The pace of life on the Close Protection circuit is ever increasing, as are the demands placed on CPOs, who always need to remain one step ahead of their clients to ensure even the shortest operation runs smoothly.
CPOs meet these demands and those of increasing competition for employment by developing themselves. We attend seminars, Continuing Professional Development (CPD) updates and courses to gain new skills and refresh old ones. The essential and desired skills of the modern CPO might include; close quarter combat (CQC), enhanced driving skills, surveillance, languages, security management, adult education tutor courses and even child care.
But where does first aid feature? Why do we need it? And to what level? Is First Aid at Work sufficient for UK employment? How about hostile and remote environments? This article considers first aid for CPOs, as opposed to CP for health care professionals.
Why First Aid?
CPOs are thinkers, planners, and problems solvers and are generally expected to pull rabbits from hats at short notice and we regularly do. We are employed to ensure not only the safety and security of the client but also their health and well being, to allow them to conduct their lives and business as normally as possible. Having a sound knowledge of basic first aid and the confidence to employ it, enables CPOs to intervene and assist in the following circumstances;
- Medical incident (Ongoing illness)
- Trauma incident (Traffic accident)
- Major incident (Terrorist attack)
- Medical emergency (Heart attack/drowning/ choking)
- Minor injuries (Blisters, strains, cuts, stings)
The ability to preserve the life, prevent a condition becoming worse and promote recovery, is worth its weight in gold, whether these skills are administered to the client, their spouse, children, friends or business partners. Many people pay lip service to basic first aid but if you travel enough with a client, whether it be in London, Athens or Baghdad, sooner or later you may need to treat; concussion, blisters, angina attacks, episodes of hypoglycaemia, jellyfish stings, heat injuries, cuts and scrapes, fractured ribs, sunburn and occasionally major trauma from traffic accidents or gunshot wounds.
Individual First Aid Training
The current baseline qualifications for CPOs to obtain a UK Security Industry Authority (SIA) license to practice are the Health and Safety Executive First Aid at Work course or the Edexcel First Person on the Scene (FPOS) Intermediate Award. Both are excellent courses, covering; basic scene safety, the aims of first aid, the primary and secondary surveys, common injuries and illnesses and how to recognize and treat them. The content of these courses has been open to discussion for some time and remains a hot topic. Are they sufficient for our role? In a word, yes. Both courses cover the general medical emergencies which CPOs are likely to come across, irrespective of their theatre of operations. Whilst the basic syllabus is generic, each course should be tailored and delivered at the appropriate level and for the right workplace.
The courses are primarily for the UK, where an ambulance should be on the scene within 10 minutes. That’s not to say that it is not an effective level of training for hostile environments, after all, the best treatment for a casualty who has received a serious penetrating injury (gunshot or blast wound) is to stop major bleeding, manage the airway, prevent hypothermia and call for help, all of which are covered on the basic courses. The key is that the courses must be delivered effectively and ideally by a trainer who knows the industry and the nature of the injuries and illnesses that may be encountered. The trainer can afford more emphasis on heat illness for teams heading to the Middle East or hypothermia and hypoglycemia for teams supporting clients who enjoy mountain pursuits in the UK.
Although the basic courses are adequate, they are exactly that, the basic benchmark. The questions many CPOs ask post qualification are; ‘where do I go next? What courses are available? What additional training do I really need and is it accredited?’
Often the decision to take up further training will be based on cost and duration. But which course? First, ask the questions, what do I hope to achieve? And, am I ready to progress? (I.e. if you can’t remember the difference between adult and baby CPR or the signs and symptoms of hypoglycemia and hyperglycemia, then perhaps a refresher course is required before attending an advancement course). If your client has a known heart condition, then perhaps opt for an Automated External Defibrillator (AED) course. Deploying to Iraq, then perhaps consider a Basic Trauma Life Support (BTLS) course or even a short oxygen administration module. CPOs looking after the boss’s children or employed in an RST role, where they have regular exposure to them, may opt for a paediatric emergency first aid course or a Pre-hospital Paediatric Life Support (PHPLS) course. Adding modules one at a time is a great way to develop your CV and achieve your aim, without overwhelming yourself with extra knowledge, most of which will be forgotten if not consolidated.
Remote & Hostile Environments
If you intend to work outside of the comfort zone, where ambulances aren’t available and medical evacuation cannot be guaranteed, CPOs may consider attending a commercial tactical medical, EMT or remote area course. Neither of these will make you an overnight medic but a good in-depth course should include and discuss; anatomy and physiology, the critical issues concerning the Tactical Combat Casualty Care protocols (TCCC), patient assessment, airway management, vital signs monitoring, medical gases, spinal management, and caring for a casualty inside and outside of the platinum 10 minutes. CPOs should choose a course based on its content, the quality of training aids, the opportunity to get ‘hands-on’ to consolidate core skills and the background of the trainers, as opposed to the title or duration.
In an ideal world we all work in harmony, train the same, think the same and react the same. This ensures the whole industry works in unison, making it a safer, more professional environment. The basic courses are designed to aid this, following set objectives. The system works beyond that with paediatric first aid and AED protocols but the gap widens and ideas vary when in the mid-range courses, with agencies operating under differing national and local protocols, whether it be the military, health care trusts or individual company policy.
For the CPO, this can be daunting when seeking enhanced knowledge, only to receive contradictory views and regulations. Don’t fight this. The medical world develops and lives are saved through research and trial new ideas. However, it can be frustrating to attend an incident as a first aider, when a passing doctor and nurse turn up, followed by the fire and rescue crews and an ambulance and everyone has different (not necessarily wrong) ideas about what and how things should be done.
The US National Association of Emergency Medical Technicians (NAEMT) Pre-hospital Trauma Life Support (PHTLS) provider course is recognised in over 30 countries and was designed to alleviate the problem. The course introduces a common protocol for all pre-hospital eventualities, from scene safety to patient handling, airway management, and fluid resuscitation. Again, the course is not an overnight paramedic ticket but merely streamlines the process within the individuals’ level of training, so that everyone is talking the same language at the side of the road. After all, our goal remains the same, to preserve life.
Consolidation of Skills
First aid needs to be instinctive in order to recognize and treat problems safely and promptly. Attending a basic course is sufficient but should be backed up by continuous refresher training, ideally annually but at least every 3 years. Many individual CPOs and larger teams conduct frequent refresher training to prevent skill fade setting in. Intermediate skills and interventions will only become natural and therefore safe, if they have been practised for real, under the supervision of a qualified professional. Consolidating clinical skills so the CPO can be classed as current and competent is extremely difficult to achieve unless working for the NHS, the military or a voluntary organisation, such as St John Ambulance.
Options to consolidate skills and build up a sound portfolio of evidence may include; joining the Territorial Army (Royal Army Medical Corps), volunteering with St John Ambulance or the Red Cross, or post training, try to get an attachment to a military field hospital. You are unlikely to gain work experience with an NHS trust hospital unless you are a qualified Ambulance Technician or are registered with the Health Professions Council (HPC). In the current climate, many organisations would appreciate an extra pair of hands and any voluntary work and development would certainly enhance your CV and employment opportunities, let alone the clients’ perception of your attitude and ability to care for them and their family.
FIRST AID FOR CLOSE PROTECTION
By: Chris Gibson MASI