What to do after First Aid at Work?
We are often asked what courses candidates can attend next; some candidates come to us because they want to learn and, having received a superb experience, they are keen to know more.
Some candidates come to us having been told they have to attend by their employer. Very often it is felt that there should be a tiered level of training within the organisation so what can we do for those who need additional skills? Some people need further training if operating far from medical assistance. It is possible for some, to make a career of providing pre-hospital medical care.
The area of First Aid and Pre-Hospital Medical Care is as expansive as any other area of study; with dedication and time you can take your training, knowledge, skills and understanding as far as you want but, as with everything else, the further one progresses the more restrictions are in place and the more commitment is needed.
1. The Starting Point
In the UK, the First Aid at Work course is the only First Aid course recognised by the Health and Safety Executive and for the vast majority of people it will meet or exceed their needs insofar as preparing them for what they are realistically likely to encounter.
Beyond this, the marketplace is flooded with exotic sounding Advanced First Aid, EMT and “Remote Medic” courses.
At this stage the candidate has the ability to choose whether they want to develop their skills in a traditional urban setting or a remote, hostile or higher-risk setting.
2. Advanced First Aid
At this stage we are still talking 'First Aid' rather than any invasive technique or dealing with medicines. Around 15-20 years ago, Advanced First Aid was all about emergency airways and improvised splinting. Nowadays Advanced First Aid touches on these subjects but the onus is on an increased understanding of anatomy and physiology as well as long term monitoring of the patient.
Learn to the the basics to the highest possible standard and very often there will be no need for the dramatic interventions.
The IHCD First Person On Scene course, regulated by the Royal College of Surgeons Faculty of Pre-Hospital Care, is a well recognised, standardised 4 day program which will equip the candidate with the advanced skills and knowledge needed to provide life-saving interventions and the ability to stabilise a casualty until professional help arrives.
For those who have an interest in remote, hostile or high-risk environments (where the protocols change due to the differences in likelihood of injury, probable severity of injury and complications associated with higher risk and increased time with the casualty) there is no single accepted program or awarding body.
Be extremely cautious about choosing an exotic sounding 'Remote Trauma Medic' course which may just be a glamorous FPOS course or, worse still, completley useless and valueless.
Further Reading: Medic Courses - a word of warning
3. Specialist Courses
Additional short-courses allow training to be complimented to fit your specificity. The above courses provide a benchmark standard within their intended remit but further training can be 'bolted-on' enhance knowledge,s kills and understanding.
Additional courses might include:
- Oxygen & Medical Gases
- Automated External Defibrillator
- Paediatric First Aid
- Administration and Handling of Medicines
- Taping & Strapping
- Manual Handling training
- Certificate / Diploma in Anatomy & Physiology
- Certificate / Diploma in Sports Massage
Short courses are an effective way of developing knowledge over time and adding to your CV and Continuing Professional Development (CPD) portfolio gradually.
At this point one should look at gaining experience to put your skills and knowledge into practice. 'Doing' is one of the best ways to learn and hands-on experience count for more than all of the training in the world but without any experience.
Clinical experience is difficult for the First Aider to achieve due to the amount of legislation involved, however, this exposure to real experience, together with regular training sessions will allow you discover if this field of work is for you, before you dedicate any more time and money to further training.
Opportunities to clinical experience include:
- Membership of one of the Voluntary Ambulance Services
- Part Time employment with a Private Ambulance Service
- Becoming a Community First Responder
- The Territorial Army Medical Services.
5. Continuing Professional Development
Trained to a good level of First Aid with a deeper understanding and a few more skills than the basics and with hands-on time under your belt, you should begin to think about developing a portfolio of Continuing Professional Development.
This records all related evidence of your continued training and self-directed learning.
Being a 'First Aider' is not considered a profession, but that does not say that you cannot conduct your behaviour professionally.
As you look to career training or further employment with, say, a private ambulance service, both will expect to see evidence of what you have been doing to keep your skills and knowledge up to date.
Further Reading: CPD – What is it and how is it done?
6. Wider Training
This is the stage many get to, either motivated by employment or simply the joy of learning where we reach the glass ceiling in training.
Beyond the skills you have already learned there is what seems a quantum leap form advanced First Aider to registered healthcare professional.
The pre-hospital skills taught beyond this point typically require the candidate to be employed in a health care role so that the application of these skills is protected (for the candidate and the patient) by the candidate's registration with their representative body. They will also be acting under the guidance of a senior health care professional so there is a hierarchy of accountability.
This leap to Paramedic requires significant commitment. There is, however, wider training that can be undertaken to broaden – rather than deepen – your knowledge. The following courses will not necessarily support your medical training but will give a wider understanding to the causes and consequences of incidents, provide evidence for your CPD portfolio and make you more employable.
- Food Hygiene - useful if working residentially or in a care setting.
- Fire Safety - Typically a 1/2 to 1 day course.
- Risk Assessments - Typically a 1/2 to 1 day course
- COSHH - Control of Substances Hazardous to Health. Useful for all employers but especially in industry.
- IOSH - Institure of Safety & Health "Working Safely" or "Managing Safely" courses
- NEBOSH - National General Certificate in Occupational Health and Safety is the benchmark H&S course in industry, with additional specific courses available beyond this.
- MIMMS - "Major Incident Medical Management and Support". Acceptance on this course is by appropriate working remit or experience. The course is the standard for managing major incidents between all emergency services.
- Conflict Management - several training providers available, look for recognised accreditation.
- Close Protection - SIA Approved BTEC Level 3 course in Close Protection Operations.
7. Career Training
By now you should have found regular part-time (or even full-time for the lucky few) work providing First Aid as a nominated First Aider at a workplace (although this is typically in addition to the 'regular' job) or with a private ambulance service. Even with a good skills base behind you, a substantial CPD portfolio and many hours of hands-on duty logged, this is as far as you can realistically get without making the move to a registered health care professional.
For the First Aider looking to become a legitimate 'medic' the shortest route to to Paramedic with registration with the HPC. This typically means giving up work (and possibly moving away) for two years to attend a University course. The old entry route of IHCD Ambulance Technician to IHCD Paramedic is not closed but it not as widely supported so opportunities to pursue this route are harder to find with no guarantee of success.
If you are in the position of being able to retrain, don't dismiss the possibility of becoming a Nurse, registered with the NMC. This is typically a three year course but with greater scope for progression and specialism at the end of it.
An alternative route is the NREMT or AREMT EMT-Basic to EMT-Paramedic routes. The NREMT route requires you to train and gain your clinical hours in the US, The AREMT route does not specify where you must gain your clinical hours. The NREMT route has been successfully transferred to UK recognised Paramedic with the Healthcare Professional Council but the AREMT route is, as yet, untested.
Both of these step-wise approaches allow a more forgiving route which may fit in most peoples ability of being able to take time off work or away from there family a week or two at a time.
8. Focussed Training
The following courses are intended for registered health care professionals; some training providers may allow non-registered candidates to 'observe' but not receive a certificate. It is up to you as the customer to decide if that is appropriate to your needs.
- Advanced Cardiac Life Support (AHA) – 2 Days
ACLS training is intended for healthcare providers who either direct or participate in the resuscitation of a patient, whether in or out of the hospital. The course focuses on team dynamics, leadership, rhythm recognition, airway management and related pharmacology.
- Advanced Life Support (UKRC) – 2 days
The ALS course offers a standardized national approach to evidence based resuscitation, similar to the ACLS course and has also been adopted by Europe and Australia.
- Advanced Medical Life Support (NAEMT) – 2 Days
The AMLS provider course is delivered at basic and advanced levels for EMTs and Paramedics. This course considers an in depth assessment-based approach of the medical patient and focuses on the differential diagnosis to quickly manage life threatening medical emergencies.
- Assessment & Treatment of Trauma (AAOS) - 1 day plus pre course e learning
ATT course is offered at basic and advanced levels. The basic course is designed for First Responders and EMTs and covers basic trauma life support concepts from the basic life support provider's level of training (anatomy and physiology and the pathophysiology of injury). The advanced course for Paramedics etc builds upon the basic trauma life support concepts and provides a more in-depth look into trauma and advanced management.
- Paediatric Advanced Life Support (AHA) – 2 days
The PALS course is designed to provide paediatric healthcare providers with the knowledge and skills necessary to efficiently and effectively manage critically ill infants and children and help improve outcomes
- Pre-Hospital Trauma Life Support (NAEMT) – 2 Days
The PHTLS course for pre hospital practitioners is designed to promote critical thinking and develop a common approach to assessing and dealing with multi system trauma.
- Tactical Combat Casualty Care (NAEMT) - 2 Days
Whilst a paramedic may have years of experience with an emergency medical service, it is the new TCCC protocols which have and continue to save lives in hostile environments. Medics should, where possible, attend TCCC training and scenario based exercises to develop their knowledge and skills to enable them to work cohesively with a tactical team. TCCC will familiarize civilian medics with the protocols adopted by most civilian and military teams, including the scene approach phases; Care Under Fire (CUF), Tactical Field Care (TFC) and Combat Casualty Evacuation Care (CCEC), employing the latest field techniques of tourniquet use and conversion, haemostatic agents, providing fluid boluses and calling in a MEDEVAC helicopter using a 9 Line MEDEVAC Request.
9. Academic Training
Once qualified and registered, the learning does not stop. Academic courses further your knowledge and demonstrate initiative, diligence and commitment. Below are a few internationally recognised, well regarded courses:
- Diploma in Immediate Medical Care (Dip IMC)
The Dip IMC, also offered by the RCSEd is intended for experienced / advanced pre hospital providers such as Paramedics, Emergency Care Practitioners and BASICs Doctors and consists of an intensive self study period followed by a series of exams presented over two days, including a written theory exam, a written incident scenario exercise, 2 vivas and a clinical incident practical exercise.
- Diploma in Mountain Medicine (DipMM)
- Diploma in Medical Care of Catastrophes
- Diploma in Remote and Offshore Medicine (Dip ROM)
- This comprehensive Diploma is offered by the Royal College of Surgeons (Edinburgh). Modules can be studied independently as CDP modules or as a whole to achieve the Diploma. Topics include tactical medicine, telemedicine, dive medicine and much more.
- Diploma in Tropical Medicine & Hygiene
- Bachelor’s Degrees - BSc Science / Paramedic Science – Part Time
A number of UK University offer flexible study options for health care professionals, including short CPD modules, certificates, diplomas and degree courses. Access to one of these courses is normally only possible where the applicant is working in a healthcare field or who has a sponsor (NS or private) to support their study.
A number of universities across the UK offer full time Paramedic Science / Healthcare related course at varying levels from Diploma and Foundation degree to Honours degree and Masters. Some of these courses are linked to the local Ambulance Service / NHS Trust and may attract funding and offer subsequent employment. Theses courses are highly subscribed.
- Masters Degree; Remote Healthcare
No matter where you are, look to where you could be but don't forget that all the training in the world is naught without experience.