New First Responder Training Standards

Please find the updated Administrative Requirement (AR) 2-100, Minimum Standards for First Responder Training in First Aid, Epinephrine Auto-Injector and Naloxone Use. The Department and its EMS medical director have completed a thorough review of this curriculum, as it last did in 2016, and has made updates to add and clarify content. With the role of persons trained to the first responder level in the minimum Basic Life Support (BLS) ambulance staffing requirements under the EMS System regulations promulgated in January 2023, it is appropriate for first responders to have more current and a little more thorough context information in their training. The updates are as follows:

·      Providing more context to the first responder role, to support keeping first responders healthy and safe, decreasing risk of injury to themselves and others;

·      Making clarifications to keep up with evolving science and experience on opioid overdose reversal through appropriate ventilation and naloxone use;

·      Specific reference to the Massachusetts Statewide Treatment Protocols (STPs) emphasizes that the care provided by first responders must be in accordance with the STPs, as only specific procedures and medications are authorized;

·      To align first responder training with other EMS education, in emphasizing the importance of the primary survey and management of imminent life threats;

·      Emphasizing the role of first responders in assessing, reporting and monitoring vital signs, as a measurement of the patient’s physiological status and changes; and

·      Emphasizing the safe and expedient access and movement of patients for responder and patient safety.

As a result, the minimum first responder first aid/optional Epi-Pen and Naloxone course length has increased from 16 to 24 hours. Please note that this continues to be less than what is required by the National EMS Education Standards’ Emergency Medical Responder (EMR) course. The CPR portion of first responder training has decreased from 8 hours to 4 hours, for a total of 28 hours of minimum training for Massachusetts first responders, from the previous 24. Renewal of CPR certification for first responders may range from 2.5 to 4 hours, depending on course delivery and sponsoring organization. 

NOTE: The person trained to the first responder level, who is staffing an ambulance must be trained to the 105 CMR 171.000/Administrative Requirement 2-100 standard in effect at the time of their training, individuals who received training before then do not require retraining with the updated content until their next refresher, within three years of the initial course.