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Reserve Forces & Cadets Association
Northern Ireland


29 September 2018

Achieving the Royal College of Emergency Medicine environmental emergency competencies as a Specialist Trainee can be difficult, driven in part by the rarities of both clinical exposure and clinical expertise. With the support of Defence Relationship Management (DRM)/Reserve Forces and Cadets Association (RFCA), the Royal Navy provided subject matter experts to deliver training themed around diving, decompression sickness, radiation safety and exposure and high-altitude clinical emergencies.

Commander Don Crosbie Royal Navy (RN), Superintendent of Diving, set the scene for his Institute of Naval Medicine (INM) colleagues by providing the background into diving undertaken by the MoD. There was an immediate connection with the Trainees who appreciate the impact of human factors, of managing risk and learning from incidents, albeit in a clinical setting. Diving, like medicine, is complex; it can go wrong, and there must be an action plan for when it does. The medical challenges of diving require a good working relationship and shared understanding between the Naval Military Divers and the INM which was evidenced throughout the presentation.

Surgeon Lieutenant Commander Tom Ottoway (RN) was next to take the floor with a lecture on radiation medicine. INM, in its capacity as advisors to the National Poisons Information Service, can truly claim to own the pinnacle of understanding in this niche area of medicine. Should a radiation incident occur the Trainees have been equipped with knowledge and understanding of the risks involved, how to manage patients and to appreciate the importance of having a plan in place.

Surgeon Lieutenant Adam Griffiths (RN) aptly finished the morning with lectures on diving and high-altitude medicine. In doing so, he was able to draw upon his own personal experience of high-altitude adventurous training. He proudly acknowledged INM’s contribution to the scientific knowledge base in environmental medicine.

No naval day is complete without a jolly on the water. With the help of our HEMS (Helicopter Emergency Medical Service) and RNLI (Royal National Lifeboat Institution) colleagues the team experienced the “man overboard” exercises and conducted simulated resuscitation in this maritime pre-hospital environment.


Overall, it was an excellent multi-agency day during which participants demonstrated a willingness to work together, to share knowledge and to learn with the common objective of informing our practice to optimise the management of patients exposed to an environmental incident.