Community Responders or First Responders or CFRs are a relatively new phenomenon that you may have heard of. This post tells you a little bit about what they are, what they do and how they operate.
In short, a CFR is a volunteer trained up by the local Ambulance Service to respond to certain categories of 999 emergency call. They don’t go to all calls and are trained in a subset of skills – it usually takes about a weekend for the training. They don’t replace an Ambulance Response – they are sent as well as one.
Rationale for having CFRs
When you dial 999 for an ambulance because of a medical emergency you would hope that one arrives swiftly. For life-threatening emergencies, minutes and seconds count. Unfortunately the ambulance services gets hit twice. Firstly, direct cuts to budgets lead to fewer ambulances on the road. Secondly, bed blocking in hospitals has a knock-on effect. If the wards don’t have free beds, patients cannot be sent there from Accident and Emergency (A&E). If A&E is full, the ambulances cannot hand over their patients and so are unavailable. You end up with a queue of ambulances outside and none available for calls.
A CFR can hold the fort until a crew (or Rapid Response Vehicle) arrives to back them up. In my experience as a CFR, I got to a patient first in approximately half the cases. Most of the time, apart from administering TLC I did not make much difference to the outcome, however in a number of cases I did make a difference and have helped save lives and improve the level of recovery of a patient by starting treatment early.
What Training does a CFR have?
Although there are ongoing attempts at a National Standard, it is not there yet, so a typical training programme might consist of:
- Pre-course learning – Anatomy and Physiology as well as medical conditions.
- 1 full-on weekend of training and practical scenarios. Training will cover the use of Oxygen, Airways, suction, defibrillators and dressings and dealing with Chest pains, unconscious patients (both breathing and non-breathing) and strokes
- A shift in an ambulance (bring biscuits)
- A DBS check and possible interview
- Driving licence and car insurance check (you respond in your own car)
- If this is passed then you will be allocated to a Group and buddied up to start with until you are confident to strike out on your own.
- In our area we also have Marked up Response vehicles. If you want, once you have enough experience, you can take a driving assessment to allow you to drive these vehicles.
What can and cannot a CFR go to?
Again, there is no National agreement, but typically:
- Chest pains
- Suspected strokes
- Suspected Heart Attacks
- Unconscious patients (pretty much any reason)
- Febrile convulsions
- Prenatal issues unless not connected with the pregnancy
- Road Traffic Collisions – we don’t have PPE and are not trained in making this type of scene safe
- Anything ‘iffy’ for a solo Responder e.g. Pub Brawl, Domestic incident
- Suspected stabbings, suicides, Mental Health issues – although the call takers cannot always tell.
- Needs a relatively clean licence
- Needs written confirmation from insurers to respond (shouldn’t be an issue)
- No additional (e.g. blue, orange) lights allowed
- Stick to the rules of the road (no speeding, jumping traffic lights for example)
- Some areas may issue parking permits allowing you to park in certain locations whilst responding to a call. For example, blue badge bays, Pay and Display without having to pay. Otherwise, no exemption.
What else can you tell me about being a CFR?
You will get to see your local area in a new light. You will find roads and cul de sacs that you never knew existed. You will go everywhere from really tidy places to rooms that you want to wipe your feet on the way out. I have seen people on Oxygen due to emphysema whilst the rest of the household are still chugging away on cigarettes, drugs users attempting CPR on their companions that don’t need CPR and also users showing no concern whilst we fail in our attempts to revive someone after an overdose.
You will bump into people that you know and you will be accosted in the street by people that you Responded to – although for the life of you, you cannot remember where, when or why.
You will have your Ups and your Downs, but there is a good support Network for the Downs, and the Ups make you believe that it is all worthwhile.
OK, I’d like to know more. What’s the next step?
Go to your local Ambulance Service website and somewhere on there will be a link to the Service’s Community Responder Schemes, describing them and telling you how you can apply.
About the author
I was a Community First Responder for 13 years and a First Aider with one of the Voluntary Societies for 12 years before that. Our Scheme was, one of the first in the area and we jointly built up the local team. I left in 2019, fed up with the creeping bureaucracy within the Ambulance Service, having been on a few thousand call-outs, a couple of hundred Cardiac Arrests and a few successful outcomes. Would I go back? Yes, no question if the environment was right.