Making the Right Choice
Instinctive.. shooting, unarmed defensive tactics, evasive driving.. whatever. In a sudden and urgent situation there may be no time to stop and ponder what needs to be done, no time to think through conflict management models. Action must be simple, effective and above all, instinctive.
I spent fifteen years in the police as a close protection officer and instructor. We spent a lot of time on instinctive shooting and all the various tactics that can be brought to bear to keep the Principal safe. The ability to deal with a sudden and potentially fatal injury, to deliver ‘care under fire’ to a colleague or Principal was something that came second and, across the UK, varied hugely from force to force. Often it was little more than bundling the Principal into a vehicle and stamping on the accelerator. The recently introduced National Police Firearms Training Curriculum has significantly sorted that out with compulsory levels of training for all firearms officers, but the question of where to get the training from, largely remains.
It was often difficult to obtain good and effective medical training from clinically current, competent and experienced instructors who really knew what they were talking about and who had an understanding of the environment that we worked in.
In my force we hooked up with the lead consultant clinician of a main Accident and Emergency Unit, who also trained and worked with a major mountain rescue team. She knew her business, was at the top of her profession and also understood the need to be able to do things quickly and effectively and get out of the situation fast.
In the world of close protection, a location can go from benign to hostile in a second. The friendly waving crowd can become an angry mob. The nice man offering a handshake is actually holding a weapon. Injuries can be sustained and there may be no chance of being able to deal with them on the spot. The mission continues, the urgency and the stakes get higher. Now is the time for good medical training to kick in.
Good CP operatives will, of course, take great pride in their ability in core skills needed for the job and a good employer will know what to look for in the people it hires. The skills must include good first aid.
When choosing where to go for training, consideration should be given to what is to be taught and how it is taught. There are many training providers out there, and a few have gained a well-deserved reputation on the circuit for delivering good first aid that is aimed at the CP operative and the threats they face. It is a world away from the standard ‘first aid at work’ training that is fine for office workers in a town in a first-world country.
Good training will focus on ‘basic things done well will save lives’. Techniques should be easy to learn, easy to remember and easy to do in the heat of the moment and, in the grim reality of remote situations where there is no ambulance going to turn up in eight minutes, they should be proven to work.
Keeping it simple and easy to remember means using the protocol of cABCDE; dealing with the things that kill a casualty quickest, first;
c – catastrophic bleeding
A – airway
B – breathing
C – circulation
D – disability/ head injury
E – exposure and environment
In order to satisfy the requirements of accrediting bodies, such as the Health and Safety Executive and the Institute of Health and Care Development, there has to be a certain amount of classroom learning and written knowledge assessments. Also there will be the need to include some subjects that may not appear to be particularly relevant to the CP operative.
However, a good course will involve a lot of hands on, practical learning, developing muscle memory, habit and a consistent approach that will achieve the best results for the casualty quickly.
A good first aider will be able to be effective either on their own, or as part of a team. Training should develop both.
So, what should a good training course have? There a number of key elements that the best providers deliver;
• Clinically experienced and current instructors, with a thorough knowledge of their subject. The higher they are qualified e.g. paramedic or even doctor, the better.
• A practical course, developed with the benefit of operational medical experience and expertise.
• A good student to instructor ratio.
• A course that teaches simple and effective techniques that can be taught, remembered and used.
• Provision of simple and effective equipment that operatives can learn to use and that can be readily sourced
• Accreditation by the right governing bodies to gain the certification needed by employers (and/or, in the UK, the SIA).
Above all, the training should mean that for the operative, delivering immediate medical care in a hostile environment, it all comes together when it’s needed… Instinctive.
Glyn Collins is Prometheus’ Training Co-ordinator for all of their medical training, including the VIPER and STORM courses. Tel: +44 (0) 1568 613942 www.prometheusmed.com