Austere First Responder (AFR)

Course Overview
Target Audience
Course Objectives

The authoritative austere medicine course for lay responders working in remote industries and those who operate in low-resource, remote and other austere environments where definitive care may be severely delayed or inaccessible.

Faculty: Austere Medicine
Course Name: Austere First Responder
Course Code:  AFR
80 Hours
Mode: Face-to-face or Hybrid
Level: BLS with extended scope austere protocols

Prerequisites: Participants must be at least 16 years of age. Minors must have parental consent.

Packaging: The course may be delivered over 8 or more full-time days. A hybrid course may be delivered over 5 full-time days in combination with the pre-work available in the learning management system. Part-time courses must be approved by the Curriculum Director.

Instructional Strategies:
This course combines lecture-based instruction with practical application. Instructional strategies include pre-reading, lectures, discussions, demonstrations, practical application, simulation, and presentations.

Effort Breakdown: 16 prep hours, 24 lecture hours, 24 practical hours, 12 simulation hours, 4 assessment hours

Certification: Upon successful completion of the course, participants receive an internationally recognised certification from Austere & Emergency Medicine International in Austere First Response (AFR), valid for three years. Re-certification can be achieved by attending a refresher course, or by completing a portfolio of ongoing learning and taking the re-certification exam.


  1. Introduction to the Austere Environment
  2. Anatomy & Physiology of Critical Systems
  3. Medicolegal Considerations
  4. Introduction to Medical Ethics
  5. Working with Diverse Cultures & Traditional Peoples
  6. Working with the SOGIESC Diverse Patient
  7. Communication in Complex & Emergency Situations
  8. Introduction to Medical Record Keeping
  9. Patient Assessment
  10. Infection Prevention & PPE
  11. Austere Basic Life Support
  12. Oxygen Administration
  13. Critical Issues with Critical Systems
  14. Spine Injury Assessment (NEXUS)
  15. Management of Anaphylaxis
  16. Cardiovascular & Cerebrovacular Emergencies
  17. General Trauma Management
  18. Environmental Medicine
  19. General Austere Medicine
  20. Intake Mediated Illness
  21. Introduction to Pharmacology
  22. Pain & Anxiety Management
  23. OB, GYN, and Neonatal Emergencies
  24. Advanced Trauma Management
  25. Emotional Distress, Acute Trauma, & Other Mental Health Concerns
  26. Acute Behavioural Disturbance
  27. Basic Rescue & Evacuation
  28. Mass Casualty Incident & Disaster Management
  29. Austere Protocols 1-7


  1. Altitude & Avalanche
  2. Landslide
  3. Appropriate Medical & Rescue Equipment
  4. Explosion, Gunshot, and Stab Injuries
  5. Introduction to Search & Rescue
  6. Advanced & Surgical Airways
  7. Advanced Management of Chest Trauma

The Course Outline may change as determined by the curriculum committee from time to time.

The Austere First Responder course is designed for a diverse range of individuals who operate in challenging and resource-limited environments, extending beyond wilderness settings. The target audience for an Austere First Responder course is the designated medic or intentional rescuer, which may include:

  1. Remote Professionals: Individuals working in isolated or austere environments, such as geologists, miners, and energy industry workers, where access to immediate medical care is limited.

  2. NGOs Involved in Relief Work and Humanitarian Crisis: Aid workers and humanitarian relief personnel who operate in disaster-stricken or conflict-ridden areas where standard medical infrastructure may be compromised.

  3. Refugee Workers: Those involved in providing assistance and support to displaced populations, including refugee camp staff and humanitarian workers in areas with limited access to medical facilities.

  4. Environmental Researchers: Scientists and researchers conducting fieldwork in remote or challenging ecosystems, where conventional medical resources may be scarce.

  5. Offshore Workers: Individuals working on offshore platforms, vessels, or remote maritime locations where medical assistance may be delayed due to the isolated nature of the work environment.

  6. Adventure and Outdoor Guides: Similar to WFR, individuals leading outdoor expeditions, adventure tours, or activities in austere settings.

  7. Search and Rescue Personnel: Those engaged in search and rescue operations in challenging terrain, including mountainous, desert, or maritime environments.

  8. Emergency Responders in Austere Environments: Professionals dealing with emergencies in areas with limited infrastructure, such as post-natural disaster scenarios.

  9. Military Personnel: Soldiers and military personnel operating in austere environments where immediate medical support may be critical.

  10. Any Individual Operating in Resource-Limited Settings: This includes professionals from various fields who may find themselves working in locations where access to standard medical care is constrained.

The Austere First Responder course aims to equip participants with the skills and knowledge needed to manage medical emergencies in austere environments, where improvisation, adaptability, and resourcefulness are essential for providing effective first aid and emergency care.

On successful completion of the course, participants should be able to:

  1. Understand the Austere Environment: Develop an advanced understanding of the unique challenges and considerations associated with providing comprehensive medical care in austere environments.

  2. Anatomy & Physiology of Critical Systems: Acquire in-depth knowledge of the anatomy and physiology of the circulatory, respiratory, and nervous systems, focusing on their relevance to first aid management in austere settings.

  3. Medicolegal Considerations: Understand and apply concepts of legal considerations pertinent to medical interventions in austere environments.

  4. Introduction to Medical Ethics: Familiarize yourself with and apply ethical principles in the practice of medicine in austere settings, considering diverse cultural contexts.

  5. Working with Diverse Cultures & Traditional Peoples: Develop skills in culturally sensitive medical care, adapting approaches when working with diverse cultures and traditional communities.

  6. Working with the SOGIESC Diverse Patient: Demonstrate proficiency in providing medical care that is sensitive to the needs of patients with diverse sexual orientations, gender identities, expressions, and sex characteristics (SOGIESC).

  7. Communication in Complex & Emergency Situations: Demonstrate sound communication skills for complex and emergency medical situations, considering diverse patient needs and cultural contexts.

  8. Introduction to Medical Record Keeping: Apply standard techniques for maintaining accurate and comprehensive medical records, addressing challenges specific to austere medical contexts.

  9. Patient Assessment: Demonstrate proficiency in patient assessment, prioritizing critical medical conditions in diverse and complex austere environments.

  10. Infection Prevention & PPE: Exhibit proficiency in implementing infection prevention measures and utilizing personal protective equipment (PPE) effectively in austere medical scenarios.

  11. Austere Basic Life Support: Demonstrate thorough proficiency in BLS techniques, including chest compressions, rescue breaths, and airway management, tailored for diverse and complex austere environments.

  12. Oxygen Administration: Master the administration of oxygen in austere settings, with a focus on critical respiratory emergencies.

  13. Critical Issues with Critical Systems: Address advanced issues related to key physiological systems, focusing on their management in diverse and complex austere medical conditions.

  14. Spine Injury Assessment (NEXUS): Develop skills in assessing and managing spine injuries, incorporating NEXUS criteria for enhanced decision-making.

  15. Management of Anaphylaxis: Demonstrate skills in recognizing and managing anaphylactic reactions in diverse and complex austere settings, implementing nuanced medical interventions.

  16. Cardiovascular & Cerebrovascular Emergencies: Acquire knowledge and skills for managing complex cardiovascular and cerebrovascular emergencies in diverse and complex austere environments.

  17. General Trauma Management: Demonstrate proficiency in assessing and managing a broad range of traumatic injuries commonly encountered in diverse and complex austere environments.

  18. Environmental Medicine: Develop skills in identifying and managing medical issues related to environmental factors in diverse and complex austere locations.

  19. General Austere Medicine: Gain knowledge of general medical presentations and interventions relevant to complex austere settings.

  20. Intake Mediated Illness: Develop skills in recognizing and managing illnesses influenced by specific intake patterns, considering the diverse dietary habits in austere environments.

  21. Introduction to Pharmacology: Acquire knowledge of pharmacological principles relevant to diverse and complex austere medical care.

  22. Pain & Anxiety Management: Demonstrate advanced proficiency in managing pain and anxiety in diverse and complex austere medical scenarios, considering cultural and individual variations.

  23. OB, GYN, and Neonatal Emergencies: Develop skills in managing obstetric, gynecological, and neonatal emergencies in diverse and complex austere settings.

  24. Advanced Trauma Management: Exhibit proficiency in assessing and managing complex traumatic injuries, incorporating advanced management techniques suitable for diverse austere environments.

  25. Emotional Distress, Acute Trauma, & Other Mental Health Concerns: Develop skills in recognizing and managing emotional distress, acute trauma, and other mental health concerns in diverse and complex austere environments.

  26. Acute Behavioural Disturbance: Demonstrate proficiency in managing acute behavioral disturbances, considering diverse cultural and individual factors.

  27. Basic Rescue & Evacuation: Exhibit skills in basic rescue techniques and evacuation strategies suitable for diverse and complex austere environments.

  28. Mass Casualty Incident & Disaster Management: Master standard techniques for managing mass casualty incidents and disasters, including the coordination of resources and personnel in diverse and complex austere settings.

  29. Austere Protocols 1-7: Apply knowledge and skills in implementing the first seven austere protocols, emphasizing their practical application in diverse and complex medical scenarios.


  1. Attendance Requirement: 100% attendance is mandatory to pass the course. Reasonable adjustments will be made where practicable.

  2. Physical Fitness Requirement: A certain level of fitness and strength is necessary to fulfill the duties of a first responder in emergency situations. Failure based on physical criteria is not discriminatory but practical for the role's demands.

  3. Written Exam: The written exam consists of 50 multiple-choice questions. A pass mark of 80% is required to successfully complete the written component.

  4. Practical Assessments: Formative and summative practical assessments are conducted throughout the course. Summative assessments include simulations and mini-codes. Competent performance of all skills is essential to pass.

  5. Exam and Class Outcome: It is possible to pass the written exam and fail the class if practical competency is not achieved.

    Conversely, it is possible to fail the written exam and pass the class if exceptional practical performance is demonstrated, and adequate knowledge of the curriculum can be demonstrated through other assessment activities.

  6. Re-exam Opportunity: If a participant fails the written exam, a verbal re-exam will be provided to offer an opportunity to showcase their knowledge.

  7. Special Accommodations: Participants with language difficulties or divergent learning needs can request a verbal or alternative style of exam. Reasonable accommodations will be made to facilitate a fair assessment process.

Note: The assessment criteria aim to ensure a comprehensive evaluation of both theoretical and practical competencies, promoting a well-rounded and capable austere advanced first responder.

Preview Video

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