FIRST RESPONCE EMERGENCY CARE
First Response Emergency Care FREC 3 & FREC 4
Regulated pre-hospital emergency care qualifications for people who may have to deliver effective medical care in high-risk, remote or time-critical environments. FREC 3 builds the core emergency-care skills; FREC 4 takes experienced responders into advanced assessment, trauma management and clinical decision-making.
From first response to advanced care
This programme gives a structured progression from immediate life-saving response to advanced casualty management. Learners are equipped to assess, treat and manage medical and traumatic incidents until advanced medical support arrives — or for longer periods where evacuation is delayed. Training across both levels is practical, scenario-based and assessed to awarding-body standard, and is delivered from Uganda for learners across the region.
Both qualifications are awarded by Qualsafe Awards, regulated by Ofqual on the RQF, and clinically endorsed by the Royal College of Surgeons of Edinburgh — Faculty of Pre-Hospital Care (FPHC): FREC 3 at PHEM descriptor D, FREC 4 at descriptor E. FREC 3 is the only FPHC-endorsed qualification listed in the Purple Guide at PHEM D and is widely accepted by the SIA for Close Protection licensing.
FREC 3 — First Response Emergency Care
Qualsafe Level 3 Award in First Response Emergency Care (RQF) · Re-launched 2025
The core pre-hospital qualification — patient assessment, airway management, catastrophic haemorrhage control, trauma care and medical emergencies. Built on the PHEM skills framework at Level D, it is widely required for security operations, close protection, event medical cover, remote work and overseas deployment, and equips learners to work alongside registered and non-registered clinicians.
Prerequisites: learners must be at least 17 years old on the first day of training. There are no other formal entry requirements, though a minimum of Level 2 in literacy (or equivalent) and a basic understanding of first aid are recommended. A reasonable level of physical fitness is needed for the practical elements.
What it covers
Foundations of Pre-Hospital Care
- Role, responsibilities and professional standards of a first responder
- Human factors and operational readiness
- Consent, confidentiality and record-keeping (PRF / PCR)
- Scene safety, dynamic risk assessment and M/ETHANE
Airway & Breathing
- Airway anatomy and stepwise airway management
- Airway adjuncts (OPA / NPA) and suction
- Choking — mild and severe
- Medical gases and emergency oxygen therapy
Resuscitation
- Adult, child and infant basic life support
- Safe AED use and maintenance
- Return of spontaneous circulation care
- Traumatic cardiac arrest within scope
- Structured handover (ATMIST / SBAR)
Trauma Care
- Mechanism of injury and energy transfer
- Catastrophic and severe bleeding control
- Tourniquets, wound packing, haemostatics, pelvic binders
- Chest injuries, wounds, burns and eye injuries
- Shock recognition and management
Head, Spinal & Musculoskeletal
- Suspected head and spinal injuries, MILS
- Safe helmet removal (2-person technique)
- Fractures, dislocations, splinting
- Moving, handling and extrication to safety
Medical Emergencies
- Stroke, sepsis, anaphylaxis, asthma, diabetes, ACS
- Breathing difficulties and respiratory distress
- Sudden poisoning, the unconscious patient and seizures
- Environmental exposure and drowning
- Safe administration of emergency medications within scope
On completion
- Conduct full patient assessments using recognised pre-hospital models
- Manage catastrophic bleeding and major trauma confidently
- Maintain a patent airway with adjuncts and assisted ventilation
- Provide emergency oxygen therapy
- Recognise and manage medical emergencies
- Perform adult, child and infant CPR and safe AED use
- Triage and manage an incident scene safely
- Give structured handovers to the next echelon of care
Assessment
Six mandatory practical assessments observed throughout the course (adult, child and infant BLS; airway and ventilation; trauma care; medical care), one multiple-choice question paper and one invigilated written exam. Five optional extended-skills practical assessments — supraglottic airway, inhaled analgesia (Nitrous Oxide and Penthrox), naloxone and blood-glucose measurement — are available only to learners who operate under clinical direction and a governance framework. Graded pass or fail; valid for three years.
Who it’s for
FREC 4 — First Response Emergency Care
Qualsafe Level 4 Certificate in First Response Emergency Care (RQF)
The advanced step for experienced responders — enhanced assessment, advanced trauma management, structured medical planning and leadership during complex incidents. It is intended for people who hold increased medical responsibility, operate with greater autonomy, or supervise medical responses in austere or hostile environments.
Standard entry: hold an in-date FREC 3 and complete a CPD portfolio evidencing 118 hours of contextualised Level 3 learning before starting FREC 4. Learners must be physically capable of performing advanced trauma skills.
Alternative entry: experienced clinicians may enter on a Qualsafe-recognised equivalent in place of FREC 3 — subject to Qualsafe approval through its Recognition of Prior Learning route and the same 118-hour CPD portfolio. Equivalence is assessed and granted by Qualsafe in advance, not self-declared.
What it covers
Advanced Patient Assessment
- Expanded ABCDE approach
- Advanced vital-signs interpretation
- Secondary assessment and differential diagnosis
Airway & Respiratory
- Advanced airway care, suction and assisted ventilation
- Nebuliser therapy
- Respiratory examination (auscultation where permitted)
Trauma Management
- Advanced catastrophic bleeding control
- Shock pathophysiology
- Advanced splinting and traction devices
- Spinal injuries and immobilisation
- Crush and blast injuries
Medical Care
- Diabetes, cardiac issues, acute asthma, anaphylaxis
- Stroke assessment tools
- Seizure management
- Lifesaving medications (within scope and where legislation allows)
Resuscitation & Response
- CPR, AED and post-ROSC care
- BVM and airway adjuncts at advanced level
- Team leadership during resuscitation
Operational & Clinical Skills
- Major incident management
- Triage systems
- Patient movement, extrication and evacuation
- Clinical documentation and report writing
On completion
- Undertake advanced patient assessments and identify deterioration
- Manage advanced trauma scenarios
- Lead first-response teams in emergencies
- Provide enhanced airway management
- Deliver structured clinical handovers
- Operate within pre-hospital care and major-incident systems
Assessment
Practical scenarios, skills stations and a written knowledge assessment, plus completion of a clinical portfolio / logbook (cases may be simulated).
Who it’s for
Scope of practice
A qualification, not a licence to practise
FREC confirms completed, assessed training — it is not a licence to practise. Any interventions, including the administration of medications, must be carried out within the learner’s own and their organisation’s scope of practice and agreed ways of working, and where required, under clinical governance authorisation.
Enquire about FREC 3 & FREC 4
Talk to the team about dates, group bookings and the FREC 4 entry route.
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