CFRs are not trained in as much depth as ECAs, let alone paramedics. However, I feel that sometimes we let down patients because we cannot give them the care that they deserve, yet we could learn without too much of an issue. I live in a region of a 2-3.5 million people, within a conurbation of 2-3 million. OK, there are a few fields around us (it’s two main cities, some large towns and a scattering of villages with fields between) but essentially it’s urban.
Sometimes the professionals can take a fair while to get to a scene – the nearest one or two could already be on calls or there could be a major traffic holdup that even blue lights can’t get through (rare as that is) – and we need to do a bit more.
If CFRs were given further training, we could have a lot of the obs done before the professionals arrive. Sure, we won’t be carrying ECG machines (because most units couldn’t afford them) but there are other things.
For instance, I’ve been asked by paramedics to do the BM reading (after they’ve checked that I know what I’m doing) whilst they get on with other things. At one company I worked at, most First Aiders were trained in the use of Entonox, just in case a problem with severe pain came up whilst we had no nurse on shift (and shifts without a nurse were rare). As a CFR I can’t officially do either. However, these could benefit the patient.
Now, I’m very aware that not every CFR would wish to use these techniques. Some will be happy just to carry on with the skills they already have, and fair play to them. They/we are doing a good job.
However, for those of us who would like to go further, shouldn’t there be a possibility of doing so? We could deal with more cases thus often ensuring a faster response to a patient (and better times for our Ambulance Trust!). We’d also get more exprience – although my patch contains 50,000+ people, I can be on call for 12 hours and get ONE call (happened recently).
I know that not every CFR would be happy doing the extra, so I wouldn’t make it compulsory. We could have more than one grade of CFR, just as there are ECAs, Techs and Paramedics in the Ambulance Service.
I wouldn’t give us too many extra skills at first, just to see how things go. The Trust would also have to be careful as to how quickly they went along this route, and provide the relevant training. However, if the right people were picked, it would enhance patient care. Sure, we’d all like it if there was one ambulance for every 10 streets, but that isn’t going to happen.
You’d also have to pick the right people. I’d suggest a basic test and an interview to get on the course, with a rigorous but realistic exam at the end of it. However, I reckon the better CFRs would be well up to this. I can’t be the only CFR with a Science degree, and many have native intelligence anyway.
I’d definitely have two grades of CFR as well. Not every CFR would welcome the new skills or necessarily be able to do them. These people are still useful, as useful as we all are now. No, this advanced training would be an extra; you could have CFRs as now, and (say) AFRs – Advanced First Responders.
There should NOT be any reduction in manning levels within the Ambulance Service, though I can see this happening anyway in the near future as the public finances come under strain. CFRs are their to assist the service, not to replace it. We’d just be enhancing patient care and assisting our professional colleagues more.
(Incidentally, I’d like to say how great it is to address ECAs, Techs and Paramedics as colleagues. It’s a real priviledge – and I really mean that.)