Request a place HART Mod 4 (Urban Search and Rescue) Paramedic

Course Details

  • Course duration: 2 week residential course
  • Course category: Command, Resilience
  • Start/finish time: Start time: 0830
    Finish time: 1730 (variable)

It is essential that HART units maintain the capability to deliver excellent clinical care to patients in an Urban Search and Rescue (USAR) environment. This course builds on the skills and knowledge gained from Module 1, 2&3 (Incident Response Unit (IRU)) Course, and focuses on confined space medicine, safe systems of work and delivering high quality clinical care in difficult and challenging environments.

PLEASE NOTE: These will only be open to operational members of HART teams and places will be allocated by each unit’s HART Manager.  Aspiring candidates should contact their HART training manager for information about the selection process that will be used to select candidates for their HART unit.

SWAH – It is the responsibility of the Trust to ensure all attendees are working in line with the PPE requirement regulations.

Course overview

This course builds on the skills and knowledge gained from Module 1,2&3 (Incident Response Unit (IRU)) Course, and focuses on confined space medicine, safe systems of work and delivering high quality clinical care in difficult and challenging environments. The new format Module 4 course (2016) will run over two sites.  This will be made up of Week 1 at Winterbourne Gunner, where the delegates learn their theory and are introduced to the new training facilities; which include trench, container, SWaH rigs and rubble pile.  Week 2 – will be held at the Fire Service College where the delegates are put through a series of challenging scenarios, culminating in a large multi agency exercise.  The programme should be regarded as dynamic, either to take advantage of opportunities as they present or to work around other students using the specialist rigs.

The instructors will be drawn from experts in their fields across the Ambulance and Fire services and includes SME’s from other key areas where their specific expertise is required. The course faculty will comprise of at least four NARU instructors and one Fire & Rescue Service tutor.

Course Programme contents

The course consists of a mixture of theory and practical sessions including the following elements:

  • USAR Context and Framework
  • Health and Safety
  • Welfare
  • Medical and Environmental Emergencies
  • Confined Space Medicine
  • Confined Space Operations
  • Clinical Care in USAR Environments
  • Remote Patient Assessment
  • Safe Working at Height
  • Building Construction and Collapse
  • Fire Service USAR Operations

The course programme has been constructed to maximise the time and facilities available. The programme should be regarded as dynamic, either to take advantage of opportunities as they present or to work around other students using the specialist rigs.

Intended Learning Outcomes

On completion of this course students will be able to:

  • Demonstrate knowledge and understanding the Health & Safety implications of a USAR incident
  • Explain the capabilities of FRS USAR response
  • Demonstrate the practical aptitude to operate safely in a USAR situation
  • Be competent and confident in delivering clinical interventions in confined spaces or at height
  • Be able to package and extricate patients in challenging situations with due consideration for patient and staff welfare

The course maps to the following:

  • NH SOP 6, 7 & 8 and associated EDS and TIS

This course is aligned to the following NHS Commissioning Board Core Standards for EPRR which will assist Ambulance Trusts in meeting these standards by providing relevant educational modules:

9.11 Have a Hazardous Area Response Team (HART) in line with the current national service specification, including a vehicles and equipment replacement programme
9.38 Explain the arrangements for managing triage, treatment and transport for casualties

Intended Audience

This course is aimed at NHS Ambulance Service Paramedics that have the necessary qualifications and skills and operate as part of a Hazardous Area Response Team. Students MUST attend Module 1, 2&3 (IRU Course) and certificated SWAH and Confined Space courses prior to attending the Module 4 (USAR) course.

We recommend that students have at least one year’s experience as a HART paramedic prior to Module 4 (USAR) course and that they have attended a SWAH refresher within six months of the course.

Eligibility Criteria

Students on this course must be HCPC registered Paramedics who operate as part of a Hazardous Area Response Team.

It is incumbent on the student to ensure they have a fitness level commensurate with the demands of the course.  The minimum fitness requirements are those demonstrated in the physical competency assessments (PCA) conducted during the selection process.  However NARU emphasis’s that this is a physically and mentally demanding course and students should be well prepared.

It is a pre-requisite of this course that students will have successfully completed the HART Module 1, 2&3 (IRU) course and certificated SWAH and Confined Space courses prior to attending the Module 4 (USAR) course.

SWAH – It is the responsibility of the Trust to ensure all attendees are working in line with the PPE requirement regulations.

Comments from previous attendees

  • “The instructor’s enthusiasm has made this a fantastic course.  The information and techniques learnt have given me confidence in all aspects of my HART role”
  • “Great course, enthusiastic instruction.  I am ready for anything now!”

Methods of Delivery

The course content is delivered using a variety of theoretical sessions from training faculty and external Subject Matter Experts (SMEs).  Students are then given the opportunity to reinforce the theory in numerous realistic practical exercises.

If you have any additional education needs which may impact on your learning please ensure the course lead is made aware prior to your attendance.  You can also contact

Dress Code

Normal Trust uniform with collars must be worn during classroom sessions and at mealtimes, i.e., Ironed work shirt and clean boots.  The dress code for the evenings is smart/casual, for example shirts with collars and clean footwear.

Due to wearing respiratory protective equipment on the practical elements of the course, all delegates are required to be clean shaven at the start of every day.

As per NARU Education Course attendance policy the following must be adhered to:

  • Jewellery – is not allowed under any circumstances by candidates undertaking training.
  • Rings, including wedding rings must either be removed or covered with tape.
  • All body piercings must also be removed.  Flesh tunnels must be blanked or covered with tape.
  • In order to promote a professional image, candidates must ensure that they keep their hair clean and tidy.  Long hair must be tied up.
  • Hair extensions that are secured by metal clips must also be removed.
  • Makeup – As per the manufacturers guidance and RPE regulations, the wearing of makeup is not permitted due to the risk it poses to not only your face fit seal but the face mask material itself.


Course Location

Week 1 the course will be held at:

NARU Education Centre
Defence CBRN Centre
Thorneydown Road
Winterbourne Gunner
Wiltshire SP4 0ES

Photo identification is required for access to DCBRNC.  Please ensure you arrive with enough time to complete the security process, this may take an additional 15 minutes or up to 1 hour during busy periods.  May we suggest that you visit the site the day before (anytime as it is open 24hrs) to get your photo security pass and allow quicker entry on the morning of your course.

View map and directions here.

Week 2 the course will move to:

The Fire Service College
GL56 0RH

View map and directions here


Unless otherwise stated accommodation see email Joining Instructions:

Week 1 – Accommodation is provided as part of the course at Winterbourne Gunner. You can check in from 1200hrs on the day before. No food is available until breakfast on day one of your course.

Please note some rooms do not have on-suite facilities. Winterbourne Gunner is a military site, we have no control over the accommodation.  Rooms are allocated on the day of arrival.

Please bring your own towel and toiletries. For additional comfort may we suggest that you bring your own pillow(s).  (However, pillows are provided)

Breakfast, lunch and dinner is provided during the course, starting with breakfast on day one and finishing with lunch on the final day.

There is a café, cash bar and gym on site. Wi-Fi is available in the accommodation block, however, there is a charge, please speak with the Mess Manager for details.

Week 2 – Accommodation is provided as part of the course at the Fire Service College.  This is available from 1400hrs the day before however, food will not be available.  Your first meal will start with breakfast on the morning of the course.

Please bring your own towel and toiletries.

Breakfast, lunch and dinner are provided during the course.

There is a café, cash bar on site.

Pre-read Downloads

Please complete the JESIP E-Learning module which is a mandatory pre course requirement. Bring a copy of your certificate as proof of completion on the first day of the course.

The following pre-learning material has been selected to help you prepare for the Module 4 (USAR) Paramedic training course. Most of the work should be revision, however some of the material is designed to help you gain an understanding of Module 4 (USAR) and this will assist you with the classroom work.

Please read the articles as they provide some background reference to Module 4 (USAR), the clinical components and the reasoning behind the training programme. You should be familiar with your Trust Major Incident plan, particularly the sections concerning command and control, as well as liaison with other organisations.


  • Ambulance Proclus – Lyon Haul Pack

  • Ambulance Proclus – SWaH Recover Pack Video

  • Ambulance Proclus – Confined Space Insert

  • Ambulance Proclus – JESIP Rail Incidents Guidance 01/10/21

  • Ambulance Proclus – Appendix NH 6.1 What is a Confined Space? flowchart

  • Ambulance Proclus – Appendix NH 6.2 Confined Space Flowchart

  • Ambulance Proclus – NH SOP6 Overview – Confined Space Operations

  • NARU: Confined Space and Unstable Terrain National Standards

  • Ambulance Proclus – NH SOP7 Overview – Safe Working at Height

  • NARU: Safe Working at Height National Standards

  • Ambulance Proclus – NH SOP8 Overview – Unstable Terrain

  • Ambulance Proclus – Triage Sieve

Latest Clinical Practice Guidelines

You should be familiar with the latest version of JRCALC guidelines (including supplementary ones), particularly the following:

  • Pain Management in Adults & Children Guidelines
  • Traumatic Cardiac Arrest – including HOT Principles
  • Recognition of Life Extinct (ROLE)
  • Advanced Life Support: Adults & Children
  • Sepsis
  • Heat-Related Illness
  • Hypothermia
  • Glycaemic Emergencies: Adults & Children
  • Trauma Emergencies: Adults & Children
  • Head Injury
  • Limb Trauma

Extended Skills and Drug Therapies

Staff attending the course who have been trained and authorised to deliver extended skills and drugs on behalf of their Trust should be familiar with all protocols and guidelines surrounding those areas. These include, but are not limited to:

  • Surgical airways
  • Ketamine
  • Midazolam
  • Calcium Chloride
  • Digital nerve blocks

Further recommended texts

  • Tortora G.J, and Grabowski S.R, 2007, Principles of Anatomy and Physiology 10th Ed.,John Wiley & Sons, New York
  • Salomone J.P, Pons P.T, (Eds),2007, PHTLS Prehospital Trauma Life Support 6th Ed., Mosby Elsevier, Missouri

Equipment Requirements

  • The following notes have been prepared to help you make the most of your stay and to bring the appropriate clothing and equipment.

Each student must bring the following: 

  • 2 x HART Trust-issued standard boots (1 clean set will be required for classroom/dining wear)
  • 1 x Head torch and spare batteries
  • 1 x Safety glasses (EN166)
  • Sufficient Ear pro
  • 1 x Knee pads
  • 1x set Incident Ground Kit
  • Technical Rescue Gloves
  • Whistle
  • 1 x helmet for USAR operations
  • Sufficient Respiratory Protection Equipment (RPE) for a two week course (minimum 10 units advised) – Fit-test certificate specifically for personal RPE
  • An additional Towel/wipes – for use during exercise
  • 1 x Water bottle
  • Pen & Paper for note taking
  • Surgical Masks – for 2 week course
  • Enough changes of underclothing and warm clothes bearing in mind the time of year
  • Clothes to be worn underground kit do not need to be uniform (note: you will get hot / wet in practical work)
  • Sports equipment if you wish to use the gym or swimming pool (note: whilst fitness is encouraged, injuries sustained may result in you taking no further part in the course) – if open.



Eye, hand, head and knee protection is not supplied.  Students must bring their trust-issued, HART-standard PPE.

For the duration of the course students will be required to provide an adequate number of tight fitting face masks (half face mask or FFP3 dust masks).  As a guide, we recommend that each student brings at least 10 of their trust-issued masks.  In order to comply with Health and Safety Regulations students must provide a face fit certificate.  This must include the student’s name, the make/type/size of mask they will be using on this course, test date and type of test performed.

We no longer supply bottled water so students must bring a water bottle to refill from the water fountain.




Request a place on this course today

This course is fully booked
Date: 28 Feb - 11 Mar 2022
Location: NARU Education Centre