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Testing the Cross Border Response to a Major Medical Incident

April 28, 2008

Monday 28 April 2008

A large scale cross border exercise took place in the coastal area of Ballykinler in County Down this weekend.  The exercise was organised to test the ability of both the Northern Ireland Ambulance Service and the Republic’s National Ambulance Service to respond jointly in the event of a major medical emergency in the border region.

This is the first time that such an exercise has been co-ordinated in this area of the border and is a follow up an earlier test in 2007 in the North West. The exercise involved months of preparation by the ambulance services personnel who underwent specialised, internationally recognised training in handling multiple casualty situations. This training in Major Incident Medical Management Support (MIMMS) was provided with the assistance of the Territorial Army Medical Services, the Royal Air Force and the Irish Army Air Corps.

The Minister for Health, Social Care and Public Safety in Northern Ireland Michael McGimpsey acknowledged the benefits of such an exercise.  He said: “A major incident involving the emergency services could happen at any time.  It is therefore important to be prepared for such an eventuality. Simulated exercises like this give the emergency services an opportunity to test their skills and ability against their major incident plan.   A coordinated response is vital in such circumstances.”
The Minister for Health and Children, Ms Mary Harney T.D. commenting on the event said: “I would like to congratulate both the organisers and the many participants on the ground in today’s exercise.  Following on the success of the exercise staged at Magilligan last year, the events of today have shown yet again the vast well of willingness for working together for the common good that exists on the island of Ireland.  She continued: “It is most reassuring to know that, in the event of a major medical incident in the border region such as has been demonstrated today, our ambulance, military, police, hospital and fire services, North and South, will provide a co-ordinated response to the highest levels of competence and efficiency.”

The weekend long exercise was sponsored by the cross border health services partnership, Co-operation and Working Together (CAWT).  CAWT’s Director General, Colm Donaghy spoke about the value of the cross border exercise.  He said,  “CAWT has been facilitating cross border collaboration between the health services in both jurisdictions for many years.  Events such as this strengthen and build upon the good relationships which already exist.  In the unfortunate event of a serious medical incident happening in the border region requiring a cross border response, both sets of ambulance services will be in a better position to handle such a challenge. I want to thank all those involved including the military, police, hospital and fire services who gave of their time, resources and expertise to make this weekend such a valuable exercise”.

Two simulated and very realistic incidents were staged in Ballykinler, Co. Down over the weekend, including an evacuation of medical patients following a flammable gas leakage close to a small community hospital and the discovery of a number of very ill non-nationals in a beach area close to a grounded boat.  The Royal Air Force and the Irish Army Air Corps were on hand to airlift the more seriously ill casualties to Craigavon Area Hospital and Cavan General Hospital.

Exercise participant, Jeremy Cowen of the Northern Ireland Ambulance Service, gave his view of the event. He said: “it is a great opportunity to work with colleagues from other emergency services, north and south. I think it is important that everyone who may be asked to respond to a major incident, such as those practiced today, understand each others’ roles. In this way all operations on the ground can be undertaken in the most coherent manner which will be of great benefit to any potential casualties”.

Commenting on the event, Frank McClintock, Assistant National Director, at the National Hospitals Office of the Health Service Executive stated: “this medical emergency exercise provides a unique opportunity for the ambulance services and the other agencies involved, to work together on a cross border basis.  It enables ambulance personnel from our National Ambulance Service and the Northern Ireland Ambulance Services to put into practice our skills and experience, in a very realistic setting. It has been excellent for building relationships across the border and we will continue to foster these relationships after this weekend event.”

The event is being independently evaluated with a view to making recommendations to improve the effectiveness of the cross border response to a major medical incident.



Sadie Bergin
Communications Manager, Co-operation and Working Together (CAWT)
Tel: 028 71 272100 or 00 44 28 71 272100 (from the Republic of Ireland)
Mob: 078 13934745 or 00 44 78 13934745 (from the Republic of Ireland)

Shirlie Murtagh
Acting PR Manager
Tel: 028 3741 4531 or 00 44 28 3741 4531 (from the Republic of Ireland)

Rosaleen Harlin
Area Communications Manager
HSE Dublin North East
Tel: 046 92 80587 or 00 353 4692 80587 (from Northern Ireland)

Notes to Editor

The objectives of the cross border major emergency planning exercise are:To put into practice the Major Incident Medical Management Support (MIMMS) training. MIMMS is the only international standard in major incident medical management.
To rehearse and demonstrate response procedures by the ambulance services with the support of the military, police and fire services in the event of a major medical incident in the border region.
To test and validate ‘bronze’ level command communication systems for both Ambulance Services and Military at incident level.
This cross border emergency planning exercise is designed to strengthen the capacity of the ambulances services from Northern Ireland and the Republic of Ireland to provide mutual support in the event of a major medical emergency. It primarily assesses and tests medical evacuation procedures and communications systems.
The following scenarios were created to support the cross border exercise: -SCENARIO 1:  Ambulance crews responded to an incident in which there has been a flammable gas leak close to a small community hospital setting.  On arrival they discovered that there are 15 in-patients with varying medical conditions requiring evacuation.
SCENARIO 2: Ambulance crews responded to an incident after a passer-by telephoned stating “a number of injured people have been found on the beach”.  On arrival the ambulance crews find that there is a large boat grounded on the beach with a number of casualties lying in the immediate vicinity.  Those found wandering around are displaying unusual signs and symptoms, which may be some form of viral infection.  The total number of casualties is 20-25.
Co-operation and Working Together (CAWT) is a cross border health and social care partnership comprising the border counties of the Health Service Executive in the Republic of Ireland and the Southern and Western Health and Social Services Boards and Trusts in Northern Ireland. CAWT manages a range of cross border health and social care programmes funded by the European Union INTERREG IIIA for Ireland/Northern Ireland 2000 – 2006 (Measure 3.2 Health and Well being) on behalf of the Special EU Programmes Body and the Departments of Health.