The Role of First Responders in Rural Emergency Preparedness and Response

First responders are often the first to arrive to the scene of an emergency or disaster. They provide services essential to the response and the community. Another term that refers to first responders is emergency response providers. The major groups of first responders include emergency medical services (EMS) personnel, firefighters, and police officers. Sometimes, healthcare providers, including physicians and nurses, respond to emergencies and disasters. First responders are a critical component of preparing for, responding to, and recovering from a disaster.

Planning

During the planning phase, it is important to consider and prepare for first responder needs related to training, staffing and volunteers, and first responder preparedness.

Training

Identifying first responders and ensuring they complete proper training is essential during the planning phase. Training and education for first responders include formal training and certifications as well as familiarity with emergency response protocols, including communication processes and specific responsibilities.

Different groups of first responders will be better suited to respond to certain kinds of emergencies. For example, firefighters might be best suited to respond to a wildfire, while healthcare workers might be better suited to respond to a viral outbreak. First responders must receive the appropriate training that corresponds to their role and skills. However, in rural areas, the number of first responders available is limited, which means that first responders might have to respond to emergencies that are outside of their jurisdiction and scope of practice. Therefore, first responders should have a general understanding of the possible types of emergencies and disasters that are likely to happen in their community and surrounding areas as well as the immediate priorities to be addressed in response efforts. The Center for Rural Development's Rural Domestic Preparedness Consortium offers trainings and resources for rural and tribal emergency responders.

First responders are critical to response efforts, and they play an important role in ensuring the response is equitable and culturally responsive. Training for first responders should include learning how to be culturally competent during disaster response. The Cultural Competency Curriculum for Disaster Preparedness and Crisis Response is a free e-learning course offered by the U.S. Department of Health and Human Services for first responders and others.

Staffing and Volunteers

In rural communities, community members often volunteer to be first responders. These volunteer first responders may need additional training since being a first responder is not their primary occupation. At the same time, they may have limited time to complete extensive training. For more information about community volunteers, see Community Engagement and Volunteer Management for Emergency Preparedness and Response.

Some rural communities may need to develop plans in anticipation of not having first responders. Specifically, the number of first responders in tribal communities is very limited. In these cases, it is important to be aware of resources that are available and plan a response that accounts for a lack of first responders. First responder agencies can develop partnerships with schools, faith-based organizations, local industry, and individuals with transferrable skills to aid in response efforts. Additionally, first responders who have retired or are no longer active may be able to fill in staffing gaps.

First Responder Preparedness

It is important that individual first responders and their families are prepared for a response. Steps they can take to minimize stress in anticipation of a disaster include:

• Build an emergency supply kit
• Make a family emergency plan
• Be informed about the kinds of emergencies they can be called to and teach family members about any protective actions they should take
• Determine alternate caregivers for children, if parents and guardians are actively responding to a disaster
• Determine alternate care for older adults, if adult caregivers are actively responding to or affected by a disaster
• Prepare for populations with disabilities, mobility challenges, medical needs, social needs, and limited English proficiency

Response

During the response phase, it is crucial to ensure personal safety of first responders. Special attention should be given to communication processes, mental health, access to protective equipment and first responder safety through a buddy system. Many EMS providers in rural areas are volunteers, who may not have access to health insurance through their jurisdiction. The lack of health insurance may limit access to healthcare services or workers compensation coverage for issues related to their volunteer EMS roles. It is important that rural communities consider these rural EMS characteristics and challenges. For detailed information on rural EMS services, see, the Rural Emergency Medical Services (EMS) and Trauma topic guide.

Effective communication and coordination are essential to first responder safety and response efforts. First responders should have an up-to-date contact list, including supervisors, response partners, and other first responders, and established methods of communication, such as radio, cellphone, and more. Communication methods will vary depending on the emergency. Sometimes, communication may not be possible, and first responder agencies will need to plan for this as well. For more information on communication, see Public Safety and Crisis Communication in an Emergency or Disaster.

During a response, first responders may need to adapt to an increased workload and the changing environment surrounding the emergency or disaster. During the COVID-19 pandemic, first responders adjusted operations to meet new requirements. For example, many fire departments reassigned non-emergency personnel to field operations, volunteers were recruited to keep up with the demand for EMS, and first response vehicles were ventilated.

Camaraderie with other responders, good leadership, and social support are protective factors for first responders. During a response, first responders face the most risk factors, including proximity to and length of exposure to the disaster, dealing with serious injuries and deaths, becoming emotionally involved, poor support from leadership and lack of interagency collaboration, not having enough information, low perceived safety, and being injured mentally or physically while on the job. It is crucial to reduce mental health risk to first responders, and strategies like developing clear communication processes, having a buddy system, and assessing the team's welfare can help.

Recovery

First responders' mental health is disproportionately affected during and following a disaster since they are on the front lines. According to the 2018 Substance Abuse and Mental Health Services Administration (SAMHSA) Supplemental Research Bulletin, First Responders: Behavioral Health Concerns, Emergency Response, and Trauma, 30% of first responders develop behavioral health conditions, including depression, PTSD, substance use, and suicide/suicidal ideation. Considerations for first responder mental health should be acknowledged during all phases of emergency preparedness.

Pre-disaster risk factors include being mentally or physically unfit to perform response duties, inadequate training, unrealistic expectations from leadership, and stressful life events. A longer duration of employment, specialized training, resilience, and assurance of personal and team capabilities were all found as protective factors. Interventions to reduce behavioral health risk include participation of first responders in the development of response plans, providing enough information regarding disasters and the necessary training, and informing first responders of the stress they may face during response.

During the recovery phase, it is especially important to promote protective factors such as professional mental healthcare and peer support and to reduce risk factors, such as watching more than four hours of television, avoidant coping, and not receiving appreciation for response efforts.

Resources to Learn More

COVID-19 Information for the First Responder Community
Website
Provides links to reliable resources for first responders to inform and guide them when conducting COVID-19 response activities to ensure safe and efficient practices.
Organization(s): U.S. Department of Homeland Security (DHS)

First Responders and Disaster Responders Resource Portal
Website
Offers resources and online trainings to learn more about signs of stress and stress management in first responders
Organization(s): Substance Abuse and Mental Health Services Administration (SAMHSA)

Information for First Responders on Maintaining Operational Capabilities During a Pandemic
Document
Identifies ways to adjust operations in order to maintain readiness and response. Shares methods for local planning and provides planning tools and resources.
Organization(s): U.S. Fire Administration, Federal Emergency Management Agency (FEMA)
Date: 3/2020

Rural Fire Department Resources for Local Officials
Website
Offers information, planning resources, and funding and program assistance for rural fire departments.
Organization(s): U.S. Department of Agriculture (USDA)