Emergency Medicine for Hostile Environments

What WMT says

This is a gold-standard, practical 3-day course for personnel working or exploring in hostile, foreign theatres on land or at sea. Combining 20 years of WMT experience with the military operational experience of WMT Senior Instructor Dr Harvey Pynn, this comprehensive course will update your medical skills, teach you the latest techniques to deal with serious injuries ballistic and blast trauma and enhance your CV. Haemorrhage (bleeding) from ballistic/blast trauma causes 90% of deaths. Immediate, effective haemorrhage control is vital, followed by patient packaging and pain control, to reduce morbidity. You’ll learn the principles of trauma management, triage, scene management, advanced haemostatic techniques (how to stop bleeding), how to give injections and the use intravenous and intraosseous (via bone) fluids. You will learn how to treat and package a severely injured casualty for onward transport to definitive care or to sustain life whilst help comes to you. Whatever your assignment in a wild or dangerous place, you (and your employer) will feel satisfied that you are prepared for the worst.

What students say

Brilliant instructor; instilled confidence in us all. Made everything sound interesting and easy to remember.
Really good 0 especially the blast and ballistic trauma.
Pitched at just the right level
Excellent refresher to [WMT's] Far From Help Part 2/Advanced Refresher course… good addition & emphasis on trauma and how laypeople can effectively impact outcomes
Very good clear instruction

Who can attend?

You are required to have had basic first aid training to attend. We expect that some participants will also have done some advanced medical training with WMT already or combat medic training in the past but this is not required. We also expect that some students will hold a UK SIA licence. This is a serious course for people working or exploring in hostile and dangerous overseas environments where the ability to react quickly “under fire” to mitigate a medical emergency may mean the difference between life and death. Qualified medics are welcome but you should discuss your experience and aims with WMT before booking.

Who is this course aimed at?

In short, this course is for anyone who wants to be prepared to deal with trauma in a remote setting. Anyone who wants to look after their own safety, the safety of others or who is guarding and protecting property, installations or human assets are welcome to attend. This course will appeal to those working in hostile places as contract security staff or close protection officers. We expect this course will also appeal to medical officers and personnel working in remote places (oil installations or aboard ship and private super-yachts for example), anti-poaching teams, journalists, film crews, “fixers”, humanitarian and aid workers, researchers and other remote site workers. If you have already completed a WMT Explorer course (Far From Help or Advanced Medicine) within the three years, you are welcome to attend to refresh and extend your skills, thereby re-certifying with WMT for a further three years. (See below for a note re: SIA license requirements).

What’s covered on this course

The thrust of this course is to prepare for the worst with thorough medical planning and the ability to use an advanced medical kit so you can manage life threatening traumatic injuries under duress including bullet/knife and/or blast trauma – and package a patient for evacuation whilst maintaining their vital signs. You’ll learn haemostatic techniques – how to stop bleeding – including using tourniquets as well as third and fourth generation clotting agents (e.g. Quickclot, Celox). You will be taught intravenous and intraosseous access (using EZ-IO and FAST 2 devices) and the application and limitations of hypovolaemic resuscitation. Airway management will be practical and reproducible in the field with tools such as nasopharyngeal airways and the i-gel supraglottic device. Methods of triage and scene management will be addressed. Emphasis will be placed on life-saving treatments followed by appropriate packaging using splinting, immobilisation, appropriate pain management, hypothermia mitigation and principles of safe transfer. In short, you’ll learn how to STOP BLEEDING and preserve life. Some teaching will be done outdoors (and at night depending on the time of year).

We’ll teach you to use prescription medications and advanced medical supplies and authorise you to obtain them. A comprehensive field manual serves as an essential aide memoir.

Outline course syllabus

Day 1 Medical
Medical planning – including anti-malarials, immunisations and trustworthy web-based resources
Legal considerations of advanced techniques
Diagnosis – history taking
Measuring vital signs and examination of the chest/abdomen
Common medical conditions. Management of diarrhoea
Tropical problems
Environmental extremes: managing cold injuries, heat problems & altitude illness

Day 2 Managing Trauma
Resuscitation guidelines & review – including use of igel. CPR practical
Triage – how to manage multiple casualties
ABC approach to injured casualties – tourniquets, intraosseous access and haemostatic agents
Management of shock
Vehicle scene safety & extrication, working around helicopters
Ballistic & blast trauma
Management of fractures & dislocations – use of splints
Advanced would care – soft tissue injuries & burns
Packaging & transporting patients – use of neck collars

Day 3 Providing ongoing medical care
intravenous/intraosseous fluids & injections
intramuscular/intravenous injections – administration of antibiotics
Pain control
Managing anaphylaxis
Practical trauma triage & moulage
Medical kits

Dr Harvey Pynn – Course Director

Dr Harvey Pynn, WMT Senior Instructor & Head of Research & Publications
MA MCEM DMM DMCC DTM&H
Harvey is currently working at Frimley Park Hospital, Surrey in accident and emergency. He has undertaken several operational tours and has recently returned from another stint in Afghanistan. Harvey has been teaching WMT courses since 2004 and he also heads up the WMT Jungle Medicine course. Harvey is an ALS, APLS and BATLS Instructor with particular interests in trauma, environmental and tropical medicine. He has completed the diplomas in mountain medicine and the medical care of catastrophes. He has also just completed the DTM&H (diploma in tropical medicine and hygiene). He is looking forward to completing his emergency medicine consultant exams in spring ’12. In April 2010 Harvey completed the gruelling Marathon de Sables in Morocco for the charity Mencap. He recently returned to Morocco to supervise an athlete event for The North Face.

Instructor-student ratios

A maximum of 8 students are accepted onto this course. This intensive level of staffing together with the consumable materials provided for practical training is reflected in the course fee.

Fees

The non-residential course fee is £650 includes all instruction, consumable materials, comprehensive field manual, teas/coffees, 3 lunches and VAT (@ 20%). The full board fee – £695 -also includes 2 night’s YHA shared accommodation, 2 evening meals and 3 breakfasts. It’s possible to book extra accommodation the night before the course directly with the YHA.

Note – SIA Licence requirements

We wish to be quite clear that this course does not cover the SIA first aid course requirements for close protection licensing. This course is quite different and is in most ways more advanced and will compliment and extend SIA license holder’s skills and enhance their CV. This course is designed to appeal to a broad range of serious “travellers”, including security personnel.

Download this web page

Download a pdf copy of this web page for this course.We are always happy to answer queries by email. Please use this contact page.

Bespoke training

WMT is available to run this course on demand, and indeed any related medical training, on a private basis anytime and anywhere in the world. Contact Barry Roberts, Commercial Director, to discuss your requirements in the strictest confidence or visit this Bespoke Training web page.

Other WMT training options

The Emergency Medicine course is a distillation of WMT’s 4-day Advanced Medicine course which is more broad based and covers more illness conditions and has less emphasis on bullet/blast trauma. Advanced Medicine is run more frequently than the Emergency Medicine course and can be completed in two, 2-day stages – Far From Help, then Far From Help Part 2/Advanced Refresher.

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