Five things you can do to prepare for a major incident

In the last few days those of us in the UK have been reminded again of the background threat of terrorism. Amongst all the interesting, tragic and heroic stories that came out of the Westminster attack, one point that is reinforced every time something like this happens is that it will always be ordinary people who are first on scene. Even in one of the most heavily policed locations in Britain, and with what was undoubtedly a rapid and efficient response by emergency services, the first few minutes of any disaster will be dominated by the actions of civilians.

To most people I think this should raise the question of what would I do under those circumstances? Am I ready, could I help, would I be useful or in the way?

Here are five broad categories for things that anyone, from any walk of life, should be doing to prepare for any kind of serious incident. And I don’t just include terror attacks in that, after all, we are all still incredibly unlikely to be involved in a terror attack. Being involved in or on the scene of a car crash is far more likely, as is some kind of natural disaster, a building fire, or even a serious workplace accident. So, rather than endlessly worrying about and preparing for very frightening but extremely niche scenarios, I have tried to provide thoughts that are useful to a wide range of circumstances.

Think ahead

The best predictors of survival in a disaster has been shown time and again to be one thing: thinking ahead, and mentally rehearsing actions to take when things go wrong. The people who sit on a plane and ignore the safety briefing because they’ve heard it all before are often the ones who, when the cabin is filled with smoke or water and panicking people, just follow the crowd to an exit that isn’t actually their nearest one. The people who have listened to the briefing and actually ‘taken a moment to familiarise themselves with their nearest exit’ as the cabin staff always tell us, are much more likely to be able to quickly get off the plane.

By the same token, being aware of exits in buildings, and your routes into and out of public places is always a sensible precaution. It doesn’t have to be a sort of Jason Bourne-esq obsession, but where is the harp in taking a moment, when you walk in somewhere new, to just think about the layout, exits, and possible secure rooms and think for a moment about what you would do if something happened.

It is mental rehearsal, without letting it become an obsession, that breaks down the momentary freeze that most people experience in high-stress situations. If you have already thought about what you are going to do, and how you are going to do it, it is much easier to force your body into action quickly.

Keep fit

There are very few crisis or disaster scenarios where one wouldn’t prefer to be fit. Whether it’s as simple as evacuating a building or vehicle, or something more complex; being able to run short distances, pull yourself up onto objects, squeeze through tight spaces, and so on is all bound to be advantageous. Perhaps more importantly, if you can do all that and still be in a position to assist others – carrying the young, old or less mobile, moving wounded people to a place of safety, and so on – then you can be a real asset and not a hindrance.

‘Fitness’ is all relative. In my opinion the word ‘fit’ alone means nothing, since it is followed by an unspoken ‘…for…’. What exactly you want to be fit for is up to you, but I would suggest that far more useful than being able to lift weights or even run marathons (much as both are fun leisure activities) is being ‘fit for life’. That means being agile and mobile; able to sprint short distances and jog slightly longer distances, lift your own bodyweight, do a few pull-ups, jump onto or over objects, pick up something heavy and run with it for a bit, and so on. This kind of basic fitness, based around functional movements related to real-life activities is what will help you get through an ordinary day without feeling tired and out of breath, and will definitely help you get through a crisis scenario. If you also want to get massive, run ultras, cycle hundreds of miles or just become amazing at golf then crack on, but don’t neglect your functional athleticism.

Do a first aid course

One of the most impressive facts that came out of last week’s attack in Westminster is the way that an MP, Tobias Ellwood, provided first aid and ultimately CPR to PC Keith Palmer immediately after the attack and seemingly even after the arrival of paramedics. The eventual tragic outcome takes nothing away from the bravery and clear-thinking that Mr Ellwood seems to have displayed during the chaos and fear of those first few moments.

It’s important to note that Mr Ellwood didn’t simply have a go; he is a trained first aider and indeed is an ex regular and current reserve Army officer, meaning that he will have conducted battlefield first aid training at least once a year since around 1989 when he commissioned.

There are two important points here. The first is that as many people as possible should attend a first aid course. The lowest level army course that all soldiers complete is actually barely different to any civilian emergency first aid course, albeit with a bit more focus on catastrophic injuries and the use of techniques that civilians tend not to be trained in, and it is unlikely that Mr Ellwood used any skills that a First Aid At Work practitioner could not have. What saves lives in the minutes after an attack is relatively simple: the ability to clear an airway, stop major bleeds and if necessary deliver CPR. If not done, those will kill people before even the fastest-responding ambulance can arrive but, if those are done, almost everything else can wait ten or fifteen minutes and be left to the trained medics. If you can be that person who is able to immediately start delivering competent basic first aid within seconds of a person being injured, you genuinely have the ability to save lives.

The second point is that Mr Ellwood, as I mentioned, had almost certainly benefited from two things that Army medical training provides that not all civilian courses do: realistic, high-pressure testing scenarios and constant repetition on at least an annual basis. As in the first point in this post, both of these are vital to overcome the freezing and mental confusion of a major incident. Simply being trained is not enough – you must practice your skills under pressure, and you must constantly refresh under the supervision of a qualified person.

Read the advice

This sort of goes back to the first point, but remember there is actually a lot of advice out there if you read it. The CitizenAid app provides lots of useful information, the NPCC publish information about what to do if caught up in an attack (Run, Hide, Tell), the FCO publishes comprehensive travel advice, and so on. It hardly needs stating that trying to find this information during an incident is futile – you need to take time to familiarise yourself with it in advance, and be ready to put it into practice or adapt your plans if required.

Carry some basic kit, at least sometimes

This is a bit of a tricky one because it’s hard to know what is sensible and practical and what is overkill, especially if you want to avoid constantly having to carry a bag around with you. Would it be beneficial if everybody at the scene of a major incident was first aid trained and carrying a battlefield dressing and a CAT tourniquet? Yes, probably, but does that mean you should carry those everywhere you go…? I’m not sure. (Especially the tourniquet; those are oddly controversial and most civilian courses won’t train you to use one so obviously only use equipment you are trained to use.) Equally, knives, torches, seatbelt cutters and window punches can also be extremely useful, but again it can get silly trying to carry everything all the time.

What is the compromise? Well, personally, I carry a UK legal (that’s the subject of a future post) pocket knife and a very small torch almost everywhere I go. It’s not much, but there are plenty of circumstances where light is helpful especially in a crisis. I have a few small first aid kits that I keep in various bags so that I generally have one on me, and I have a better first aid kit in the car, including some kit that could deal with more catastrophic injuries.

It’s not ideal, but it seems like a fair balance between having some equipment but not needing to wear a utility belt everywhere I go. Sticking some decent kit in your car is a no-brainer, you have plenty of space and it’s probably the location where you are most likely to either be involved in or come across a serious incident. Beyond that, it’s really up to you. The best advice I can give us to at least own some kit that you know how to use. Have plenty of first aid equipment of various types including battlefield dressings, chest seals and burn dressings, and then make pragmatic decisions about what you carry when and where.

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