Emergency First Aid (EFA)

Occupational Statement:

GEMR certified Emergency First Aid (EFA) personnel provide emergency first aid for patients until emergency medical services (EMS) personnel can reach the patient. EFAs have the basic first aid knowledge and skills necessary to provide first aid level care to life threatening emergencies until higher qualified Emergency Medical Services personnel can arrive to care for the patient.

Emergency First Aid qualified persons function as part of a comprehensive EMS response system, which seeks bystander and first responder first aid care prior to EMS arrival to improve patient outcomes. The GEMR Emergency First Aid certification is designed for those personnel who are most likely to encounter patients in need of first aid as part of their occupation or volunteer activities, such as law enforcement personnel, fire personnel, lifeguards, teachers, security officers, safety officers, maritime personnel, and members of the public engaged in high risk activities.

A GEMR Emergency First Aid (EFA) certified person may:

  1. Identify the need for Emergency Medical Services (EMS) and how to activate EMS.
  2. Demonstrate entry level knowledge of Duty to Act, Good Samaritan Concept and Laws, Consent, Implied Consent, and Ethical Decision Making.
  3. Conduct primary assessment, using the MARCH (Massive Hemorrhage, Airway, Respiration, Circulation, Head Injury/Hypothermia) method.
  4. Identify and record pulse.
  5. Identify and record respirations.
  6. Identify common life threatening medical and environmental conditions.
  7. Place a patient in the “recovery position”.
  8. Place patient in a “Back Up Head Elevated” position.
  9. Open and maintain an airway by positioning the patient’s head.
  10. Provide external cardiopulmonary resuscitation for infants, children, and adults.
  11. Perform cardiac defibrillation with an automatic or semi-automatic defibrillator during cardiopulmonary resuscitation (CPR).
  12. Provide obstructed airway care for infants, children, and adults.
  13. Identify wounds requiring dressing and bandaging, but not requiring hemorrhage control, and apply dressing and bandaging to wound.
  14. Identify life threatening external hemorrhage and provide external bleeding control and bandaging.
  15. Provide extremity tourniquet application for severe external hemorrhage control.
  16. Provide junctional tourniquet application for severe external hemorrhage control.
  17. Identify open chest wound and apply chest seal.
  18. Identify possible opioid overdose and administer nasal route naloxone.
  19. Identify possible anaphylactic shock and assist in the administration of the patient’s epinephrine auto injector.
  20. Identify the need for oxygen in severe hemorrhage, stroke, diving injuries, seizure, anaphylaxis, shock, or cardiac arrest and administer oxygen via mask.
  21. Prepare and administer aspirin by mouth for suspected myocardial infarction (MI) in patients with no known history of allergy to aspirin or recent gastrointestinal bleed.
  22. Provide simple immobilization care for musculoskeletal injuries.
  23. Identify stress physiology and apply stress reduction technique during emergencies.
  24. Provide basic mental health first aid and de-escalation until EMS can arrive.

The Global Emergency Medical Registry (GEMR) is honored to serve this aspect of emergency first aid with an international standard certification following education, competency evaluation, and testing.

The GEMR Emergency First Aid (EFA) Certification is designed to provide industry, governments, regulators, and administrations with a third-party certification for this level of first aid around the globe which is referenceable and can be checked via the gemr.org “Verify Certification or Endorsement” box on the GEMR Home Page.

EFA – Initial Candidate Information for Certification

Pre-Certification Educational Outcomes:

Upon completion of a program of education, the candidate will:

  1. Be a minimum of 13 years old.
  2. Be prepared for and eligible to take the GEMR Written Examination and skills process to obtain certification from The Global Emergency Medical Registry (GEMR).
  3. Be prepared to upload all EFA/EFR skills sheets with instructor signature, indicating compliance to the standard during examination of that skill.
  4. Completed a program of education, which utilized the Global Emergency Medical Registry (GEMR) Emergency First Aid Initial Emergency First Aid Certification for First Responder and Law Enforcement Personnel Curriculum and Lesson Plans Instructor manual (3/23/2026) and prepared to upload course completion certificate, skills sheets, and course sponsor records to GEMR.

Educational Program Expectations:

Educational programs must have followed the Global Emergency Medical Registry (GEMR) Emergency First Aid Initial Emergency First Aid Certification for First Responder and Law Enforcement Personnel Curriculum and Lesson Plans Instructor Manual (3/23/2026) to meet the GEMR certification requirements.

The Global Emergency Medical Registry (GEMR) Emergency First Aid Initial Emergency First Aid Certification for First Responder and Law Enforcement Personnel Curriculum and Lesson Plans Instructor manual (3/23/2026) is available for download by organizations, instructors, and regulators at www.gemr.org at no cost.

Minimum Educational and Examination Objectives:

The Global Emergency Medical Registry (GEMR) establishes minimum standard educational objectives for the registry levels. Certification decisions are based on objective evidence of competence and are conducted in alignment with ISO 17024 principles.

Minimum educational objectives and skills requirements are located in the Global Emergency Medical Registry (GEMR) Emergency First Aid Initial Emergency First Aid Certification for First Responder and Law Enforcement Personnel Curriculum and Lesson Plans Instructor manual (3/23/2026), located at www.gemr.org for free download.

Please note that the instructor manual also includes minimum required equipment for the EFA course.

Certification Requirements for GEMR EFA:

Participants must:

  1. Attend the full 16 instructional hours of an EFA course.
  2. Successfully complete the GEMR EFA online written examination with score 85% or better.
  3. Demonstrate competency in required practical skills and upload successful, signed, skills sheets to their GEMR profile under “transcripts”.
  4. Demonstrate attendance at an Emergency First Aid course, compliant to the GEMR Emergency First Aid standards outlined in this document, by uploading completion certificate to “transcripts”.

GEMR Certification is valid for two (2) years from the date of course completion, renewal certification requires completion of a refresher course and skills sheets.

Certification decisions are based on objective evidence of competence, including successful completion of training, validated skills assessments, and standardized examination processes in alignment with ISO 17024 principles.

Responsibilities of Registry Certified Personnel:

Certified personnel must notify the Registry within 30 days regarding the following matters:

  1. Change in mailing address (the best way to update a mailing address is by editing your account profile)
  2. Any criminal conviction.
  3. Disciplinary action taken by any agency having jurisdiction (or government body) that has resulted in suspension, revocation, or expiration of registration/licensure; termination of right to practice; voluntary surrender of registration/licensure while under investigation.

The Registry considers the individual to be solely responsible for their certification and reporting, any failure to follow process or report as required is solely the failure of the certified person and may result in immediate dismissal of their certification, as well as, immediate notification to any pertinent regulatory agency of their dismissal.

Disciplinary Policy and Rights of Appeal for The Registry can be found on The Registry website.

GEMR Required Skills Attestation for Initial Certification:

All initial Certification Candidates must upload the following skills sheet documentation forms (located at https://www.gemr.org/library/), signed by the medical director or Course Director, to their transcript page of their profile by creating a “Skills Documentation” course in their transcript and uploading all the following:

  1. Bleeding Control (BLS) Skill Documentation Form.
  2. Bleeding Control - Combat Application Tourniquet (BLS) Skill Documentation Form.
  3. CPR/AED (Adult) Emergency First Aid Skills Documentation Form.
  4. CPR/AED (Child) Emergency First Aid Skills Documentation Form.
  5. CPR/AED (Infant) Emergency First Aid Skills Documentation Form
  6. CPR/AED (Adult Ballistic Vest) Emergency First Aid Skills Documentation Form .
  7. Epinephrine Auto Injector Administration Emergency First Aid Skills Documentation Form.
  8. Naloxone Nasal Administration Emergency First Aid Skills Documentation Form.
  9. Oxygen Administration via Mask Emergency First Aid Skills Documentation Form.
  10. Integrated Scenarios Emergency First Aid Skills Documentation Form.

GEMR Written Examination:

At the conclusion of initial training, the candidate must complete their profile on gemr.org, upload all required documents.

The candidate will then receive an assignment to test for the GEMR EFA Online Testing System, the candidate must score a minimum of 85% to show compliance with the standard and successfully complete the examination process.

Emergency First Aid (EFA) - Renewal Certification:

The GEMR EFA Certification expires two years from the time of initial certification. During that two-year period, the certified individual must complete the following process to renew their certification.

  1. Complete an Emergency First Aid Refresher Course which must have followed the Global Emergency Medical Registry (GEMR) Emergency First Aid Refresher Emergency First Aid Course Curriculum and Lesson Plans Instructor Manual (to be issued 3/1/2027) to meet the GEMR certification requirements.
  2. Upload to the individual’s transcript page the following instructor signed and dated skills documentation forms:
    1. Bleeding Control (BLS) Skill Documentation Form.
    2. Bleeding Control - Combat Application Tourniquet (BLS) Skill Documentation Form.
    3. CPR/AED (Adult) Emergency First Aid Skills Documentation Form.
    4. CPR/AED (Child) Emergency First Aid Skills Documentation Form.
    5. CPR/AED (Infant) Emergency First Aid Skills Documentation Form
    6. CPR/AED (Adult Ballistic Vest) Emergency First Aid Skills Documentation Form .
    7. Epinephrine Auto Injector Administration Emergency First Aid Skills Documentation Form.
    8. Naloxone Nasal Administration Emergency First Aid Skills Documentation Form.
    9. Oxygen Administration via Mask Emergency First Aid Skills Documentation Form.
    10. Integrated Scenarios Emergency First Aid Skills Documentation Form.
  3. Complete renewal attestation on profile page and pay renewal fee.

GEMR Written Examination:

No written exam is required for renewal certification

Renewal Certification Completion:

Once all the above steps have been completed, and the candidate has been audited, the candidate will be able to complete their registration payment and receive their certification.

Reciprocity:

There is no reciprocity available for the GEMR Emergency First Aid certification.