UK Medical Response Training


The Defence Chemical Biological and Nuclear Centre (DCBRNC) based at Winterbourne Gunner in Wiltshire, designs and runs a total of eighteen courses that qualify individuals of all three branches of the UK armed services (Royal Navy, Army and Royal Air Force) for operational, training and for staff CBRN defence appointments.

The actual involvement of Winterbourne with chemical warfare dates from the formation of the Chemical Warfare School in 1926, and today there is a heavy emphasis placed on CBRN medical training. DCBRNC is home to the Joint CBRN medical faculty, a unit that acts as the centre of excellence for CBRN medical training for medical officers and others across all sections of the UK military. The centre also provides specialist medical training to other NATO members across all facets of CBRN.

The Joint CBRN medical faculty supports development of the medical response to a CBRN incident and the management of CBRN casualties. It is a cross-government group with the remit under the surgeon general to develop CBRN clinical guidance, medical training and research.

The one-week CBRN clinical course is the advanced level CBRN medical course for medical officers, nurses and senior medics and paramedics of the Defence Medical Services
especially those with a counterterrorism or CBRN role, and looks at medical support from point of exposure through to definitive hospital care at Role 3. On completion, candidates will be in date for CBRN clinical for 5 years while some units may require more frequent training periods. Intermediate/advanced life support or Battlefield Advanced Trauma Life Support (BATLS) training is desirable although not essential.

As well as military training, DCBRNC also supports civilian response in partnership with the Health Protection Agency and Department of Health and is the home of the National Ambulance Resilience Unit (NARU) Training & Education Centre. Working in partnership with NHS Ambulance Services, NARU’s aim is to ensure the effective and efficient coordination of the implementation of government policies related to national resilience, to enhance pre-hospital clinical response capabilities that are evidence-based, to current and emerging threats and risks. Thereby delivering fit for purpose patient outcomes to disruptive challenges or threats to public health.

Through central coordination, NARU enables NHS Ambulance Trusts to work together to provide a safe and reliable response to major, complex and potentially protracted incidents at High Visibility Events (HVE). Consistency in implementation of core deliverables is essential if ambulance trusts across the country are to remain prepared and resilient to deliver an effective national response capability at all times.

The operational response to a CBRN, terrorism event or Major Incident is recognised as being extremely complex and challenging; and is likely to require a mutual aid response in order to assist the Trust managing the incident.

NARU’s 4-day Command/Resilience course provides a common standard of training and education aligned to the Ambulance Commanders National Occupational Standards (NOS) as well as the Joint Emergency Services Interoperability Programme (JESIP) Joint Doctrine and includes the clinical aspects of CBRN.

CBRN based medical training uses blended learning techniques including interactive presentations, tabletop exercises, collective training and simulation. Very highly invested, the medical training area which is used for pre-hospital training exercises along with high-fidelity hospital training using the SimMan3G Trauma simulator which is designed to train emergency medical personnel and military in trauma and hemorrhage control, is dedicated to CBRN medical management. The training faculty was awarded the 2011 Military Civilian Health Partnership Award for Education and Training.

Medical courses including clinical courses, defence medic CBRN course, casualty
decontamination area course and enhanced CBRN First Aid are open to partner nations as well. The 3-day Emergency Medical Treatment course is developed to provide military doctors with an awareness of the effects of CBRN agents and teach the competencies to provide Role 1 (pre-hospital) CBRN casualty management.

The CBRN Clinical course is designed to train Roles 1, 2 (hospital) and 3 (medical, nursing and allied health) professionals in the recognition and treatment of all casualties in a CBRN environment. This course supports the military competencies for Emergency Medicine, Acute Medicine, Intensive Care and specialist nurse training.

The Defence Medic CBRN course is designed to train pre-hospital Role 1 medics in the recognition and treatment of all casualties in a CBRN environment. This course supports includes advanced first aid in the hot zone, emergency medical treatment and casualty decontamination.

When fully deployed, CBRN Medical Support capability is designed to detect, provide information, physical protection and medical based countermeasures together with full casualty care and wider hazard management. It is also possible for DCBRNC to provide bespoke training to military and civilian organisations on an availability basis.

Caption: An instructor at the Defence NBC Centre operates a Manportable Chemical Agent Detector. (MOD)

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A defence photo-journalist for more than 30 years, and member of the Independent Defence Media Association (IDMA) and the European Security and Defence Press Association (ESDPA). David is the author of 18 defence-related books, and is former IHS Jane’s consultant editor and a regular correspondent for defence publications in the UK, USA, France, Poland, Brazil and Thailand.