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Bleed, Trauma & Mass Casualty Response

Having first aid supplies to treat major injuries is strongly recommended by several official bodies and a key consideration for compliance with the Protection of Premises Bill, also known as ‘Martyn’s Law’.

Whether the risk being considered is a public attack or a serious workplace accident – major bleed injuries can be treated with readily available and affordable equipment, which can be used with minimal or no training. The sooner treatment can be given, the greater the chances of survival.

Traumatic injuries such as major bleeds, howsoever caused, can result in death in minutes – often before professional help can arrive. Having provisions to stop severe bleeding readily available and easy to access can be vital in keeping casualties alive until emergency services are able to help.

Guidance On Enhanced First Aid Provision & Preparedness

Why Should I Enhance My First Aid Provisions?

Basic first aid provision is a legal requirement and is common among organisations. However, enhanced first aid provision and preparedness is also strongly recommended by several official bodies in everyday settings:

Public premises and events

Public premises and events are strongly encouraged by ProtectUK and the National Counter Terrorism Security Office (NaCTSO) to provide Public Access Trauma (PaCT) kits. Furthermore, 'Martyn’s Law' is a bill being pursued by government, which would mandate any public premises or event with a capacity of over 200 to consider the risks arising from a terrorist attack and have plans in place to mitigate physical harm in the event of one occurring.

Workplaces or sites with any hazards

Workplaces or sites with any hazards such as machinery, sharp or moving objects which have potential to cause critical injuries such as major bleeding must have 'adequate and appropriate’ first aid for any risks present. Alongside other health and safety measures, this may be achieved by adding bleed control products to existing first aid provisions, or adding Workplace Critical Injury Packs compliant to BS8599-1.

Whether the risk being considered is a terrorist/public attack or a serious accident on site – major bleed injuries are often a fatal consequence. However, they can be treated with readily available and affordable equipment, which can be used with minimal or no training. The sooner a person with life threatening injuries receives appropriate first aid and treatment, the greater their chances of survival.

Basic first aid provisions such as an HSE or BS8599-1 compliant first aid kit do not have any items to treat major bleeding, yet thousands of UK workplaces and sites will have machinery or equipment which could cause a critical injury in the event of an accident or malfunction.

Many workplaces, organisations, public premises and events provide defibrillators which save hundreds of lives every year. Trauma and Bleed Control provisions are significantly more affordable, easier to implement and could save multiple lives in the event of a mass casualty situation.

There have been 14 terror attacks in the UK since the start of 2017. Furthermore, the UK's Intelligence Services and Counter Terrorism Policing have disrupted 39 late-stage terror attacks and are investigating 800 live cases annually.

Subsequently, the threat level facing the UK is currently set at 'substantial', meaning an attack is likely.

What Should I Consider When Enhancing First Aid Provisions?

The Health and Safety Executive state “First aid provision must be 'adequate and appropriate in the circumstances'. This means that you must provide sufficient first aid equipment (first aid kit), facilities and personnel at all times”.

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First aid supplies should be placed in locations that are accessible to the public and usable by individuals, irrespective of their training background.

As part of their counter terrorism awareness guidance, ProtectUK and the National Counter Terrorism Security Office (NaCTSO) recommend that first aid provisions ‘should support the administrating of immediate, lifesaving first aid’.

The provisions should be ‘well advertised across the premises’ and be clearly signposted, ensuring all staff, visitors and guests are made aware of them for ease of identification in an emergency. Consider the use of signage to assist with ensuring provisions can be quickly found, with regular reminders and information on the nearest provisions as necessary.

Is your first aid kit adequate?

ProtectUK recommend that "organisations should undertake an assessment to determine if the current first aid kit, such as workplace first aid kits, are adequate for the treatment of immediate life-threatening injuries". Additionally, the Health and Safety Executive state that risk assessments must "consider the circumstances of your workplace, workforce and the hazards and risks that may be present."

It is recommended that consideration should be given to:

do they support the treatment of those with major bleeding?
do they support those who are not breathing as a result of unconsciousness or an obstructed airway, typically after a head injury or cardiac arrest?
are they able to help more than one injured person?

Additional supplies to supplement basic first aid provision may include:

Public Access Trauma Kits (PAcT)
Products or Kits to treat major bleeding, such as Tourniquets, Trauma/Pressure Dressings, Wound Packing, Haemostatic Dressings and Granules
Casualty Stretchers and Evacuation Products
Resuscitation Products such as guedal airways
Defibrillators
Additional items to treat and manage shock

Why Should Organisations Ensure Adequate First Aid Preparedness For Mass Casualty Events?

Protect UK strongly encourage public and private sector organisations to 'enhance first aid preparedness and response planning, so it takes into account the likely injuries which can be the result of a malicious event, such as a terrorist attack'.

It is common for organisations to have a basic level of first aid preparedness not only to comply with legal requirements, but also as a means to enhance the first aid resilience of their workforce. This effort is aimed at safeguarding the welfare of employees, visitors, and anyone in the vicinity of a business premises by offering humanitarian assistance to those in need.

By enhancing their level of first aid provisions, an organisation contributes to strengthening their own and the general population's ability to perform life-saving first aid effectively, which will undoubtedly increase the survival chances of individuals with life-threatening injuries.

Furthermore, the Terrorism (Protection of Premises) Bill, also known as Martyn’s Law, will require those responsible for publicly accessible premises with capacities over 200 to take steps to reduce the threat to the public from terrorist attacks, through assessing risks and having appropriate measures in place to mitigate physical harm.

Under current proposals, an inspection regime will be put in place with full powers of entry into any qualifying location. Regulators will have a range of sanctions to address non-compliance with the proposed law, and will be able to impose penalties, including restriction notices or fines of up to £18m or 5% of worldwide revenue.

Having first aid provisions to treat critical injuries readily to hand and clearly signposted is a reasonably practicable and effective step for organisations to take as part of these plans.

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How Can Organisations Ensure Adequate First Aid Preparedness For Terror Attacks?

Remember:

The arrival of emergency services might be delayed due to potential dangers, which could affect their ability to respond quickly
The initial need for first aid can significantly strain emergency services and the broader healthcare system, especially when multiple injuries occur over a large area
Although the severe nature of injuries in a terrorist attack might be similar to those in other emergencies, the additional threat from the attackers necessitates more comprehensive planning for first aid
There should also be an assumption that there will be more than one casualty

A terrorist incident introduces unique difficulties that might not be apparent in other situations, potentially causing life-endangering injuries to people. Recent incidents of terrorism in the UK have shown that bystanders in the vicinity of such attacks are eager to assist, including by administering first aid to the injured – often resorting to makeshift solutions in the absence of readily available supplies to treat critical injuries.

There is no need to resort to having to use such solutions (such as using ties, scarves and belts for tourniquets) if risks are properly assessed and the right provisions are made available in the right way.

Having first aid provisions to treat major bleed injuries readily to hand and clearly signposted is a reasonably practicable and effective step for organisations to take in order to mitigate physical harm in the event of an emergency.

Protect UK recommend that individuals caught in an attack who are both willing and capable of providing first aid should be allowed to do so. Nonetheless, ensuring their safety is crucial to enable them to offer first aid in a manner that is both safe and effective.

To assist organisations on their counter terrorism first aid preparedness and response, ProtectUK and NaCTSO offer guidance prioritising four key areas:

First Aid Needs Assessment, which includes taking a risk based approach
Having an appropriate First Aid Response Plan
Having adequate and appropriate First Aid Provision
Training where required

Visit the ProtectUK website for further details on assessing risk and creating response plans.

What Is Martyn’s Law?

The Terrorism (Protection of Premises) Bill was in the programme of legislation that the Government intends to pursue in parliament. The Bill is also known as ‘Martyn’s Law’ in tribute to Martyn Hett, who was tragically killed alongside 21 others in the Manchester Arena terrorist attack.

Martyn’s Law will enhance public safety by ensuring better preparedness for, and protection from, terrorist attacks. It will mandate, for the first time, who is responsible for considering the risk from a terrorist attack and how they would respond, to reduce harm and save lives.

The scope of premises and events included is very broad and includes retail, hospitality, entertainment, recreation, exhibitions, visitor attractions, education, transport, education, healthcare, places of worship and more. The Bill will establish a tiered model based on the principal activity and having a public capacity of over 200.

Under current proposals, an inspection regime will be put in place with full powers of entry into any qualifying location. Regulators will have a range of sanctions to address non-compliance and will be able to impose penalties, including restriction notices or fines of up to £18m or 5% of worldwide revenue.

The bill is expected to become law in 2024. However, compliance shouldn’t be onerous and is designed to sit alongside existing health and safety obligations. Depending on the premises or event – it may simply involve consulting official guidance, conducting a risk assessment, establishing procedures, and providing basic training.

Martyn’s Law will help to ensure organisations address the care gap between a mass casualty event occurring and medical help arriving, by having appropriate measures in place to respond to a terror attack and mitigate physical harm. Traumatic injuries such as major bleeds can result in death in minutes, but having provisions to stop severe bleeding readily available, clearly signposted and easy to access can be vital in keeping casualties alive until medical professionals are able to help.

How Does Protection of Premises Bill (Martyn’s Law) Affect First Aid Obligations?

The Draft Terrorism (Protection of Premises) Bill, also known as Martyn’s Law, will enhance public safety by ensuring better preparedness for, and protection from, terrorist attacks. It will mandate, for the first time, who is responsible for considering the risk from a terrorist attack and how they would respond, to reduce harm and save lives.

The draft bill is expected to become law in 2024. However, compliance shouldn’t be onerous and is designed to sit alongside existing health and safety obligations.

It does not specifically state any mandatory requirements for first aid as this will vary between premises and events. However, it does mandate that applicable premises and events assess the risks properly and have appropriate procedures in place to respond to an attack and mitigate physical harm in the event of an attack. This may include the need to provide the necessary first aid to be able to carry out those procedures, along with additional security measures, staff training, evacuation/invacuation planning, and other elements.

A basic level of First aid preparedness is an existing legal obligation and is common within organisations. Enhancing first aid provisions with items which can treat trauma such as catastrophic bleeding almost certainly improves the chances of reducing harm and saving lives, as is the goal of Martyn’s Law.

ProtectUK and National Counter Terrorism Security Office (NaCTSO) state "Public and private sector organisations are strongly encouraged to enhance their first aid preparedness and response planning, so it takes into account the likely injuries which can be the result of a malicious event, such as a terrorist attack."

The draft standard terrorism evaluation will be used by many organisations in assessing the measures they need to take. This is included in the official draft government guidance on Martyn’s Law and states: "First aid kits and fire safety equipment should already have been deployed to mitigate the identified risks and where appropriate staff trained in their use. Consider if additional equipment and training may be needed to support the response to a terrorist incident. This might include Public Access Trauma (PAcT) first aid kits or tourniquets which can be purchased or additional firefighting equipment to be deployed near likely attack points."

The Terrorism (Protection of Premises) Bill, also known as Martyn’s Law, will enhance public safety by ensuring better preparedness for, and protection from, terrorist attacks. It will mandate, for the first time, who is responsible for considering the risk from a terrorist attack and how they would respond, to reduce harm and save lives.

The bill is expected to become law in 2024. However, compliance shouldn’t be onerous and is designed to sit alongside existing health and safety obligations.

What Is The Care Gap?

The care gap is the time between an incident that causes a medical emergency and the arrival of professionals who can treat the casualty immediately. When a medical emergency occurs, people expect an ambulance to be immediately deployed, arrive in a matter of minutes, and for the casualty to receive medical attention immediately upon arrival.

But when a mass casualty event occurs, alongside logistical challenges and any dangers still present, there can simply be too many casualties and too few paramedics, so some casualties have to wait to be treated. This is when the care gap becomes too large, and further damage or even death can result from a lack of prompt medical intervention.

Traumatic injuries such as major bleeds can result in death in minutes, but having provisions to stop severe bleeding readily available and easy to access can be vital in keeping casualties alive until professional help arrives.

This is also the case for premises with machinery or sharp/moving objects where there is a risk of a major bleed injury occuring. The time it takes to bleed out from a critical bleed is often less than the fastest time it takes for an ambulance to arrive. This is an example of the care gap and why any premises where there is a risk of a critical bleed injury occuring should be prepared with enhanced first aid provisions, such as a Critical Injury Pack compliant to BS8599-1 or having bleed control products included alongside basic first aid provisions.

What Is A Public Access Trauma (PAcT) Kit?

A public access trauma first aid kit, also referred to as a PAcT First Aid Kit is a first aid kit which supports the treatment of immediate, life-threatening injuries such as major bleeding and those who are unresponsive with absent or abnormal breathing.

PAcT First Aid Kits are designed to be used by anyone, regardless of their level of first aid training, and supports the first aid efforts until the emergency services arrive. PAcT First Aid Kits should be placed in locations that are public and easily accessible, enabling even an injured person capable of self-treatment (often referred to as 'walking wounded') to use them.

Businesses should include the PAcT First Aid Kit in their first aid culture and response plans. Organisations should ensure that every person should be aware of the location of a PAcT First Aid Kit, regardless of the setting. Consider using recognisable, obvious and compliant safety signage with regular reminders to ensure that life-saving first aid provisions can be quickly and easily located when time is of the essence.

Protect UK state that: "All public and private sector organisations are encouraged to include PAcT First Aid Kits within the first aid provisions they have in place. They are an additional lifesaving resource which improves an organisation’s first aid resilience."

"PAcT First Aid Kits should be commonplace across the UK. Aside from bridging the gap until the emergency services arrive, PAcT First Aid Kits are recognised by all the emergency services, police, ambulance and fire service, across the whole country, which means PAcT First Aid Kits will form part of their first aid response planning too."

While the background to PAcT first aid kits relate to mitigating physical harm from a terrorist related attack, PAcT First Aid Kits can be used to support any incident where there is an immediate life-threatening injury.

Ensuring the provision and correct implementation of PAcT First Aid Kits on your premises is a simple, reasonably practicable and effective step for organisations to protect personnel on site.

Who Should Provide PAcT Kits?

All public and private sector organisations or events should have PAcT kits on site, ready to use and clearly signposted to provide lifesaving resources for on-site personnel and the public alike.

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PAcT first aid standards have been developed to be relevant for all organisations, regardless of their size, location and type.

Furthermore, Health and Safety Executive strongly recommends that businesses consider the needs of non-employees in their first aid provisions. The PAcT Kit is a crucial part of fulfilling this recommendation.

Providing PAcT First Aid Kits on your premises is a reasonably practicable and effective step for organisations to take to adequately protect those on site.

Protect UK state that:

"All public and private sector organisations are encouraged to include PAcT First Aid Kits within the first aid provisions they have in place. They are an additional lifesaving resource which improves an organisation’s first aid resilience."

Why Should I Install PAcT First Aid Kits?

The draft standard terrorism evaluation form will be used by many organisations in assessing the measures they need to take in preparation for Martyn’s Law. This is included in the official draft government guidance and states:

"First aid kits and fire safety equipment should already have been deployed to mitigate the identified risks and where appropriate staff trained in their use. Consider if additional equipment and training may be needed to support the response to a terrorist incident. This might include Public Access Trauma (PAcT) first aid kits or tourniquets which can be purchased or additional firefighting equipment to be deployed near likely attack points."

As part of its guidance on First Aid Regulations, the Health and Safety Executive strongly recommends that non-employees are included in an assessment of first aid needs and that provision is made for them.

It also states that organisations must have adequate first aid to cover risks identified during a risk assessment.

PAcT First Aid Kits are designed to be used by anyone, regardless of their level of first aid training, and support first aid efforts until the emergency services arrive. PAcT First Aid Kits should be placed in locations that are public and easily accessible, enabling even an injured person capable of self-treatment (often referred to as 'walking wounded') to use them.

ProtectUK recommend that PAcT First Aid Kits are embedded within their first aid culture and response plans. Organisations should ensure that every person should be aware of the location of a PAcT First Aid Kit, regardless of the setting.

The PAcT First Aid Kit standards are relevant, fit for purpose and have a clear aim of improving the survivability of a person with life threatening injuries.

The standards are relevant for all organisations, regardless of their size, location and type.

Ultimately, traumatic injuries such as major bleeds, howsoever caused, can result in death in minutes – often before professional help can arrive. Having provisions to stop severe bleeding readily available and easy to access can be vital in keeping casualties alive until emergency services are able to administer treatment.

Providing PAcT First Aid Kits on your premises is a reasonably practicable and effective step for organisations to protect personnel on site.

How Many PAcT Kits Do I Need?

With any life-threatening situation, it should be assumed that there will be more than one casualty.

Larger premises, facilities and organisations accommodating more employees, visitors, and guests would require more items in each PAcT First Aid Kit and will need to distribute multiple kits throughout their premises. For instance, a smaller site with a single main entrance might have just the minimum recommended two PAcT First Aid Kits, typically positioned in the reception area and another in a different section of the site. In contrast, a large sports venue might place several kits in numerous locations throughout. The determination of appropriate coverage levels can be achieved through an assessment process.

Where Should PAcT Kits Be Located?

To meet the requirements of the standards, a PAcT First Aid Kit must be located in Publicly Accessible Locations and at most, within a few minutes’ walk from the next available PAcT First Aid Kit.

In addition, it is strongly recommended that organisations consider any areas where the public may go within the premises. Whilst these areas may not be publicly accessible, they may be a place the public go to in an emergency to seek refuge or help. Locating a PAcT First Aid Kit in these areas, such as after a security check area (employee/visitor), staff rooms, security control rooms and first aid rooms will help to ensure immediate lifesaving first aid provisions are available when needed most.

An assessment process will aid in determining the optimal placement of PAcT First Aid Kits, considering how effectively they can be transported from these locations, the safety of the person moving the kit, and the time it takes to get the kit to where it's needed.

Organisations should ensure that every person should be aware of the location of a PAcT First Aid Kit, regardless of the setting. Consider using recognisable, obvious and compliant safety signage with regular reminders to ensure that life-saving first aid provisions can be quickly and easily located when time is of the essence.

It is also important to communicate the location of the PAcT First Aid Kit to neighbouring organisations and local emergency services to ensure that everyone is informed of its whereabouts.

ProtectUK and NACTSO recommend that "PAcT First Aid Kits should be mounted on a wall or in a cabinet so it is visible and easy to access by anyone".

Consideration should also be given to how accessible the kit would be for a casualty who might require the kit to treat themselves, on a leg injury, for example.

Our kits go further to meeting these recommendations as standard by featuring glow in the dark labelling in case there is loss of power in an emergency, and we also offer signage and dedicated PAcT points over and above basic kits, also on a glow in the dark material.

This graphic gives guidance on some places where it may be best to locate PAcT across different types of premises:

How Should I Install a PAcT Kit?

A PAcT First Aid Kit should be easily identifiable and clearly labelled "Public Access Trauma First Aid Kit".

An evaluation should be conducted to select the most suitable container for the first aid kit. For instance, a small bag or a hard plastic box may be appropriate for a small shop, whereas a larger facility that covers multiple floors might benefit from a bag with shoulder straps, facilitating easier transport across different areas.

ProtectUK and NACTSO recommend that "PAcT First Aid Kits should be mounted on a wall or in a cabinet so it is visible and easy to access by anyone". Consideration should also be given to how accessible the kit would be for a casualty who might require the kit to treat themselves, on a leg injury, for example.

Our kits go further to meeting these recommendations as standard by featuring glow in the dark labelling in case there is loss of power in an emergency, and we also offer signage and dedicated PAcT points over and above basic kits, also on a glow in the dark material.

We also offer a full range of box, case and bag options in various formats to provide a solution for all types of premises.

Like all publicly available equipment, these kits should be regularly inspected and any damaged or expired items should be replaced. This maintenance helps preserve the kit's reliability and minimizes the effects of theft or vandalism.

Tamper proof seals, similar to those used on fire safety equipment can also help to keep PAcTs safe as long as they do not inhibit the use of the kits in an emergency.

Organisations should ensure that every person should be aware of the location of a PAcT First Aid Kit, regardless of the setting.

Consider using recognisable, obvious and compliant safety signage with regular reminders to ensure that life-saving first aid provisions can be quickly and easily located when time is of the essence.

It is also important to communicate the location of the PAcT First Aid Kit to neighboring organisations and local emergency services to ensure that everyone is informed of its whereabouts.

What Goes In A PAcT Kit?

PAcT Kits are designed to treat more than one casualty. At a minimum, a kit compliant with the official PAcT standards should contain the following items:

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Organisations should carry out an assessment to determine if additional content is required and add this as necessary, whilst also considering the size of the kit.

ProtectUK and NACTSO state "We recommend a minimum of at least two PAcT First Aid Kits located within a premises. It would be expected that those organisations with larger premises, and those hosting more staff, visitors and guests, would have more content within each kit and will have several PAcT First Aid Kits located across their premises."

As with existing first aid provisions and publicly available equipment, these kits should be regularly inspected, and any damaged or expired items should be replaced – consider holding back up stocks where appropriate. This planning and maintenance helps to preserve the kit's reliability and minimizes the effects of theft or vandalism.

Purchasing a complete kit may well be the most suitable option for some organisations, but there is no reason why an organisation cannot 'self-assemble' their own PAcT First Aid Kits. Provided they meet the above contents list and ensure that kits are accessible and easy to locate, they will meet the requirements of the standards.

Why Should I Add Bleed Control Products To Workplace First Aid Provisions?

The Health and Safety Executive state "First aid provision must be 'adequate and appropriate in the circumstances'. This means that you must provide sufficient first aid equipment (first aid kit), facilities and personnel at all times".

ProtectUK recommend that 'organisations should undertake an assessment to determine if the current first aid kit, such as workplace first aid kits, are adequate for the treatment of immediate life-threatening injuries'. Additionally, the Health and Safety Executive state that risk assessments must "consider the circumstances of your workplace, workforce and the hazards and risks that may be present."

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It is recommended that consideration should be given to:

do they support the treatment of those with major bleeding?
do they support those who are not breathing as a result of unconsciousness or an obstructed airway, typically after a head injury or cardiac arrest?
are they able to help more than one injured person?

Workplaces, premises, facilities or sites with any hazards such as machinery, equipment, sharp or moving objects which have potential to cause critical injuries such as major bleeding must have 'adequate and appropriate’ first aid for any risks present. Alongside other health and safety measures such as correct training, procedures and installing safety signage, this may be achieved by adding bleed control products to existing first aid provisions, or adding Workplace Critical Injury Packs compliant to BS8599-1 which are designed to be issued as a supplementary resource to small, medium or large first aid kits.

Basic first aid provisions such as an HSE or BS8599-1 compliant ‘standard’ first aid kits do not have any items to treat major bleeding, yet thousands of UK workplaces and sites will have machinery or equipment which could cause a critical injury in the event of an accident or malfunction.

The time it takes to bleed out from a critical bleed is often less than the fastest time it takes for an ambulance to arrive, so having provisions to stop severe bleeding readily available and easy to access can be vital in keeping casualties alive.

This is an example of the care gap and why any premises where there is a risk of a critical bleed injury occuring should be prepared with enhanced first aid provisions, such as a Critical Injury Pack compliant to BS8599-1, or having bleed control products included alongside basic first aid provisions.

The simple and small investment of adding bleed products such as tourniquets, trauma dressings and haemostatics to your organisations first aid provisions could save lives.

Which Bleed Control Products Do I Need?

We offer a market leading range of Trauma and Bleed Control Kits in a range of formats from single person treatments to mass casualty options where life saving supplies can be deployed for rapid treatment of multiple individuals.

Our range is based around likely scenarios to be considered in risk assessments across a wide range of premises, so there is a simple, practical and attainable solution available for all kinds of organisation.

We also offer a comprehensive range of refill items featuring dozens of individual components featured within the various type of trauma and bleed control kits. Buying individual items is ideal for organisations and medical professionals to supplement their existing supplies, or for where there may be a specific risk or product need. We offer a full selection of the biggest and most reliable brands in this area.

To help decide which Trauma Bleed Control products your organisation may need to meet its first aid obligations we have created the below guide which summarises each product type, their applications and purchasing considerations:

Bleed Control Kits

Recommended for organisations looking to supplement existing basic first aid provision.

Our bleed control kits feature a selection of products to treat different types of critical bleed injury and are available with a range of contents and in a variety of containers to suit every requirement depending on risks present. Recommended for organisations looking to supplement existing basic first aid provision with a selection of additional products suitable for treating major bleeding and can be used with minimal first aid knowledge. These kits are also ideal for use by emergency medical professionals.

Workplace Critical Injury Kits

These kits are also designed with contents that can be used with minimal first aid knowledge.

These kits have been specifically designed in line with the BS8599-1 standard to be issued as a supplementary resource to small, medium or large first aid kits for workplaces or lone working where there is a hazard that could result in a critical injury such as a major bleed.

PAcT Kits

A Public Access Trauma First Aid Kit, also referred to as a PAcT First Aid Kit is a first aid kit which supports the treatment of immediate, life-threatening injuries such as major bleeding and those who are unresponsive with absent or abnormal breathing. They primarily exist to provide life-saving provisions to anyone in the vicinity during mass casualty events, such as terrorist attacks.

Our PAcT kits go further to meeting recommendations as standard by featuring glow in the dark labelling in case there is loss of power in an emergency, and we also offer signage and dedicated PAcT points over and above basic kits, also on a glow in the dark material.

Mass Casualty Points & Stations

Our points, stations and cabinets are designed for maximum practicality whilst creating a neat, professional and obvious focal point.

Consider combining mass casualty points, cabinets and stations with the location of a defibrillator, if you have one.

For major incidents in premises where there may be the potential for multiple casualties, ensuring ease of access and distribution of life saving trauma treatment is vital. Having life-saving supplies onsite, but not near casualties, or in an easily transportable format, negates much of the benefit of having them.

Our innovative range of Mass Casualty products feature points, stations and cabinets which contain different formats of bleed control and trauma kits for workplace or public settings, neatly packaged in formats to enable rapid distribution and transportation to casualties, such as in run on bags originally designed for responding to injuries on the sports field. Individual bleed control treatments can then be distributed quickly and easily to casualties or those able to treat them, minimising the ‘care gap’ before emergency services arrive, which can cost lives.

All first aid provisions must be clearly signposted, easy to find and simple to access – however this is especially important in a critical event when time is of the essence. ProtectUK and NACTSO further recommend that "PAcT First Aid Kits should be mounted on a wall or in a cabinet so it is visible and easy to access by anyone".

Having an appropriate number of points, stations or cabinet containing bleed control and trauma kits ready to distribute is an elegant solution to providing appropriate lifesaving supplies in a format that is both practical for its intended use and demonstrates a professional commitment to keeping everyone on the premises safe.

Tourniquets

Used to restrict blood flow to injured areas and reduce blood loss.

A staple in all bleed control and trauma kits and often the first item that should first responders should look to apply to control blood loss, particularly on severe injuries to limbs. For major bleeds where trauma dressings or haemostatic dressings would not sufficiently control blood loss, tourniquets are applied to stop the flow of blood to an area of the body using pressure.

We offer a range of windlass style tourniquets up to military grade, which provide the highest levels of pressure without the need for a high level of strength, and are suitable for treating the most severe of traumatic bleed injuries. We also supply zip-tie style tourniquets for extreme ease of rapid application in an emergency.

In previous terror attacks in the UK, due to a lack of appropriate supplies readily available, many casualties were treated with makeshift tourniquets such as ties, belts and scarves.

It is important to note the time tourniquets are applied so when emergency services arrive, they know how long blood flow has been restricted to an area of the body. This is why pens are included in many of the kits with tourniquets.

Trauma Dressings

Essential item for treating moderate to severe bleed injuries.

Trauma dressings feature large, thick absorbent pads, and elasticated straps with an integrated fixing, usually Velcro. This helps to instantly apply direct pressure to wounds to stem blood flow, at the same time as absorbing blood and providing protection from contaminants. Depending on the severity and location of the wound, haemostatic products and tourniquets may be used in conjunction with trauma dressings. Trauma dressings are supplied vacuum packed, are low cost, and can be easily added to existing first aid supplies.

Haemostatic Dressings

Haemostatic dressings can be easily added to existing first aid supplies.

Effective for controlling severe bleeding in areas where a tourniquet cannot be used, and effective on smaller ‘neater’ injuries where bleeding is too much for standard first aid items. Haemostat products feature various agents specifically designed to encourage blood clotting, reduce blood loss, and improve results in emergency trauma situations.

Haemostatic Granules

Granules can be quickly and easily applied directly to deep penetrating wounds.

Available with or without an applicator, granules can be quickly and easily applied directly to deep penetrating wounds, such as stab injuries to encourage blood clotting and minimise blood loss if a tourniquet cannot be used.

Gauze

For packing deep wounds to stem blood flow and reduce blood loss.

Supplied in Z folded lengths of up to 3m – for injuries where a tourniquet cannot be used, gauze is used to ‘pack’ wounds before applying pressure to stem blood flow and reduce blood loss. Available with or without added haemostatic agents.

Chest Seals

Offer an efficient way to protect the chest cavity.

Designed specifically for shielding the chest cavity from respiratory hazards caused by deep puncture wounds. Air entering the chest cavity through a wound can severely impair breathing if the chest has been deeply punctured. Chest seals offer a rapid and efficient way to protect the chest cavity in such instances.

Other Items

All first aid provisions must be easy to access and clearly signposted.

Other Items to facilitate effective treatment include shears to cut clothing, resuscitation products for unresponsive casualties, foil blankets to manage shock, PPE to minimise cross contamination during treatment, and casualty handling equipment like stretchers.

Given the nature of injuries that can occur in mass casualty events from incidents such as bomb blasts, additional supplies of first aid to treat burn injuries and eye injuries are also recommended.

As with all existing first aid provisions and publicly available equipment, these kits should be regularly inspected and any damaged or expired items should be replaced – consider holding back up stocks where appropriate. This planning and maintenance helps to preserve the kit's reliability and minimizes the effects of theft or vandalism.

All first aid provisions must be easy to access and clearly signposted. Consider using recognisable, obvious and compliant safety signage with regular reminders to ensure that life-saving first aid provisions can be quickly and easily located when time is of the essence.

Who Needs A Critical Injury Pack Compliant To BS8599-1?

Any workplace, premises or occupation where there is a risk of a bleed injury occuring that standard first aid supplies would not be able to treat.

As Low As £77.67

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Basic first aid provisions such as an HSE or BS8599-1 compliant first aid kits do not have any items to treat major bleeding, yet tens of thousands of UK workplaces and lone workers and sites will have machinery or equipment which could cause a critical injury in the event of an accident or malfunction.

The time it takes to bleed out from a critical bleed is often less than the fastest time it takes for an ambulance to arrive. This is an example of the care gap and why any premises where there is a risk of a critical bleed injury occuring should be prepared with enhanced first aid provisions, such as a Critical Injury Pack compliant to BS8599-1, or having bleed control products included alongside basic first aid provisions.

ProtectUK recommend that 'organisations should undertake an assessment to determine if the current first aid kit, such as workplace first aid kits, are adequate for the treatment of immediate life-threatening injuries'. Additionally, the Health and Safety Executive state that risk assessments must "consider the circumstances of your workplace, workforce and the hazards and risks that may be present."

It is recommended that consideration should be given to:

do they support the treatment of those with major bleeding?
do they support those who are not breathing as a result of unconsciousness or an obstructed airway, typically after a head injury or cardiac arrest?
are they able to help more than one injured person?

The HSE also recommend that the public be taken into consideration when determining first aid requirements.

Workplace Critical Injury Packs Compliant To BS8599-1 have been specifically designed in line with the BS8599-1 standard to be issued as a supplementary resource to small, medium or large first aid kits for workplaces or lone working where there is a hazard that could result in a critical injury such as a major bleed. These kits are also designed with contents that can be used with minimal first aid knowledge.

Alternatively, you may wish to supplement your existing basic first aid supplies with items from Critical Injury Packs.

Categories

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Bleed, Trauma & Mass Casualty Response

Guidance On Enhanced First Aid Provision & Preparedness

Why Should I Enhance My First Aid Provisions?

Public premises and events

Workplaces or sites with any hazards

What Should I Consider When Enhancing First Aid Provisions?

Is your first aid kit adequate?

Why Should Organisations Ensure Adequate First Aid Preparedness For Mass Casualty Events?

Bleed Control Kits

How Can Organisations Ensure Adequate First Aid Preparedness For Terror Attacks?

Remember:

What Is Martyn’s Law?

How Does Protection of Premises Bill (Martyn’s Law) Affect First Aid Obligations?

What Is The Care Gap?

What Is A Public Access Trauma (PAcT) Kit?

Who Should Provide PAcT Kits?

Why Should I Install PAcT First Aid Kits?

How Many PAcT Kits Do I Need?

Where Should PAcT Kits Be Located?

This graphic gives guidance on some places where it may be best to locate PAcT across different types of premises:

How Should I Install a PAcT Kit?

What Goes In A PAcT Kit?

Why Should I Add Bleed Control Products To Workplace First Aid Provisions?

Which Bleed Control Products Do I Need?

Bleed Control Kits

Workplace Critical Injury Kits

PAcT Kits

Mass Casualty Points & Stations

Tourniquets

Trauma Dressings

Haemostatic Dressings

Haemostatic Granules

Gauze

Chest Seals

Other Items

Who Needs A Critical Injury Pack Compliant To BS8599-1?

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