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London Ambulance service

1.1 Update on Major Incident Management - Information for all staff

This bulletin has been issued to make staff aware of our current capabilities and contingency planning. Since the events of September 11^th, levels of security in the capital have been raised as a precautionary measure. Despite media and public speculation, there is no intelligence to suggest a specific threat of terrorist activity in the LAS area.

The LAS is recognised as having well-established plans to deal with all major incidents. These arrangements are contained within the Major Incident Plan (MIP) and the London Emergency Service Liaison Panel (LESLP) Manual which addresses multi-agency response to major incidents. These are available at ambulance stations and are an established part of existing training programmes for all staff.

The LAS has been working with government departments and our emergency service colleagues since September 11^th to produce additional contingency plans to augment our well-practiced ‘normal’ response to major incidents in London. The Service has undertaken a comprehensive review of its preparedness to deal with both a conventional terrorist attack, such as an explosive device, and an unconventional attack using chemical, biological, radiological and nuclear (CBRN) agents.

The media has continued to speculate on the potential for chemical or biological attacks in the UK. This has been aggravated by the recent anthrax-related incidents in the USA. It is important to stress that it is extremely difficult to use anthrax to construct an effective biological weapon, capable of contaminating large numbers of people. Contamination in the USA has resulted only from the delivery in the mail of material containing anthrax spores.

Anthrax bacteria can cause infection of the skin, the gastro-intestinal tract and the lungs. In general, it responds well to early treatment with antibiotics. It is the pulmonary form, caused when spores are inhaled, that is potentially the most serious. It should be noted that anthrax is not contagious and cannot be transmitted from person to person.

There have been no incidents in the UK which have confirmed the presence of anthrax. The situation is subject to constant review and additional measures to protect staff will be considered if the situation changes. Vaccination is available but is not recommended for the prophylactic treatment of health workers; its administration is restricted predominantly to the military.

LAS CBRN capability

· The LAS has a well-established capability to respond to CBRN incidents. The LAS MIP has included a chapter on CBRN for a number of years that was revised and re-published in 2000.

· Senior officers from the LAS participate regularly in CBRN-related training and exercises with the other emergency services in London and the UK.

· We have the proven ability to deploy decontamination units with well-trained staff in full protective equipment. These units can be used for the decontamination of patients either on scene or at an A&E department if patients have made their own way to hospital.

· The LAS is working with the Department of Health (DoH) and others to develop contingency plans for the decontamination of larger numbers of patients, should the need arise.

· Where there has been a confirmed or suspected release of CBRN agents, frontline staff will be asked to attend a predetermined RVP and a HAZMAT team will be deployed to decontaminate patients prior to their transportation to hospital.