“A view from inside the suit”.

The Hazardous Area Response Team A unit within the ambulance service providing: skills, training and equipment for incidents involving hazardous materials clinical interventions in hazardous environments response to conventional incidents - support Command and Control - triage and clinical interventions - early logistical support for mass casualties At present there is only one HART Incident Response Team and one USAR Team in England. It is the intention of the DH to roll the full package out to four ambulance trusts next financial year – based in London, Leeds, Manchester and Birmingham Important to note that it is not a specialised team, but more a team with extended training. Of all the core competencies for HART by far the most important is an ability to deliver solid ambulance aid and paramedical skills potentially under difficult and very stressful conditions.

The Hazardous Area Response Team Triggers: Serious/Major Incident Fire / Explosion/Improvised explosive devices Intelligence led Major Pre-planned events Site specific CBRN/HAZMAT including STEP 123 Transportation incidents Serious major or catastrophic incident Fire in excess of 8 pump attendance from the fire brigade, any confirmed explosion and/or improvised explosive devices Any intelligence led operation where the attendance of the team could benefit the operation i.e. raids on meth amphetamine labs Pre planned events where the risk assessment would indicate a higher than normal level of risk to public, emergency responders and protected principles Site specific i.e. Control of Major Accident Hazard sites Cbrn/hazmat incidents including STEP 123 (safety triggers for emergency personnel) Transportation incidents – the most common in London being trains stuck in a tunnel In excess of 5,500 activations for all vehicles since go live in December 2006 30 – 533, 31 – 603, 32 - 304, 55 – 2147, 56 - 2010

London Ambulance Service HART Vehicles Command & Control forward command vehicle for HART; extensive range of technologies: high-speed satellite internet link Helmet-mounted cameras Roof mounted camera with thermal-imaging On-line access to data and scientific support Briefing area Weather station December 9, 2018 London Ambulance Service

London Ambulance Service HART Vehicles Light Equipment Vehicle Extended Duration Breathing Apparatus Gas Tight Chemical protection Suits NHS PRPS PPE Personal issue Civil Responder Mark 1 PPE Conventional and CBRN Multi Casualty treatment packs Mass-oxygen delivery system Limited Detection, Identification and Monitoring capability DIM – RAMGENE for radiation monitoring, ZWELLEGER IMPACT PRO for Oxygen levels, carbon monoxide, Hydrogen sulphide and lower explosive level – methane, PAC 3000 for oxygen level monitoring, ELECTRONIC PERSONAL DOSIMETERS December 9, 2018 London Ambulance Service

London Ambulance Service HART Vehicles Heavy Equipment Vehicle: Additional supplies of consumables Additional conventional and CBRN treatment packs An additional mass-oxygen delivery systems PPE resilience First Response Units adapted to carry EDBA ,GTCPS and CR1 in addition to standard FRU equipment Cat A calls December 9, 2018 London Ambulance Service

The Training EDBA and GTCPS 2 weeks Civil Responder mark 1 2 days HART course 3 weeks venue PT Scenario based training Relevant Theory The pilot course used in London late last year has been in the main accepted by the National Training group as the national standard

The challenges Physiological stresses Dexterity Mobility The senses Fear and anxiety Comfort Senses taste, smell if that happens we are in trouble touch, hearing, sight, all restricted by the PPE to a greater of lesser degreee

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