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Reactive Medical – Event Cover & Expedition Policy

 

(Eleven Forty One is a trading name of Reactive Medical Ltd )

Document Status: Approved
Version: 1.0
Effective Date: 09 June 2025
Review Due: 09 June 2026
Policy Owner: Medical Director

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1. Purpose

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To provide a detailed framework for planning, delivering, and evaluating medical cover at events and expeditions, ensuring patient safety, legal compliance, and best‑practice clinical standards in line with the • Purple Guide (2024), • JRCALC UK Ambulance Service Guidelines (2024), and • Faculty of Pre‑Hospital Care (RCSEd) Guidance (2023).

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2. Scope

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Applies to all Reactive Medical personnel (employed, contracted, or voluntary) providing:

  • Public events (music, sports, film sets, community fairs)

  • Mass participation events (marathons, cycling sportives, obstacle races)

  • Remote area expeditions (mountain, moor, coastal, overseas) where statutory ambulance response may be delayed.

 

3. Roles & Responsibilities

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RoleKey Responsibilities

Medical DirectorClinical oversight, approval of medical plans, PGDs & SOPs, liaison with statutory services

Event Medical Lead (EML)On‑scene clinical commander; ensures implementation of plan; submits post‑event report

Expedition Medical Officer (EMO)Remote clinical lead; conducts pre‑screening; responsible for medical kit; telemedicine liaison

Clinical Governance LeadAudits PRFs; investigates incidents; monitors CPD

Operations ManagerLogistics, rostering, equipment dispatch, vehicle readiness

Safeguarding LeadReceives and escalates safeguarding concerns

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4. Pre‑Event / Expedition Planning

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  1. Initial Client Consultation

    • Obtain event brief, site plan, expected footfall, participant demographics.

  2. Risk Assessment (see Template EV‑RA‑01)

    • Hazard identification; likelihood/severity matrix (HSE Five Steps).

    • Calculate medical resource using UK CAS Model & Purple Guide casualty ratios.

  3. Medical Plan (EV‑MP‑01) drafted by EML/EMO and approved by Medical / Company Director.

    • Staffing levels & skill mix (minimum FREC 3; ILS/ALS for high‑risk).

    • Equipment list (Annex A) & replenishment strategy.

    • Casualty collection points (CCPs), treatment centres, access/egress routes.

    • Communications plan (radio channels, call signs, cellular dead zones).

    • Adverse weather triggers & contingencies (Met Office warnings).

  4. Client Sign‑Off & Insurance Confirmation.

  5. Notification to Local Ambulance Service / SAG where required (>5 000 attendance).

  6. Pre‑Deployment Briefing (EV‑BR‑01) for all staff — safety, safeguarding, scope, handover pathways.

 

5. Staffing & Competence

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  • Minimum Standard: All clinicians FREC 3; ratios increase to FREC 4/Paramedic for high‑acuity risk.

  • Competency Verification: Annual clinical skills check; scene‑specific drills.

  • Crew Mix Examples:
    • Low‑risk village fete — 2× FREC 3
    • 10 000‑runner half‑marathon — 1× Paramedic Team Leader, 3× FREC 4, 4× FREC 3, 1× First Aider per 1 000 participants
    • Remote mountain trek — EMO (doctor/paramedic), 1× Remote Paramedic, 2× FREC 4.

 

6. Equipment & Medicines

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6.1 Core Event Kit (per treatment centre)

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  • Monitor‑defibrillator (3‑lead ECG, NIBP, SpO₂, EtCO₂)

  • Suction unit, oxygen (B‑type cylinder + regulator), airway adjuncts (OPA/NPA/i‑gel)

  • Trauma kit: CAT tourniquets, haemostatic gauze, dressings, SAM splints, pelvic binder

  • Minor injury supplies: plasters, steri‑strips, irrigation

  • Drugs: listed under PGDs (opiates, antiemetics, salbutamol, TXA, glucagon)

  • Automated External Defibrillators (AED) at ≥ 1 per 500 m radius

 

6.2 Expedition Kit (enhanced)

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  • Portable ultrasound (if EMO qualified)

  • Altitude and hyperthermia monitoring equipment

  • Wilderness medical & dental module, water purification system

  • Satellite communications (Iridium / Garmin inReach)

  • 12‑lead ECG capability and portable blood analyser (i‑STAT) for >14‑day expeditions

 

6.3 Medicines Management

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  • Controlled drugs kept in portable safe; stock reconciled daily (see CD‑REG‑01)

  • PGDs reviewed triennially; staff sign PGD register prior to deployment

 

7. On‑Site / In‑Field Operations

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  1. Arrival & Setup: Treatment centre erected; signage installed; radio check; kit log EV‑KIT‑IN.

  2. Dynamic Risk Assessment: Completed hourly or when conditions change.

  3. Patient Assessment & Recording: Use JRCALC‑compliant PRF (paper or MedicDB app).

  4. Clinical Escalation:

    • NEWS2 > 5, chest pain, stroke FAST positive → Category 1 ambulance request.

    • Paramedic support requested via radio “Code Red”.

  5. Handover: SBAR to NHS crew; copy PRF handed over / emailed via NHSmail within 30 min.

  6. Safeguarding: Concerns reported to Safeguarding Lead within 1 hr; MASH referral ≤ 24 hrs.

  7. Infection Control: 5 Moments of Hand Hygiene, PPE as per risk, clinical waste disposed in UN3291 streams.

 

8. Communications & Command

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  • Call Signs: MED1 (EML), MED2‑n (teams), MEDCOM (Ops HQ)

  • Channels: Primary UHF; backup VHF; event‑control liaison via dedicated talk group.

  • Major Incident: Use METHANE message to statutory services; adopt JESIP principles.

 

9. Transport & Non‑Transport

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  • Default Position: Non‑transporting service — NHS ambulance requested for hospital transfers.

  • Private Ambulance Use: Only if pre‑booked and CQC‑registered; staffed minimum Paramedic + FREC 4.

  • Refusal of Care: Document capacity assessment; provide advice sheet; PRF note “RTI” (Refused Transfer/Intervention).

 

10. Adverse Weather & Environmental Hazards

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TriggerAction

Met Office YellowIncrease hydration points; staff rota review

Met Office AmberSuspend high‑risk activities; EMS stand‑by with ALS capability

Met Office RedEvent stop; evacuate site as per Event Risk Assessment

Lightning < 30 sec flash‑to‑bangCease open‑field activity; shelter protocol

Heat index > 32 °COpen cooling station; misting fans deployed

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11. Post‑Event / Expedition

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  1. Hot Debrief: Within 30 min of stand‑down; record key points on DEB‑01.

  2. PRF Audit: 100 % review for ALS cases; 10 % random sample others.

  3. Incident Reports: Any SI/NM to Clinical Governance Lead within 24 hrs.

  4. Kit Restock & Sterilisation: Completed within 24 hrs; logged in EV‑KIT‑OUT.

  5. Post‑Event Report: Submitted to client within 10 working days; includes caseload, response times, learning points.

 

12. Quality Assurance & Audit

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  • KPIs: Response time to first patient contact, % patients treated on‑site, analgesia compliance, safeguarding referrals, PRF completeness.

  • Annual Audit Plan: Includes at least one major event and one remote expedition.

  • Staff Feedback: Anonymous survey, actioned via Clinical Governance Committee.

 

13. Training & Competency Maintenance

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  • Scenario Training: Mass‑casualty drill annually; remote telemedicine scenario before each expedition season.

  • CPD: Expedition clinicians must complete FPHC Wilderness Medicine module + TEM Alpine Trauma course or equivalent within 3 years

 

14. Review & Continual Improvement

 

This policy is reviewed annually or following:

  • Significant event (e.g. major incident activation)

  • Changes to legislation (e.g. CQC regulations) or guidance (Purple Guide updates)

  • Audit findings requiring revision

Document changes are logged in Appendix A; superseded versions archived per Document Control Policy.

 

Appendices

  • Appendix A: Change Log

  • Annex A: Standard Equipment Lists (Event / Expedition)

  • Templates: EV‑RA‑01 Risk Assessment, EV‑MP‑01 Medical Plan, CD‑REG‑01 Controlled Drugs Register, DEB‑01 Hot Debrief Form

 

 

End of Document

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