Solent Medical Skills | Pre-Hospital Medical Training

 Level 4 Certificate in First Response Emergency Care –


Your next step to a rewarding career as a semi-autonomous first line provider of emergency care


Course details:

The Level 4 Award meets all the competencies for non-health care professional pre-hospital providers to care for patients as a primary role, i.e. semi-autonomous practitioners. It has 39 hours of contact learning time and also needs a total of 180 hours. This is made up of pre-course reading (10 – 30 hours), ongoing CDP or self-study and the contact learning time. Learners have a maximum of 12 months to complete these hours after the last day of their course.

For the mandatory pre-course reading there is a choice of two textbooks Generic Core Material or Ambulance Care Essentials, both available from our awarding body Qualsafe.

After the course, students are able to show development by writing reflective reports about clinical experience at work (as a doorman, event medic, close protection operative, etc), the choice is yours! Please note that the post-course hours are mandatory and a certificate cannot be issued until these are completed) Learners who do not have access to medical based work can still complete a course by logging appropriate self-study.

Course prerequisites: Most candidates will have to successfully complete FREC Level 3 before being allowed onto the FREC Level 4 course. However if you have NHS training at ECA level or above, you can go straight onto FREC 4. We offer a shortened (3-day) FREC 3 conversion from FPOS-I or other APL on selected datesFor those with no previous medical experience, you will have to do the full 5-day Level 3 before attempting FREC 4. If you are unsure, please contact us before booking to confirm that your prior qualifications are sufficient.

FREC® Level 4 content:

ABCDE approach to conducting an initial patient assessment
Homeostasis/physiological variables including:
  • Blood glucose levels
  • Blood and tissue oxygen and carbon dioxide levels
  • Blood pressure
  • Core temperature
  • Water and electrolyte concentrations
  • Ph level of body fluids
Normal physiological values including:
  • Breathing rate
  • Capillary refill
  • Heart rate
  • Blood pressure
  • Temperature
  • Blood glucose level
  • Oxygen saturations
Negative and positive feedback mechanisms
History taking:
  • Presenting complaint/History of presenting complaint
  • Past medical history
  • Drug/medication history
  • Overall impressions
  • SOCRATES pain scoring
  • Wong-Baker FACES pain rating scale
  • FLACC scale
Glasgow Coma Scale
FAST test
Physiological measurements:
  • Sphygmomanometer
  • Thermometer
  • Pen torch
  • Blood glucose meter
  • Peak flow meter
  • Pulse oximeter
  • Peak expiratory flow rate
  • Capnography
Heart and cardiovascular emergencies
Atheromatous plaque
Pathological changes associated with heart disease
Structure of the heart/Function of the heart:
  • Location
  • Pericardium
  • Myocardium
  • Endocardium
  • Blood supply
Cardiac conduction system
  • Sinoatrial node
  • Atrioventricular node
  • Autonomic nervous system
  • Stages of the cardiac cycle
Coronary artery disease:
  • Heart failure
  • Arhythmias
Blood vessel pathological changes:
  • Atheromatous plaques
  • Causes of atheroma
  • Effects of atheroma
  • Predisposing factor in atherosclerosis
  • Arterioscelerosis
  • Thrombosis
  • Infarction
  • Haemorrhage
  • Aneurysm
  • Electrical changes of the heart (P,Q,R,S,T waves)
  • Difference between 3 and 12 lead ECG trace
  • Cardiac output
  • Stroke volume
3-lead ECG:
  • Normal sinus rhythm
  • Ventricular fibrillation
  • Ventricular tachycardia
  • Asystole
  • Pulseless electrical activity
  • Bradycardia
  • Tachycardia
  • First degree atrioventricular heart block
  • Second degree atrioventricular heart block type 1 (Wenckebach)
  • Second degree atrioventricular heart block type 2 (Mobitz)
  • Third degree atrioventricular heart block (complete)
ECG paper components:
  • Small squares
  • Large squares
  • Calibration
  • Paper speed
12-lead ECG including:
  • Premature ventricular contractions (PVC)
  • Accessory pathways
  • ST elevation/depression
  • R on T
  • SVT’s including: supraventricular tachycardia, atrial fibrillation and atrial flutter
Invasive skills assists including:
  • Canulation and bag fluids preparation
  • Intra muscular injection (IM)
  • Subcutaneous injection (sub-cut)
  • Supraglottic airways including: I-Gels, Laryngeal Mask Airways (LMA’s)
  • Intraosseous access bone drilling/puncturing
  • Endotracheal (ETT) tube intubation
  • Magill forceps
 Other topics:
  • Sexual assault
  • Major incidents
  • Other emergency services
  • Terrorist incidents
  • Thoracic trauma

Throughout the course, learners will get repeated patient assessment scenarios.

Your next step after you achieve FREC Level 4? Find out about taking FREC Level 5 with Solent Medical Skills.

Contact Solent Medical Skills

If you have any questions or queries - or need some advice about any of our courses please contact us.

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