Top 10 Benefits of an EMR License

EMR License

Firefighters are often the first emergency response personnel on the scene of an emergency, but are not permitted to use certain medical devices, like an epi auto-injector.  When there are BC Ambulance Service delays or firefighters find themselves in remote rescue scenarios, it is beneficial to the patient if firefighters have the skills to assist patients to use life-saving medications. However, responding fire fighters must work within the scope of their license and within their level of training. For this reason, Iridia supports first responders transitioning from an EMA-FR to an Emergency Medical Responder (EMR) license level. 

EMR license protocols outline the roles and responsibilities of firefighters and paramedics who respond to a medical emergency on-scene. The goal of the protocols is to quickly identify and respond to any potential life threatening medical emergency.

Using the EMR protocols provides firefighters with better tools to attend to a patient’s needs. It allows firefighters to use additional pain relief as well as immobilization tools when responding to emergency situations.


Top 10 Benefits of an EMR License

  1. 80 additional hours of training which provides a greater ability to diagnose and treat a wide spectrum of illnesses   
  2. Ability to provide an effective way to relieve a patient’s pain through the use of Entonox
  3. Having basic diagnostic tools such as blood pressure cuffs and pulse oximeter use covered within the EMR license level
  4. Training in patient transport and packaging techniques which exactly mirror the BC Ambulance Service
  5. Having a license level which meets national standards instead of the local FR3 license
  6. Ability to provide “symptom relief” medications such as ASA and Nitro to patients
  7. A license that does not require a re-certification course every three years
  8. Additional training on how to provide more in-depth patient charting
  9. Access to a wider range of Continuing Medical Education programs to maintain skills
  10. The ability to provider a higher level of care to patients in need

Our EMR program is just the beginning. We believe in a bright future for BC fire departments and their delivery of pre-hospital care.


7 thoughts on “Top 10 Benefits of an EMR License

  1. Unfortunately firefighters are not that well trained. Educating a plumber or an electrician on how to deal with often complex and chaotic medical emergencies may seem excellent on paper however in the real world it is far from efficient. Firefighters often mistake CHF for COPD and admin ventolin. I have seen firefighters take blood pressures and regularly come back with 120/80 conveniently. I have seen firefighters in Toronto admin nitro without obtaining an initial blood pressure because “the patient said it would help” only to determine the SBP was 58 upon my initial assessment. I have seen firefighters do extended pulse checks because they were so unsure if the pt had a pulse or not, so instead they put on a NRB and waited for us to come through the door – pt was VSA (this is happened more than once). Toronto firefighters are apparently trained to the EMR level as per their website. I can say from experience that approximately 5% of firefighters understand what they are being taught, medically related to the EMR level. Most have no idea, don’t pay attention, don’t care and coast through the required EMR medical training with little care. Firefighters are in the business of fighting fires, not in the business of “patient care” or else they would have become medics, nurses or doctors. I deal with this day in and day out. Firefighters are using their “advanced medical training” to ensure budgets remain in place and they continue to increase annual call volumes on the backs of paramedics. Annual recertification, 100% PCR audits, all ALS calls critiqued and over-sight from base hospitals, paramedic service and provincial body. If I mess up on ACLS on a VSA, I have a meeting with my BHP. My firefighting friend and colleague forgot to apply pediatric pads to a child found VSA in a pool, CPR only until medics arrived – fire department awarded them rest of the day off due to stress and they were both told “good job”. I would have lost my job on the spot. Firefighters dupe the public into thinking they actually make a difference on medical calls. They don’t. Unconscious and VSAs should be all they attend.

    • Thank you for your perspective regarding the training and performance of firefighters within the Toronto EMS system. I am hopeful, in the spirit of improving patient care and system improvement, there are opportunities within your system for you to provide these same observations in a safe forum to the fire crews as well as the local EMS as a whole. I am still a firm believer that no one providing patient care goes to work to do a bad job and shortcomings in performance are 90% about the process and systems and 10% the people.

      In BC we are fortunate that all pre-hospital care providers must successfully complete a licensing process administered by an arm of the government – the Emergency Medical Assistant Licensing Branch. This means that in order to practice at an EMR level, whether a firefighter or a member of BC Ambulance you must successfully complete the same exam process. Additionally, there is a *requirement for minimum patient contacts and completion of ongoing CME to maintain the EMR license level.


      I am also a firm believer that for a pre-hospital care system to function optimally it must be viewed as one system providing care and not fire and ambulance working independently. In the end, both services have a vital role to play in the safety and care of the residents in the community and I am eternally optimistic that we can foster a healthier spirit of cooperation rather that making this some type of competition.

      Dr. Allan Holmes
      Founder, Iridia Medical

  2. If only there was a branch of Emergency Services that dealt with patient treatment and transport we could use them to help these patients inside of training firefighters. OH WAIT, there is!!! PARAMEDICS.

    Why train Fire Departments to render patient care when you could just put more Ambulances on the road for the same price? Should we train Police to manage fires? or Paramedics to investigate crime scenes? No, because that is crazy.

    HIRE MORE PARAMEDICS, and leave FD’s to do what they do best.. FIRES, HAZMAT and extrications.

    • Thank you for the points you raise. Putting more ambulances on the road is one possibility; however this may not be the most effective solution when a significant percentage of patients do not require transport.

      As an alternative, we would like to implement a system where a highly trained care provider with a direct video link to a physician (when necessary) could arrive first on scene (via a fast response vehicle) and be empowered to re-triage patient to stay at home – and be sent to a variety of other health or social assistant resources, then we could have some efficiencies.

      The fact that our system currently defaults everyone to go to the hospital is inefficient for providers, patients and the taxpayers and perpetuates the need for more and more ambulances.

      Dr. Allan Holmes
      Founder, Iridia Medical

      • Dr. Holmes,

        I would like to challenge your comments with some evidence I was able to locate on this world wide web. I do not agree that FFR (firefighter first response) is necessary in many medical responses in urban settings, besides the “hail mary” cardiac arrest and of course an unconscious patient as suggested by Wendy.

        An independent study was recently performed in Toronto and I would like to include the link here:

        It actually suggests doing the opposite of what you’re advocating and has factual evidence for you to review.

        Another study:

        This study essentially states the professional firefighters union of Ontario is deceptive and EMS/paramedic services are the most appropriate response service for medical calls.

        The question I have for you is this: who would you like to show up in an emergency should a family member or friend of yours require emergency medical assistance. I can guarantee with 100% certainty that it is not an EMR. A PCP or ACP with years of field experience on an ambulance with adequate patient contact times instead of an EMR with 2-3 minutes with a patient prior to paramedic arrival.

        Funding single paramedic rapid response vehicles instead of a huge fire truck with 4 firefighters and increasing the number of ambulances, with of course alternative destination protocols and community paramedicine is far more efficient and cost effective than throwing money to a FD.

  3. You mentioned that EMR license protocols outline the roles and responsibilities of firefighters and paramedics who respond to a medical emergency on-scene. Is this license something that civilians can get as well? I can imagine that responding to an emergency would require quick thinking and training. Finding an EMR training center could be very beneficial.

    • That’s a great question! Emergency Medical Responder (EMR) training program is an approximately 100 hour blended program that provides fundamental medical training and most often taken by those entering a career in pre-hospital emergency care. The program is intended for emergency response personnel, but is open to anyone with an interest in emergency care, including those with little or no prior training. The training program is offered by a number of providers including the Justice Institute, St. John Ambulance, and the Red Cross.

      To provide the full scope of EMR therapies (see, care providers who successfully complete a training program are also required to successfully complete a licensing exam administered by the Emergency Medical Assistant Licensing Board of BC.

      Responding to an emergency does require quick thinking and training and we encourage everyone to have a least basic training in CPR and the use of an Automated External Defibrillator. Sudden cardiac arrest remains one of the leading causes of death and the skills learned in a Cardiac Arrest Management workshop or a CPR class can be truly lifesaving.

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