Information and Intention
Recent terrorist attacks within the UK have demonstrated a willingness from those individuals caught up in the attack to help where they can, and in particular, provide first aid to those who are injured.
The types of injuries during a terrorist attack will be different to other incidents, and the dangers posed by the attacker(s) will require greater planning on the level of first aid preparedness.
Organisations are well placed to assist by enhancing their level of first aid planning, including the availability of first aid provisions for any individual on or near the site.
Information for sites with a Security Control Room (SCR) who wish to consider instigation of first aid once it is safe to do so after a terrorist incident can be found in NPSA guide First Aid - The role of Security Control Rooms during a terrorist attack Supplementary Guidance.
First aid preparedness should form an integral part of an organisation’s incident response and business continuity planning. Within these plans, a First Aid Response Plan should be outlined, which provides strategic oversight, management and direction setting for the administration of first aid.
This plan, which is most likely to be generic for any first aid related event, should have an appreciation of the challenges terrorist attacks present.
It should be acknowledged that the sooner a person with life threatening injuries receives first aid, the greater their chances of survival.
Method
First aid preparedness is a commonplace activity within organisations, not only as a regulatory requirement, but as a means of improving the first aid resilience of a workforce and safeguarding the interests of employees, visitors and any person within the immediate area of a business premises by providing humanitarian assistance to those in need.
By enhancing their level of first aid provisions, an organisation will be helping to improve the resilience of the general population to effectively administer lifesaving first aid, which will almost certainly improve the chances of survival of a person with life threatening injuries.
First aid response has been enhanced to include Public Access Trauma (PAcT) First Aid Kits which support the treatment of immediate, life-threatening injuries such as major bleeding and those who are not breathing on their own.
A PAcT First Aid Kit should be:
• Located in areas to which the public have access;
• Available for use by any person; and
• A PAcT First Aid Kit should be easily identifiable and clearly labelled Public Access Trauma First Aid Kit.
PAcT First Aid Kit should, at a minimum, contain the following items:
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Personal Protective Equipment: disposable gloves (x4 pairs), disposable glasses, disposable face mask;
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Tuff cut scissors;
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Large trauma wound dressing;
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Woven triangular bandage;
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Windlass tourniquet;
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CPR face shield;
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Indelible marker pen; and
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PAcT First Aid Kit Aide Memoire.
In addition, first aid kits should contain eye wash and flushing kits as standard.
PAcT First Aid Kits must be located in publicly accessible locations and areas to which people can easily access. They are designed to be used by any person, regardless of their level of first aid training and supports the first aid efforts until such time the emergency services arrive.
The PAcT First Aid Kit may also be used by an injured person who is able to self-treat themselves.
An assessment process will help determine the best location for the PAcT First Aid Kits. The following are examples of the types of locations although this is not an exhaustive list:
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Fire exit
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Main entrance
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Reception
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Refuge area
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Canteen
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Muster point
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Ticket/booking hall
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Platforms
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Loading bays
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Within vehicles
Further information on PAcT can be accessed via ProtectUK: Standards for Public Access Trauma (PAcT) First Aid Kits.
As part of such crisis response, organisations should have available at strategic points within the facility ‘grab bags’ which contain essential equipment and information. All relevant contact information, the staff involved, tenants and other site information should be contained in an easily accessible format. ProtectUK have completed a crisis response kits checklist to assist organisations.
Administration
Policy and procedures should mention crisis response plans and first aid preparedness, should the threat level be raised or following an incident. Identify ownership of the incident and governance of the decision making, including who is responsible for the management, coordination and strict compliance, together with the relevant records keeping, and how its effectiveness is assured. Ensure staff understand processes and procedures to be adopted, including action and contingencies.
In addition, organisations are encouraged to support, and where possible, participate in exercises held by the emergency services. These are an excellent opportunity to familiarise response plans and help inform any training needs requirement. Details of staff members who attend such exercises should be retained within their employment training records.
Risk Assessment
A risk assessment should identify threats which could have an impact on the business and its vulnerabilities. Such risk assessments should clearly define organisational as well as individual duty of care to staff and others. Staff and visitors may have different responses to the same incident and therefore you should risk manage the impact of staff, contractors and/or visitors as well as members of the public not following or directly contradicting instructions.
A key action for a business is to create a Crisis Communication Plan (TACTIC EB4). This should be a core component of its risk preparations. It should be developed following a detailed risk analysis looking at potential issues and possible solutions. Typically, these issues relate to an organisation’s people, assets, property and operations, and the plan is there to guide action and communications.
Communications
Internal Stakeholder Engagement:
Unless the information is particularly sensitive or involves personal data, all information relating to the crisis response plan and locations of PAcT First Aid Kits should be shared with your staff members. Staff should also be briefed on what to do in the event of the above circumstances.
It is necessary to ensure points of contact for liaison with other neighbours are known to staff internally, and partners externally. Internal communications should encourage crisis and first aid response awareness by general staff and a positive security culture should be encouraged through internal communications.
You must provide regular information for your staff so that they can help deliver on the crisis response plan. Your internal audience will inevitably cross over into your external audience, so you should consider the messages you want these individuals to communicate to their external networks, e.g. families and friends. Remember that social media is a potential area where this crossover may occur.
External Stakeholder Engagement:
Engagement with neighbouring businesses should be on a regular basis and should be constructive. The sharing of information regarding your crisis response plan, location of PAcT kits and general first aid kits is essential to making the system work.
Early identification and engagement with key external stakeholders are important. Local organisations whose sites are nearby, or have shared use of the site being protected, are also likely to play an important part in developing and delivering on any crisis response outcomes, and consideration should also be given to engaging with any working groups or forums who may already have identified ‘best practices’ and lessons learned from similar sites within the business area the site operates within.
There are a number of key principles that should be applied when engaging with stakeholders:
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The engagement should be different for different stakeholders, at different times – it should be flexible as one type of engagement process does not necessarily suit all stakeholders.
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It should be a two-way engagement process, where information and knowledge are shared.
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Communications should be genuine and timely, where there is the ability to influence outcomes, dependent on feedback.
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Engagement with stakeholders should be open and transparent.
As with all matters relating to crisis response and first aid, the relationships with the emergency services are key. The contact may be with either the local resilience planning teams or those specifically tasked with providing advice and guidance to certain sites.
External Media Engagement:
After a terrorist incident has occurred, organisations should not communicate directly with the media or external audiences on anything related to the incident, without prior consultation and agreement with the police. In addition, avoid revealing details about the incident through social media without prior police consultation.
An appropriate individual should be identified in the organisation to liaise with the police in order to disseminate approved information which is accurate, and which will not compromise the criminal investigation.
Health and Safety/Other Legal Issues
Businesses/organisations should ensure that all activities are assessed in line with Health and Safety and other legal/policy frameworks, such as:
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The Disability Discrimination Act 1995
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The Human Rights Act 1998
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Health and Safety Acts
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The Data Protection Act 2018
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Employment Rights Act 1996
Your actions must be justified, necessary and proportionate to the threat you are facing.
Specifically, organisations are directed to the Health and Safety (First Aid) Regulations 1981 which requires employers to provide adequate and appropriate equipment, facilities and personnel to ensure their employees receive immediate attention if they are injured or taken ill at work.
The Regulation sets out the essential aspects of first aid that employers have to address within all workplaces.
As a minimum, there must be:
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A suitably stocked first-aid kit.
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An appointed person to take charge of first-aid arrangements.
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Information for all employees giving details of first-aid arrangements.
You should ensure that there are well-defined governance arrangements and that records are kept of the issues, decisions made and the reasoning behind those decisions, which involve crisis response plans and the administering of first aid. Records will provide evidence to any investigations or public enquiries and assist in defending against legal action, criminal charges or civil claims. The importance of keeping accurate records and having well defined governance arrangements has been demonstrated during the Manchester Arena Inquiry.