The terms used in this rule shall be defined as follows:
(a) Emergency Medical Responder (First
Responder) means a person who has completed required training and who
participates in an organized program of mobile pre-hospital emergency medical
(b) Emergency Medical
Responder (First Responder) Certification means successful participation and
completion of the Emergency Medical Responder Course and certifying
(c) Emergency Medical
Responder (First Responder) Course means instruction in basic knowledge and
skills necessary to provide emergency medical care to the sick and injured
individuals who may respond before licensed Basic or Advanced Life Support
(d) First Responder
Service - shall mean a service providing capabilities for mobile pre-hospital
emergency medical care using emergency medical response vehicles.
Operation of First Responder
Services. A licensed ambulance service classified as a primary provider shall
coordinate first response services within its service area. If the primary
provider is a contracted ambulance service, the county or local government may
designate a representative who shall coordinate first responder services within
the service area of its jurisdiction. First responder services shall meet the
following standards for participation in the community EMS system. To
participate in the community EMS system, each First Responder Service shall:
(a) Be a state-chartered or legally
recognized organization or service sanctioned to perform emergency management,
public safety, fire fighting, rescue, ambulance, or medical
Provide a member on
each response who is certified as a First Responder, Emergency Medical
Technician, or EMT- Paramedic in Tennessee.
Personnel may provide the following
additional procedures with devices and supplies consigned under medical
(i) First Responders and Emergency
Medical Technicians trained in an appropriate program authorized by the
Division may perform defibrillation in a pulseless, nonbreathing patient with
an automated mode device.
Emergency Medical Technicians-IV and EMT-Paramedics may administer:
(I) Intravenous fluids with appropriate
retention with Board approved airway procedures.
EMT-Paramedics and advanced life
support personnel trained and authorized in accordance with these rules may
perform skills or procedures as adopted in Rule
(iv) First Responders and Emergency Medical
Technicians participating in a recognized first responder organization within
the community EMS system may, upon completion of the approved training,
periodic review training, and concurrent quality assurance of the local EMS
system Medical Director, utilize a dual-lumen airway device (such as the
Combitube or Pharyngeal Tracheal Lumen airway) that has been approved by the
procedures shall be consistent with protocols or standing orders as established
by the ambulance service medical director.
3. Services shall provide at least six (6)
hours of annual in-service training to all EMS First Responder personnel, in a
plan and with instructors approved by the medical director.
(c) Provide services twenty-four
(24) hours a day, seven (7) days a week, and notify the primary service and
dispatching agent of any time period in which the service is not available or
staffed for emergency medical response.
Provide minimum equipment and supplies
and such other equipment and supplies as shall be mutually adopted under the
agreement with the primary ambulance service and medical director. The
following minimum equipment shall be provided:
Emergency Medical Care (Jump) Kit
(i) Dressings and bandaging
supplies, with adhesive tape, adhesive bandages, sterile 4" gauze pads, sterile
ABD pads, 3" or wider gauze roller bandages, bandage shears, occlusive dressing
materials, at least four triangular bandages, and burn sheets.
(ii) Patient assessment and protective
supplies including a flashlight, disposable gloves, antibacterial wipes or
solution with tissues, trash bags, an adult blood pressure cuff with manometer
and a stethoscope.
Resuscitative devices including oral airways in at least five sizes, a pocket
mask, suction device capable of 12 inches vacuum with suction tips for
oropharyngeal suction, and an oxygen administration unit capable of 2 to 15
liters per minute flow rate with a minimum 150 liter supply.
3. Splints for upper and lower
4. Patient handling
equipment including a blanket and appropriate semi-rigid extrication
maintain a memorandum of understanding or agreement of coordination within the
service area with the primary provider of emergency ambulance services. If the
primary provider is a contracted ambulance service, said agreement shall be
developed and maintained with the designated representative of the county or
local government. Such agreement will provide for policies and procedures for
1. Personnel and staffing,
including a roster of response personnel and approved procedures for such
personnel, and the crew component operational for emergency medical
2. Designation of
vehicles to be operated as pre-hospital emergency response vehicles, including
unit identifiers and station or location from which vehicles will be
3. Nature of calls for
which first response services will be dispatched, and dispatch and notification
procedures that assure resources are simultaneously dispatched and that
ambulance dispatch is not deferred or delayed.
4. Radio communications and procedures
between medical response vehicles and emergency ambulance services.
5. On-scene coordination, scene control and
responsibilities of the individuals in attendance by level of
6. Medical direction and
protocols and/or standing orders under the authority of the ambulance service
7. Exchange and
recovery of required minimum equipment and supplies and additional items
adopted for local use.
of patient information, records and reports, and quality assurance
9. Terms of the
agreement including effective dates and provisions for termination or
responder services shall maintain professional liability insurance providing
indemnity to emergency care personnel and the organization. Each first
responder service shall maintain the minimum liability coverage which is set
forth in T.C.A. §
Emergency Medical Responder (First
Responder) Training Programs:
utilize texts and curriculums approved by the Board.
(b) Class size shall not exceed twenty-five
(25) students per instructor.
Course must be conducted by an instructor authorized by the Division.
(d) Shall obtain course approval from the
(e) Shall provide an
attendance policy acceptable to the Division.
(f) Shall maintain accurate attendance
(g) Must maintain student
records, such as exams, attendance records and skills verification for 5
(h) Must provide
documentation of a student's successful completion of course, attendance, and
verification of skills competency to the Division.
(i) Must provide adequate classroom space
with adequate lighting and ventilation.
(j) Must provide adequate lab space for
(k) Must assure
adequate audio visual instructional aids and supplies are available.
(l) Must provide adequate equipment for
First Responder Certification requirements:
(a) Must be at least seventeen (17) years of
(b) Must be able to read,
write and speak the English language.
(c) Must be currently certified in Basic
Must meet all attendance requirements of training program.
(e) Must successfully complete an approved
First Responder Course.
successfully complete written examinations within two (2) years of completion
of First Responder course.
1. Achieve a
passing score on a Board approved written examination with a minimum score as
established by the Board.
Applicants who fail to pass the examination shall be eligible to reapply for
submit an Application for certification form as provided by the Division of
Emergency Medical Services.
Must remit the appropriate certification and application fees, as determined
under rule 1200-12-01-.06
(i) Certification shall be issued for a
period not to exceed two (2) years.
First Responder renewal certification:
Certifications may be renewed upon filing
an application, possession of a current Cardiopulmonary Resuscitation card
verifying successful completion of a basic life support course which includes
automatic external defibrillation for health care professionals, and
verification of one of the following:
Successful completion of refresher training course of at least sixteen (16)
hours meeting the refresher course curriculum approved by the board;
2. Satisfactory completion of an
approved renewal examination; or
Completion of ten (10) continuing education hours in the following areas:
Preparatory: one (1) hour consisting of:
(I) EMS systems.
(II) Well being of the first
(III) Legal and ethical
(IV) Human body.
(V) Lifting and moving patients.
(ii) Airway: two (2)
(iii) Patient assessment:
two (2) hours.
one (1) hour.
injury: two (2) hours.
(I) Medical: one (1)
(II) Trauma: one (1)
(vi) Children and
childbirth: one (1) hour.
Rescue and EMS operations: one (1) hour.
Those persons who fail to timely renew
certification as provided by law are subject to the following:
1. Late renewal within sixty (60) days or
less from the expiration of certification will require payment of a twenty-five
dollar ($25.00) reinstatement fee, and in addition to CPR certification,
successful completion of either the approved written examination or the
required refresher course.
Reinstatement of certification sought to be renewed more than sixty (60) days
after expiration of certification but less than two years will require payment
of a twenty-five ($25.00) reinstatement fee and in addition to CPR
certification, successful completion of both the refresher course and the
approved written examination.
Out-of-State requirements for
certification: Any First Responder who holds a current certification in another
state and who has completed an approved US Department of Transportation First
Responder Course may apply for Tennessee First Responder certification by
complying with the following:
1. Conform to
all certification requirements for Tennessee First Responder; and,
2. Successful completion of any EMS Board
approved written and practical examinations; and,
3. Submit the appropriate application forms
and fees, if applicable, to the Division of Emergency Medical
Official response shall be performed only as assigned upon the specific policy
guidelines of the coordinating dispatch agency responsible for dispatching
emergency ambulances and/or an emergency (911) communications district. No
emergency medical first responder or emergency medical response vehicle shall
be authorized to make an unofficial response on the basis of information
obtained by monitoring a radio frequency of a law enforcement, ambulance
service, fire department, rescue squad, or public safety agency.
Tenn. Comp. R. &
Original rule filed
March 25, 1987; effective May 9, 1987. Amendment filed March 7, 1989; effective
April 21, 1989. Amendment filed March 7, 1994; effective May 21, 1994.
Amendment filed January 9, 1997; effective March 25, 1997. Amendment filed
November 16, 2005; effective January 30, 2006. Amendment filed December 16,
2005; effective March 1, 2006. Amendment filed April 6, 2010; effective July 5,
2010. Amendments filed January 11, 2013; effective April 11,
68-140-504(1) and (2), 68-140-506, 68-140-506(c), 68-140-507, 68-140-508,
68-140-508(a) & (b), and 68-140-517.