1. “A view from inside the suit”.

2. 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.

3. 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, , 55 – 2147,

4. 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

5. 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

6. 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

7. 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

8. 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

9. Thank you