IIEC Course: Gareth Wilson


In 2013 the UKMPA took part in a project looking at Pilot Boat operations, with special reference to a pilot falling in the water and the cutter crew’s training for subsequent action and care.

It became apparent that Pilots and cutter crews are working in areas beyond the usual eight minute NHS Ambulance response, and in fact are unlikely to have medical assistance via search and rescue services or ambulance in the first twenty minutes following illness or injury.

This delay puts considerable pressure on cutter crews and Pilots, because rather than recovering someone from the water a rescue involves prevention of death from major loss of blood or asphyxiation, which can occur after about three minutes. Current thinking is rightly focused on how to prevent hypothermia. Research has shown that it takes at least thirty minutes of immersion in UK waters for crew members to become core hypothermic. Casualties recovered before that time may be just ‘cold’. Physiological reactions to cold-water shock play a major part in survivability rates after an unplanned dynamic entry into the water! While this sounds dramatic, the effects are documented and sadly highlighted in some recent tragedies.


Standard HSE or STCW First Aid courses are designed to enable crews to look after the patient in the eight-minute gap before an ambulance arrives. They rely on crews’ recall of course content from many years before, and also on practical skills learnt that may never have been practised. Standard first aid courses and their associated equipment cannot guarantee survival for Pilot or crew while operating at sea.

Looking to improve things, the Technical and Training Committee commissioned Paul Savage, one of the UK’s Leading Maritime Casualty Care experts, to review the current system and develop a bespoke training package and a set of matching equipment.

Paul was Head of Medicine of the RNLI for nine years and in that time revolutionised training of lifeboat crews and lifeguards. He designed and introduced a highly successful yet simple casualty care course that allowed volunteers from all walks of life to become effective, immediate casualty-carers, working in hostile maritime environments. Paul has spent thirty years as an RNLI and Coastguard medic, and for his work was awarded an OBE in 2014.


Paul agreed that on a voluntary basis he would work with the UKMPA to develop a bespoke course. He established a set of treatment check cards to guide casualty-carers through required treatment, removing reliance on memory of courses on casualty care in the heat of an incident. This should improve current ‘First Aid’ training and move it towards an Immediate Casualty Care course, similar to the one that he introduced to the RNLI. Equipment and methods used in this course are similar to those expected from other Search and Rescue responders, so a commonality of approach and equipment, promoting effective treatment, handover and co-operation can be utilised at sea. This can only benefit the patient.

The course was designed using methodologies and research from several sources, including RNLI training and current best practices from the Royal College of Surgeons, the Resuscitation Council and Professor Mike Tipton, a leading expert in the reactions of humans in cold water. The equipment used to teach on the course allows more effective care than ‘first aid’, and has been evaluated and proved in maritime and military environments.

The concept of this bespoke course, named Maritime Immediate Emergency Care Course (Maritime IEC Course), was showcased by the UKMPA at our Conference at Cowes in September this year. Following on from positive feedback, the course has been finalised and the check cards and documentation has gone to print, enabling a 2017 booking programme.

As the course uses specific medical equipment, the course and equipment review go hand in hand. Pilot boat equipment can be upgraded ready for service on the last day of the course. The equipment is specific to the course and special training is therefore required.


To assist with Clinical Governance issues, standardisation and insurance, Paul has agreed to become an Honorary Medical Adviser (HMA) to the UKMPA, personally teaching the courses in the districts to ensure standardisation of quality and approach across the country. All this exceeds usual ‘first aid’ training. Using Paul as an established SAR and Paramedic educator makes for the safest and most easily governed option.

The UKMPA continues to verify and review the course and the check cards and notifies us of any changes and updates. It will also further develop the course, through the HMA, and offer advice and gather feedback from the districts on medical incidents and interventions.

On successful completion of the course, candidates will be issued with an HSE EFAW certificate as well as a Maritime IEC certificate that meets HSE requirements and regulations for Pilot Boats. We are looking towards STCW certification
in the near future. Currently if STCW95 EFA is required the course becomes a two-day course rather than one day, but the aim is to get full STCW95 EFA accreditation for the one-day course, though this will take time. Certification can be upgraded to STCW95 with a small charge per head.

The courses at present will be run
by Paul himself and can be tailored to suit your district’s needs. It is costed much the same as an HSE EFAW or STCW95 course. A review of your current equipment and renewal if required will be quoted on a case by case basis and delivered upon course completion. The course will be held at a location to suit you
and in this way provides a fully mobile solution.

The course is presently a one-day course for a maximum of 12 people and is intense. No one watches someone else’s practice. With three full sets of medical equipment utilised during training, your hands on skills will be tested and evaluated throughout the day. Some practical sessions are encouraged to be outside or on your pilot boats if possible.

Training for basic Search and Rescue techniques is a course component and ensures you can effectively and rapidly search for a lost casualty and request assistance from other SAR organisations. In order to make booking easier for the districts while our website is being renewed, the course bookings will be managed through the following link.


There is an email “contact us” link from this page where you can communicate with Paul directly to discuss your requirements.

Leave a Reply

UK Maritime Pilots' Association
European Maritime Pilots' Association
Internation Pilots' Association SITE SPONSORS
Navicom Dynamics
OMC International