What medical skills do CP operatives actually end up using?

N

NR Medical Training

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Interested to get the views of others on here.

A lot of people in the close protection world do medical training because it is expected, sensible, or client driven, but in practice I think there is often a gap between what gets taught, what gets remembered, and what is actually likely to be used.

For us, the things that seem to matter most are not always the flashy bits. It is often the basics done well under pressure:
  • recognising that something is going wrong early
  • good patient assessment
  • managing catastrophic bleeding properly
  • airway positioning and basic airway management
  • oxygen where appropriate and within scope
  • good decisions about escalation
  • staying calm and organised when the environment is far from ideal

In reality, most people are not going to be doing advanced medicine on the side of the road. More often, it is about spotting the problem, keeping the patient alive, buying time, and handing over well.

I’d be interested to hear from those actually working in CP roles:

What medical skills or knowledge have you found most useful in the real world?
And what do you think gets overemphasised in training?
 
I’d humbly suggest it depends what environment you are operating in. In central London, you are supposedly (and I’ll leave politics and NHS resourcing comments there) 8 mns away from an ambulance. Therefore, I’d concur that critical injuries such as catastrophic bleeding or airway management then good comms and a handover are critical. You aren’t reaching for a pen knife and a biro at this point. However, in hostile environments, you could be dealing with ballistic and blast injuries with little to no medical infrastructure, and what little there may be might well leave you in a worse state.
 
Fair point, and I’d agree.
Environment really does dictate what matters most. In a central London setting, where advanced help should generally be close, it’s often about managing immediate threats well, keeping things simple, and handing over properly.

In hostile or remote environments, that’s obviously a very different picture. Once you lose rapid access to meaningful medical support, the training requirement changes with it.

That’s probably where a lot of the debate sits really. People talk about CP medical training as though it’s a single standard, when in reality it depends heavily on environment, threat, and expected delay to care.
 
I agree wholeheartedly with you. The term ‘CP’ is an umbrella term, encompassing everything from making Z list celebrities look important, through executive protection and hostile environment via C suite clients and wealthy Sheiks. A better question for you is what area of protection are we talking about? Then go from there.
 
One other thought….. you mention remembering training. How often do people drill? That’s a matter of capacity and time. Not many companies are likely to pay for operators to take a day or two training. Regular refreshing basic skills is better than doing thorocotomy training once a decade ago.
 
Yes, completely agree.

“CP” is such a broad label that it almost becomes unhelpful unless you define the actual role and environment first. The requirement for someone working low threat executive protection in a UK city is obviously very different from someone operating in a hostile or remote setting.

I think the point on drilling is a really important one as well. There’s a big difference between having done some training at some point and being able to perform under pressure when something actually goes wrong. In most cases, regularly revisiting basic, high value skills is probably far more useful than doing something niche once years ago and never touching it again.
 
I'll put my 2 pence worth in...

In all honesty, The level of medical training required by the SIA to obtain a Close Protection license scares me. The minimum is Level 3 FAAW. 3 days. That's it!

Honestly I believe the bare minimum should be FREC3 for anything in the homeland, and arguably FREC4 + SALM for overseas or high risk environments. I know some companies require FREC3 as a minimum however the bare minimum standard of L3 FAAW is just worrying!
 
I can see why you’d say that.

There does seem to be a real gap between minimum licensing requirements and the level of medical preparedness that may actually be needed in some CP roles. As ever, a lot comes back to environment, threat profile, and expected time to definitive care.

For lower risk work in the UK, one level may be seen as enough from a licensing point of view, but that does not automatically mean it is the most sensible operational standard. Once risk, remoteness, or likely delay to care increases, the case for a higher level of training becomes much stronger.
 
NR Medical Training said:
I can see why you’d say that.

There does seem to be a real gap between minimum licensing requirements and the level of medical preparedness that may actually be needed in some CP roles. As ever, a lot comes back to environment, threat profile, and expected time to definitive care.

For lower risk work in the UK, one level may be seen as enough from a licensing point of view, but that does not automatically mean it is the most sensible operational standard. Once risk, remoteness, or likely delay to care increases, the case for a higher level of training becomes much stronger.
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Exactly this. I think it needs to be re-evaluated by the SIA for the minimum medical training requirement.

The minimum requirements are wrong for all SIA licenses in my opinion. SG and DS are EFAW minimum, and CP is FAAW.

The SIA are due to be making some changes in April next year to the curriculum. Ironically at the same time that Martyn's Law becomes enforceable. Although they'll tell you it's just coincidence.

I personally suggest that FAAW 3 day should be the minimum for SG & DS, as they are the most likely to need to administer first aid to members of the public due to the broad nature of environments they work in like concerts and events. It would be handy for the L3 FAAW to have some bolt-ons like ten second triage for this exact application.

Some could argue that FREC 4 would be the ideal minimum for CP roles due to the remoteness or delay in care due to OPSEC, but it isn't a quick qualification to obtain. Hence FREC 3 that can be done in 5 days, not over months and months is a better fit.
 
There is definitely a difference between what satisfies a licensing minimum and what may be genuinely appropriate for the role being carried out. The recent SIA changes have already pushed more trauma and catastrophic bleed content into security first aid training, and close protection applicants still need a level 3 first aid qualification or above, but that still does not settle the wider question of what the operational minimum ought to be.

From an operational point of view, it probably comes back to the same issue discussed above, environment, threat, and likely delay to meaningful care. For some lower risk UK work, one baseline may satisfy the licensing requirement. For higher risk, remote, or overseas roles, the argument for a higher level of training is obviously much stronger. That’s just my view on it, but I do think there’s a real conversation to be had there.
 
NR Medical Training said:
There is definitely a difference between what satisfies a licensing minimum and what may be genuinely appropriate for the role being carried out. The recent SIA changes have already pushed more trauma and catastrophic bleed content into security first aid training, and close protection applicants still need a level 3 first aid qualification or above, but that still does not settle the wider question of what the operational minimum ought to be.

From an operational point of view, it probably comes back to the same issue discussed above, environment, threat, and likely delay to meaningful care. For some lower risk UK work, one baseline may satisfy the licensing requirement. For higher risk, remote, or overseas roles, the argument for a higher level of training is obviously much stronger. That’s just my view on it, but I do think there’s a real conversation to be had there.
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I completely agree with you mate.

I think that maybe this is an opportunity to get some heads round a table, and develop a CP specific med course?

I could think of a few people that would be worth having in the development of it and I'd happily also assist.
 
I think there’s definitely something in that. It would need the right operational and clinical people around the table to make sure it reflects the real world rather than just rebadging existing content. If done properly, I think it could be a worthwhile piece of work.

Appreciate the offer too mate. Feel free to drop me a message or an email if you fancy a chat about it at some point.
 
NR Medical Training said:
I think there’s definitely something in that. It would need the right operational and clinical people around the table to make sure it reflects the real world rather than just rebadging existing content. If done properly, I think it could be a worthwhile piece of work.

Appreciate the offer too mate. Feel free to drop me a message or an email if you fancy a chat about it at some point.
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I'll drop you a message mate
 
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