Level 4 · 180 hours total
First Response Emergency Care (FREC 4)
The next step for experienced responders: deeper clinical assessment, physiological observations and decision-making for more complex emergency and urgent care.
Qualsafe Level 4 Certificate in First Response Emergency Care (RQF)
At a glance
The essentials.
Level 4
180 hours
39 hours minimum, plus directed study
Qualsafe Awards
Ongoing CPD and refresher training
603/2759/5
Who it is for
Is this the right course?
FREC 4 is for people already working in pre-hospital care who want a more advanced level of clinical assessment and emergency care. It is a substantially larger qualification than FREC 3, not simply another five-day course.
Qualsafe designed it for roles such as emergency care assistant, intermediate ambulance practitioner, event medical provider, associate practitioner and healthcare assistant, along with specialist medical roles in the military, police and fire services.
Before you book
- You must be 18 or over on the first day of training
- You must hold a valid Qualsafe FREC 3, or a Qualsafe-recognised equivalent
- You must provide a CPD profile evidencing 118 hours of study or contextualised practice before starting
- Qualsafe recommends Level 2 literacy or equivalent
The 118-hour requirement matters: you cannot finish FREC 3 one week and begin FREC 4 the next without that evidenced learning and practice behind you. Talk to us early and we will help you plan it.
What it covers
On the course.
Three components: patient assessment and management, emergency trauma care, and focused emergency and urgent care.
- Structured patient assessment and triage
- Physiological observations: blood pressure, temperature, pupils, blood glucose, peak flow and SpO2
- Cardiovascular anatomy, physiology and cardiac conduction
- Coronary artery disease, arrhythmias and heart failure
- 3-lead and 12-lead ECG acquisition and monitoring
- Airway management including supraglottic airway devices, oxygen and ventilation
- Respiratory emergencies and sepsis
- Major trauma, thoracic injury, fracture and spinal immobilisation, extrication
- Paediatric assessment and illness
- Maternity and childbirth
- Mental health emergencies and major incidents
- Assisting higher-level clinicians with interventions
An important distinction
Learning to assist a clinician with an intervention does not by itself authorise you to carry out that intervention independently. What you may do in practice remains governed by your employer’s clinical governance, your assessed competence and the law.
The time commitment
180 hours in total: at least 39 guided learning hours, plus around 141 hours of directed study, workbooks and contextualised practice. Qualsafe’s recommended programme runs roughly 20 hours of pre-course study, two days in the classroom, around 40 hours of study, two further classroom days, then around 81 hours of study and revision before a final classroom day. An intensive five-day model is possible, but the independent study and assignments still have to be completed.
How you are assessed
- Two practical assessments
- Three skills tests
- Three learner workbooks and assignments
- Two invigilated examinations
All components must be completed successfully to achieve the qualification.
Pricing
Costs and dates.
Coming soon. Course fees and scheduled dates are being finalised. We deliver at your premises or at a venue we arrange — tell us your numbers and preferred dates and we will come back with options and a price.
Where it leads
Staying qualified.
FREC 4 is not a certificate you earn and then leave alone. It stays valid while you maintain a CPD portfolio and attend refresher training covering cardiorespiratory arrest and life-threatening illness and injury. Qualsafe recommends annual Immediate Life Support training, and refresher training may include an ILS qualification.
The qualification supports progression into higher-level pre-hospital and ambulance care, and is particularly relevant if you are building a career in private ambulance services, event medicine or emergency care support roles. If you are not yet at this level, start with FREC 3.
If your role involves giving lifesaving medicines, the next step is SALM, the Safe Administration of Lifesaving Medication, coming soon.