The following list identifies the types of incident for which a HART response may be deployed. These incidents may not reach major incident status but could require specific skills sets and PPE.
• Major incident response
• Decontamination team
• Major incident logistics
• Casualty clearing area operation
• Setting up a field hospital
• Ambulance service response to an active shooter incident
• Large scale incidents involving firearms and explosives
• HART are the first strike with operational AITs supporting (similar to SORT)
MERIT doctors are on call 24/7 to provide advanced medical care on scene at a range of emergency incidents, up to and including major and mass casualty incidents. This may include provision of advanced airway procedures, surgical interventions, and critical care over and above current levels of ambulance practice.
A major aspect of their role is to take the medical lead at some scenes or to provide appropriate advice via the EOCs.
The following incidents are examples of when a MERIT doctor may be called to provide assistance:
• Trapped casualty with life or limb threatening injuries with a prolonged release time (estimated >60 minutes)
• Significant multi-casualty incidents where scene assistance is required, for instance to support advanced triage decisions.
In the event of a major incident they would provide direct support to the Ambulance Service operational and tactical commanders in the form of forward medical advisor (bronze) and medical advisor (silver).
The NCMCV are part of the National Capabilities Programme. Each vehicle contains enough medical equipment to provide emergency treatment for 100 casualties (either P1 or P2) and 250 P3.
The ISUs are designed to transport specialist major incident or decontamination equipment to the scene of an incident. There are two types of ISU which are major incident and decontamination.
The PSU is designed to transport first aid equipment to the screen of a mass casualty incident. The intention is for basic first aid equipment to be transported to scene to be available for use by the public and qualified first aiders in the initial stages of an incident
It is not reasonable to leave possibly contaminated members of the public with no medical care while waiting for a specialist response. JESIP, in conjunction with NARU have established a set of response principles that work equally well in CBRNe or HAZMAT incidents.
IOR starts from the very first emergency call and includes the roles of EOC and first responders saving life by rapid response, evacuation, disrobing, decontamination and provision of advice.
Continuous communication with multi-agency colleagues at the scene and with the control room is essential, as is communicating with casualties providing advice and reassurance.