High threat and medical training

Medical training
Hostile Environments Awareness Training can equip individuals with skills such as lifesaving advanced medical training

Oliver Carter, managing director and principal consultant at Oscar Charlie Bespoke talks about preparing for operating in austere and high threat regions by conducting intensive security and medical training

As we gaze out over today’s ever-evolving global security landscape, it comes as no surprise that we have seen an exponential emergence of companies springing up, aiming to offer a plethora of security, risk management and medical training courses to individuals or organisations seeking to operate in these remote, austere and often exceptionally dangerous environments. It stands to reason that these dangerous and often fiercely contested territories are contested for a reason, be it religious, political or financial.

These factors are more often than not also some of the same key influencing factors why we see organisations sending individuals into these territories; whether that’s an NGO facilitating aid in a conflict zone, media organisations covering the news, or oil and gas companies exploiting these often resource-rich lands. As long as there are rewards to be had, we can rest assured there will always be people willing to shoulder the opposing risks.

The difference between life and death

A well thought out and tailored Hostile Environments Awareness Training (HEAT) package can literally mean the difference between life and death. It can equip individuals not only with the hard skills such as lifesaving advanced medical training and techniques, but also the soft skills that are just as important and often overlooked, such as cultural awareness, planning exercises and the development of communication skills – all potentially just as lifesaving.

Along with such a training package must come a suitably experienced and qualified instructional team: a team with significant and recent experience operating in hostile environments; a team with robust and relevant medical experience, backed not only with qualifications but with current clinical exposure to real patients; and, perhaps most importantly, a team founded on integrity and trust.

As the global security landscape evolves, so too do the threats. The importance of receiving up to date, relevant and credible security and medical training to equip individuals in the best way possible to operate safely and effectively in these environments cannot be overstated.

Risk is whatever the bearer perceives it to be, and it is important to remain cognisant of this fact. Risk can also take many forms, whether that’s reputational, political, financial or physical. It is therefore important for any individual or organisation to understand the risks they face before they can quantify and qualify them and go on to develop appropriate mitigating action.

It is fair to suggest, for example, that Egypt and Tunisia are becoming increasingly unstable, primarily due to organic political instability and their proximity to other hostile regions; yet around 231,000 British nationals visited Egypt in 2016, with most visits being trouble free. Despite extensive media coverage of these regions, individuals and organisations are still willing to travel to these locations for both business and tourism purposes.

The need for HEAT medical training

Anyone who has worked in environments such as the Middle East or North Africa will likely tell you that specialised medical training received in areas such as security management, travel planning, cultural awareness and first aid is of critical value.

The purpose of providing HEAT training to individuals travelling to, or operating in, hostile environments is to allow them to operate as safely and effectively as possible in a complex and challenging environment. Situations encountered could be as minor as a small vehicle bump or becoming delayed whilst moving through a checkpoint, through to being involved in a terrorist attack such as a bomb incident or active shooter scenario. It is a proven concept that individuals who have been exposed to a situation before will be able to call upon that training and act in a more appropriate manner should a similar incident arise.

Advanced medical training
© U.S. Army Europe

A good example of this is using the CABCDE approach to casualty management: this system is utilised by even the most advanced medical practitioners, who will have used this approach in medical training scenarios many times before. This means they are more likely to react instinctively when managing a casualty for real, meaning that when there are multiple concurrent stresses, training will kick in, and the likelihood of overlooking important elements in the management of the casualty can be reduced.

  • C – Catastrophic haemorrhage
  • A – Airway (with cervical spine control)
  • B – Breathing
  • C – Circulation (with haemorrhage control)
  • D – Disability
  • E – Exposure

Bespoke security and medical training practices

Oscar Charlie Bespoke’s key areas of training are security awareness and basic and advanced medical training. The company only employs highly qualified and vastly experienced instructors with backgrounds in either UK special forces or other elite military units who have worked in austere, high threat and complex environments.

All instructors have highly developed and niche skill sets, ranging from specialist surveillance and reconnaissance, media security advisors and Health and Care Professions Council (HCPC)-registered paramedics with extensive clinical expertise. This allows for the unique and highly credible provision of real-time and up-to-date training, based on genuine likely situations encountered in hostile environments and evidence-based clinical practice.

As the company title suggests, Oscar Charlie Bespoke specialises in the design and delivery of bespoke training packages, tailored specifically to the client’s unique and exacting needs. This personal approach enables the training syllabus and course scenarios to be focused towards the unique learning outcomes and objectives most appropriate to the theatre of operations, experience of the individuals undertaking the training, and also the nature of the business in question.

The HEAT courses offered by Oscar Charlie Bespoke are generally around five days in duration, although these can be tailored to the client’s needs, whether that’s a one-day refresher for experienced or previously trained individuals, through to a full five-day package that assumes no knowledge and starts off with the very basics.

Courses can be run at our exceptional training facility in the UK or at the client’s location, either in the UK or abroad, provided suitable training amenities are available. Courses generally have a balanced split of security awareness and medical training and a typical course would include theory presentations to ensure a foundation knowledge, followed by slow-time practical training scenarios allowing hands on practice of the skills and techniques.


As the delegates’ expertise and confidence builds, the pace of the training is increased in line with their progress. This ensures maximal training value is achieved by pushing delegates towards the upper limit of their comfort zones, but without the pace running away with itself and training value being lost.

As the course progresses, delegates are split into teams and will work through a series of extremely realistic practical scenarios to test their ability at managing stressful situations. Actors with expert knowledge and experience of operating in hostile environments are employed to add realism to the scenarios and during medical training, all actors are fully briefed by paramedic instructors on how to act and react depending on the injuries sustained and the treatment rendered by the team. If the team is not treating the casualty appropriately, the casualty’s condition will likely deteriorate, just like a real casualty would. These training scenarios form the foundation of what could potentially be encountered during the individual’s deployments and allows delegates to practice all of the skills and techniques taught in a safe and controlled environment.

All scenarios are fully debriefed immediately afterwards to ensure learning points are effectively captured and that any areas of uncertainty or concern are addressed immediately by the expert instructors. Uniquely, Oscar Charlie Bespoke also employs a faculty of expert guest speakers to give talks throughout the course on highly specialised topics such as kidnap and ransom and post-traumatic stress disorder (PTSD). At the end of a typical HEAT course, delegates will have attained a high level of knowledge, confidence and experience to allow them to operate in austere and hostile environments both safely and effectively.

Oscar Charlie Bespoke

Managing director and principal consultant of Oscar Charlie Bespoke, Oliver Carter, has worked as a consultant and security advisor within hostile environments for the past seven years, and has over 12 years’ service within UK elite forces. As well as a security specialist, Oliver is also a highly experienced UK-registered HCPC paramedic who works both on frontline 999 ambulances and also in hospital emergency departments.

Oscar Charlie Bespoke offers a wide range of first aid and advanced medical courses, first responder courses, security awareness and remote medical courses – all with full accreditation from their respective awarding bodies and are fully regulated within the UK.

The ethos of Oscar Charlie Bespoke is one of continuous professional development, evolving our training to meet the ever-evolving threats our clients face. As Winston Churchill said, “to improve is to change, to be perfect is to change often”.

Special Report Author Details
Author: Oliver Carter
Organisation: Oscar Charlie Bespoke Ltd
Telephone: +44 (0)772 044 7148
Email: oliver@oscarcharlie.net
Website: Visit Website


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