1. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust HART IMPROVING PATIENT OUTCOMES ADDING VALUE EVERY DAY.

2. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Department of Health Emergency Preparedness Division lead project Drivers Civil Contingencies Act 2004 National Risk Assessment Model Response Programme CONTEST strategy. HART origins

3. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Development of HART Feasibility study 2004/5 Hot Zone Project Paper submitted May 2005 London Bombings July 2005 Ministerial Approval August 2005.

4. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Where are we?

5. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust England 15 Operational teams 2 Teams in Scotland and 1 in Ireland Team in Wales, Live July 2012

6. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust HART in Wales.

7. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust The reason for HART in WALES To provide advanced clinical interventions within the inner cordon by treating casualties where they fall.

8. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Definition of HART in Wales A capable multi skilled medical response adding a further dimension to Welsh Ambulance core business Facilitating Patient care and extrication in hazardous environments A multi agency approach to emergency incidents.

9. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Where are we at the moment ?  Live since July 1 st 2012  Supporting Cwm Taf and ABM with FRUs

10. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Structure Specialist Operations ManagerHART Training Manager TL Team of 5 Head of Operations - Resilience SORT

11. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Who do we work with? NHS Ambulance Trusts Fire and Rescue Services DIM Teams Police Services Health Protection Agency Local Authorities Military Mountain/Mines/Cave Rescue Teams.

12. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Areas covered 1.WAST – Cardiff (45 mins Home office Model Response) 2.WAST all region  South East  Central & west  North (NWAS Mutual aid) 3. National mutual aid response  GWAS  WMAS  SWAS.

13. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Training 1 week PRPS Training – In house  Including 3 days SR3 Training 2 weeks EDBA Training – South Wales Fire and Rescue service 3 weeks IRU Training – Winterbourne Gunner CBRN defence centre 3 weeks USAR Training - National FRS training College 1 Weeks USAR awareness – SWFRS USAR 5 Days Inland Water operations Swift Water Rescue Training 1 week 4 x 4 & WINCH Training Developing capabilities On going Inter-Agency Training.

14. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust National Multi agency Fire and police fully integrated into the project-ACPO/CFOA Common operational standards Sharing best practice & equipment Joint training.

15. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust IRU – CBRNe, HAZMAT & Command Training

16. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust IRU – CBRNe, HAZMAT & Command

17. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust USAR – SWAH Confined space & Unstable terrain

18. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust USAR – SWAH Confined Space & Unstable Terrain

19. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Inland water operations (IWO)

20. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Vehicles

21. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust National Vehicle issueVehicle Type - Wales HART Communications VehicleAlternative vehicle with up to date developments more suited to Welsh environment and needs Forward Reconnaissance Vehicle Heavy Equipment Mass Casualty VehicleWAST to use SORT mass casualty vehicles already part of WAST fleet USAR Discovery 4 response vehicles Crew CarrierVehicle specialy adapted to meet the Welsh need ‘All Terrain Vehicle’ (later addition to the project) Polaris dual patient ATV plus Transporter Vehicle

22. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust HART Equipment.

23. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust  Mass casualty/ CBRN cubes  Bulk Dressing’s  Mass Triage  Nerve agent antidotes  PRPS & Gas Tight Suits  EDBA – 10 Sets  Defensive DIM – Zellweger – O2, CO2,H2S, Methane etc – Ram Gene – Radiation Detectors – Electronic Personal Dosimeters  SR3  Bulk Oxygen

24. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Mass Oxygen delivery 48 Patients 8 Litres/Min 4 Patients 15 Litres/Min 150 metre distance.

25. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Staffing  Numbers  Skill sets  Grades  Training.

26. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Staffing Models Considered Skill mix per team Numbers trained in USAR Interoperability with other HART teams in the UK.

27. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Benefits of HART.

28. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust The Benefits Provides a HART IRU and USAR capability that didn’t exist in WAST Brings additional skills and equipment to day to day incidents Multi agency response.

29. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust The Benefits Cont…. Promote early release of domestic crews from incidents. Future development of specialist ambulance roles i.e. Illicit drugs labs, chemical suicides. Enhancing developments already undertaken in Wales with WG support regarding SORT and Mass Casualty arrangements.

30. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Decon Shower Decon Shower InnerCordonInnerCordon WIND Triage In CPPE Casualties Triage Sieve & Sort A&E Loading Point Outer CordonOuter Cordon DECONTAMINATION & EVACUATION - 2011 WARM ZONE SORT staff COLD ZONE Normal Emergency Responders Do Not Cross the Inner Cordon into the Warm Zone under any circumstances Casualty Clearing SELF PRESENTERS HOTHOT Fire Service

31. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Decon Shower Decon Shower InnerCordonInnerCordon WIND Secondary Triage In CPPE Casualties Triage Sieve & Sort A&E Loading Point Outer CordonOuter Cordon DECONTAMINATION & EVACUATION - 2012 WARM ZONE SORT staff COLD ZONE Normal Emergency Responders Do Not Cross the Inner Cordon into the Warm Zone under any circumstances Casualty Clearing SELF PRESENTERS HOTHOT HART Fire Service Initial Triage In CPPE

32. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust National HART activity HART responds to varied incidents, and each team can expect to deal with on average, per year: 500 HART incidents per trust 10,000 life-threatening calls per trust Terrorism, currently between 2 - 5%.

33. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Emerging risks Flooding Pandemic Flu CBRNE Terrorism Marauding firearm events Lone gunmen What we don’t know, we don’t know.

34. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust In Summary HART will Provide a dedicated team of clinicians available 24x7x52 Deal with challenging incidents over and above normal ambulance provision Provide additional support for Category A emergency calls Allows clinical care in the hot zone Provides medical support to partner agencies in hazardous rescue activities Improved multi agency working Assists core ambulance buisness.

35. TYL l P AMBIWLANS AMBULANCE HART Tim Ymateb Lleoliad Peryglus Hazardous Area Response Team Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru Welsh Ambulance Services NHS Trust Any Questions