may mandate their presence, or the event organisers may simply request it.
How can they work for you?
Having a doctor present at your event as a part of a multidisciplinary team offers event visitors and crews greater scope of assessment and treatment. They can prescribe medications that may reduce the need to visit a GP. This is great for event visitors and very helpful to event crews, who cannot easily leave their posts while on duty. Their presence may be required to fulfil the requirements of governing bodies.
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