The answer, is that everyone, irrespective of where they live and work, needs first aid training and knowledge.

People die from preventable injuries.  In other words, death because of bleeding caused by injuries which someone with the correct training and a small amount of experience could manage.  The person with this knowledge could include the victim himself/herself, as there is nothing stopping self-help, except a positive mind set.

The fact that people are living and working in a foreign country is particularly relevant.  Sometimes the environment itself may not be as permissive as it is in Western Europe or the US, for example.  Environments of extreme heat or cold can have unusual effects on someone’s health and wellbeing, which can consequently affect decision-making. If you add in any injury to this environment, then complications will soon multiply and compound any situation.

At the same time, cultural and language barriers may also have a significant detrimental effect.   Medical facilities may be more rudimentary in certain parts of the world which are usually associated with international development and security tasks. All this adds up and become component parts of a hostile environment.

Survivability is dependent just as much, if not more, on what happens in the first 2 to 3 minutes following an injury, as it is on the 3 to 4 hours of surgery in a modern operating theatre.  In fact, without that initial intervention and treatment the surgery will not happen or even be necessary, because the patient will be lost. Therefore, a decent grasp of basic first aid principles and self-help is important to the overseas operators, as it may be the difference between life and death.

Soldiers on a modern battlefield are trained and expected to administer self-help as soon as they can, in a large number of cases this is what saved them.  Casualties are able, in horrific circumstances, to administer and receive life saving first aid, which is enough to stabilise them before any medic, or doctor is able to attend to them.  This is especially important if you are in a hostile or none permissive environment, as there is no guarantee you will get to a suitable medical facility quickly.

First Person on the Scene (FPOS) training is the industry standard for people who are responsible for protection of personal and premises abroad.  But what would happen if these operators become casualties themselves? Or if they are otherwise engaged dealing with a live incident whilst you or someone close to you requires lifesaving treatment?

There are many locations where an ambulance just won’t come, does not exist, or is unavailable for a whole raft of reasons.  Ambulance staff, if they do attend, may be there just to transport casualties to hospital, A&E or am emergency room.  They are not trained to deal with casualties at scene in a pre-hospital environment as paramedics are in the developed world.

The question therefore, is not: Do I need first aid training? The question should be: What level of first aid training am I comfortable with?  An assessment of risk and exposure to injury and trauma of yourself and your co-workers is what you should be aiming for, so that you understand what you are getting in to.  The longer you spend in any hazardous or challenging environment, the higher the chances of being involved in an incident.

So, whilst carrying out a short task in, for example, Southern Europe for two weeks, you may well be content with Basic First Aid at Work level of training and qualification, for yourself and any staff you may be responsible for.

However, if you find yourself in an environment which has seen a lot of conflict or instability and perhaps a degree of terrorist activity, you may want to consider something more suited to managing the types of injuries associated with such incidents.  Training and qualifications which will equip you and your colleagues to successfully manage trauma effectively such as FPOS, or in extreme circumstances, Tactical Combat Casualty Care (TCCC).

This doesn’t just apply to injuries that are caused by the actions in the conflict zone and by terror attacks.  The same types of injuries can be caused by road traffic and industrial accidents.  The same mechanism of blast, direct and indirect trauma is the cause of injuries and they can be just as catastrophic.

With the right level of experienced trainers with the correct equipment and knowledge. Learning skills like this can become second nature, so that you can react instinctively when and if the situation arises and keep, you, your friends, colleagues and your family alive.

Correct training will save lives in situations which result in catastrophic blood loss.  Accidents in the home, on the roads, in work or just going about the day to day business of living can have exactly the same effect on the human body as guns, knives and explosives.

Catastrophic bleeding occurs when an artery or major blood vessel is cut.  The average home or workplace are full of objects and machines which can achieve this, yet the average home or workplace first aid kit is ill-equipped to deal with such trauma.

Again, a surprisingly little amount of specialist equipment is required.  Simple pressure techniques, proper bandages and some clotting agents are all that is needed.

Consideration should also be given by the employers of people who are asked or required to enter hostile or unstable environments.  Employers have a duty of care, which is not easily discharged, by simply having the correct level of insurance in place.  I personally have heard it said that “everything will be handled because the insurance cover will be able to sort a casualty evacuation”. But what if the nearest airport can’t operate at night? Or in foul weather conditions? Or what if you and your co-workers are so far out that simply getting medical staff in and casualties out is a matter of hours? What then?

The cost of such training and skill can be obtained for less than you would think, and it could prevent you or someone you live and work with becoming a victim of violence or accident caused by any mechanism or action.  Ultimately, the right knowledge could even save yourself.

Yes, overseas workers need to have first aid training.

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