NES 106 Part 3 Requirements for Medical and Dental Organization in HM Surface Ships and Submarines

Ministry of Defence Defence Standard 02-106 (NES 106)

Issue 1 Publication Date 01 April 2000

Incorporating NES 106 Category 2

Issue 1 Publication Date July 1993

Requirements For Medical AndDental Organization In HM Surface

Ships And Submarines

Part 3Specific Requirements - Medical

Organization For Action InHM Surface Ships

DStan

DStan is now the publishing authority for all Maritime Standards (formerly NESs). Any reference to any other publishing authority throughout this standard should be ignored. Any queries regarding this or any other Defence Standard should be referred to the DStan Helpdesk as detailed at the back of this document.

AMENDMENT RECORD

Amd No Date Text Affected Signature and Date

REVISION NOTE

This standard is raised to Issue 1 to update its content.

HISTORICAL RECORD

This standard supersedes the following:

Naval Engineering Standard (NES) 106 Part 3 Issue 1 dated July 1993.

Ministry of Defence

Naval Engineering Standard

NES 106 Part 3 Issue 1 July 1993(Reformatted)

REQUIREMENTS FOR MEDICAL AND DENTAL ORGANIZATION IN HMSURFACE SHIPS AND SUBMARINES

PART 3

SPECIFIC REQUIREMENTS—MEDICAL ORGANIZATION FOR ACTION INHM SURFACE SHIPS

This NES Supersedes

DGS 89DGS 90

Record of Amendments

AMDT INSERTED BY DATE

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NAVAL ENGINEERING STANDARD 106

PART 3

ISSUE 1 (REFORMATTED)

REQUIREMENTS FOR MEDICAL AND DENTAL ORGANIZATION IN

IN HM SHIPS AND SUBMARINES

SPECIFIC REQUIREMENTS—MEDICAL ORGANIZATION FOR ACTION IN

HM SURFACE SHIPS

The issue and use of this Standard

is authorized for use in MOD contracts

by MOD(PE) Sea Systems and

the Naval Support Command

ECROWN COPYRIGHT

Published by:

Director of Naval ArchitectureProcurement Executive, Ministry of DefenceFoxhill, Bath BA1 5AB

NES 106Part 3

Issue 1 (Reformatted)

iii

SCOPE

1. This part of the NES defines the Specific Requirements for Medical Organization for Actionin HM Surface Ships.

NES 106Part 3Issue 1 (Reformatted)

iv

NES 106Part 3


v

FOREWORD

Sponsorship

1. ThisNaval Engineering Standard (NES) is sponsored by theProcurement Executive, Ministryof Defence, Sea Systems.

2. This NES comprises:

Part 1 Common Requirements — Medical and Dental Facilities

Part 2 Specific Requirements — Medical and Dental Facilities Surface Ships

Part 3 Specific Requirements — Medical Organization for Action — Surface Ships

Part 4 Specific Requirements — Medical and Dental Facilities Submarines

The Specific Requirements are to be read in conjunction with the Common Requirements.

3. If it is found to be unsuitable for any particular requirement the MOD(PE) is to be informedin writing of the circumstances.

4. Any user of this NES either within MOD or in industry may propose an amendment to it.Proposals for amendments that are not directly applicable to a particular contract are to bemade to the MOD and those directly applicable to a particular contract are to be dealt withusing existing procedures or as specified in the contract.

5. No alteration is to be made to this NES except by the issue of an authorized amendment.

6. Unless otherwise stated, reference in this NES to approval, approved, authorized or similarterms, means by the Ministry of Defence in writing.

7. Any significant amendments that may be made to this NES at a later date will be indicatedby a vertical sideline. Deletions will be indicated by 000 appearing at the end of the lineinterval.

8. Extracts from British Standards within this NES have been included with the permission ofthe British Standards Institution.

9. When NES are incorporated into contracts, users are responsible for their correct applicationand for complying with contract and any statutory requirements. Compliance with an NESdoes not of itself confer immuity from legal obligations.

10. This NES has been issued to reflect changes in technical requirements and supersedes DGS89 and 90.

Conditions of Release

General

11. This Naval Engineering Standard (NES) has been prepared for the use of the Crown and ofits contractors in the execution of contracts for the Crown. The Crown hereby excludes allliability (other than liability for death or personal injury) whatsoever and howsoever arising(including but without limitation, negligence on the part of the Crown, its servants or agents)for any loss or damage however caused where the NES is used for any other purpose.


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12. This document is Crown Copyright and the information herein may be subject to Crown orthird party rights. It is not to be released, reproduced or published without written permissionof the MOD.

13. The Crown reserves the right to amend or modify the contents of this NES without consultingor informing any holder.

MOD Tender or Contract Process

14. ThisNES is the property of the Crown and unless otherwise authorized in writing by theMODmust be returned on completion of the contract, or submission of the tender, in connectionwith which it is issued.

15. When this NES is used in connection with aMOD tender or contract, the user is to ensure thathe is in possession of the appropriate version of each document, including related documents,relevant to each particular tender or contract. Enquiries in this connection may be made ofthe local MOD(PE) Quality Assurance Representative or the Authority named in the tenderor contract.

16. When NES are incorporated into MOD contracts, users are responsible for their correctapplication and for complying with contracts and any other statutory requirements.Compliance with an NES does not of itself confer immunity from legal obligations.

Related Documents

17. In the tender and procurement processes the related documents listed in each section andAnnex A can be obtained as follows:

a British Standards British Standards Institution389 Chiswick High Road,London W4 4AL

b Defence Standards Directorate of Standardization and Safety Policy,Stan, 1 Kentigern House, 65 Brown Street,Glasgow G2 8EX

c Naval Engineering Standards CSE3a, CSE Llangennech, Llannelli,Dyfed SA14 8YP

d Other documents Tender or Contract Sponsor to advise.

Note: Tender or Contract Sponsor can advise in cases of difficulty.

18. All applications to Ministry Establishments for related documents are to quote the relevantMOD Invitation to Tender or Contract Number and date, together with the sponsoringDirectorate and the Tender or Contract Sponsor.

19. Prime Contractors are responsible for supplying their subcontractors with relevantdocumentation, including specifications, standards and drawings.

Health and Safety

Warning

20. ThisNESmay call for the use of processes, substances and/or procedures thatmay be injuriousto health if adequate precautions are not taken. It refers only to technical suitability and in

NES 106Part 3


vii

no way absolves either the supplier or the user from statutory obligations relating to healthand safety at any stage of manufacture or use. Where attention is drawn to hazards, thosequoted may not necessarily be exhaustive.


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NES 106Part 3


ix

CONTENTSPage No

TITLE PAGE i. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SCOPE iii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FOREWORD v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sponsorship v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Conditions of Release v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General v. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .MOD Tender or Contract Process vi. . . . . . . . . . . . . . . . . . . . . . . . . .

Related Documents vi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Health and Safety vii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Warning vii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONTENTS ix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 1. MEDICAL ORGANIZATION FOR ACTION 1.1. . . .1.1 Secondary Medical Facilities 1.1. . . . . . . . . . . . . . . . . . .1.2 Location 1.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 2. SECONDARY MEDICAL POSITION 2.1. . . . . . . . . .2.1 Layout 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.2 Equipment 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.3 Cupboards 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.4 Operating Table 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.5 Operating Table Light 2.1. . . . . . . . . . . . . . . . . . . . . . . .2.6 Bulkhead Lining 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.7 Switch Sockets 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.8 Communications 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FIGURE 2.1 TYPICAL LAYOUT OF SECONDARYMEDICAL POSITION 2.2. . . . . . . . . . . . . . . . . . . . . . .TABLE 2.1 SECONDARY MEDICAL POSITIONEQUIPMENT 2.2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 3. EMERGENCY WARD 3.1. . . . . . . . . . . . . . . . . . . . . . . .

SECTION 4. CASUALTY SORTING AREA 4.1. . . . . . . . . . . . . . . . .

SECTION 5. FIRST AID POST 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . .5.1 Location 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.2 Equipment 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5.3 Master Key 5.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 6. FIRST AID BOXES 6.1. . . . . . . . . . . . . . . . . . . . . . . . . .6.1 Location 6.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6.2 Master Key 6.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 7. STRETCHERS 7.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7.1 Neil Robertson Stretchers 7.1. . . . . . . . . . . . . . . . . . . . .7.2 Transport Stretcher 7.1. . . . . . . . . . . . . . . . . . . . . . . . . .


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7.3 General Service Stretcher 7.1. . . . . . . . . . . . . . . . . . . . .

SECTION 8. UPPER DECK MEDICAL STATION 8.1. . . . . . . . . . .8.1 Location 8.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8.2 Compartment Size and Equipment 8.1. . . . . . . . . . . . .

ANNEX A. RELATED DOCUMENTS A.1. . . . . . . . . . . . . . . . . . . .

ANNEX B. DEFINITIONS AND ABBREVIATIONS B.1. . . . . . . .

NES 106Part 3


1.1

1. MEDICAL ORGANIZATION FOR ACTION

a. The medical organization for Action (MOFA) incorporates the SecondaryMedical Facilities that provide cover under emergency conditions by thedistribution of Medical material throughout the ship and the provisioning oflocations from which First Aid Parties may operate.

1.1 Secondary Medical Facilities

a. The Secondary Medical Facilities to be provided are as follows:

(1) In all classes of Ship

(a) Secondary Medical Position (SMP)

(b) Casualty Sorting Area (CSA)

(c) First Aid Posts (FAP)

(d) First Aid Boxes

(e) Stretchers

(f) Upper Deck Medical Stations (UDMS)

(2) In addition to the above facilities Class A and B ships are to be providedwith an Emergency Ward.

1.2 Location

a. All Secondary Medical Facilities are to be remote from the Medical Complex.

b. The SMP, CSA and Emergency Ward are to be within the citadel and within thefollowing parameters:

(1) as near as possible to midships;

(2) on or above the Main Communications Deck;

(3) readily accessible to all members of the ship’s company;

(4) at a height such that the ship’s motion is at a minimum;

(5) as far as possible from sources of heat, noise and infection;

(6) accessible to stretcher cases from all parts of the ship. The dimensions ofa General Service Stretcher are 2300 mm × 590 mm requiring a clearopening of 700mmand aminimum turning radius around corners of 3000mm;

(7) wc facilities are to be within a reasonable distance;

(8) in ships with aircraft lifts, to have direct access to the Flight Deck via thelift.


1.2

NES 106Part 3

Issue 1 (Refomatted)

2.1

2. SECONDARY MEDICAL POSITION

a. The Secondary Medical Position (SMP) to be provided is to be a designated areawithin a Wardroom or Ratings Dining Room where permanent fittings arepartitioned off from the adjacent area.

2.1 Layout

a. A typical layout of the permanent fittings is shown in FIGURE 2.1.

2.2 Equipment

a. The equipment (permanent fittings) is listed in TABLE 2.1.

2.3 Cupboards

a. The cupboards are to be secured to prevent unauthorized use and entry.

2.4 Operating Table

a. A folding Operating Table is to be provided and to have deck securingarrangements for the working position.

b. The table is to be normally stowed folded in the SMP area and is to be accessibleat all times.

2.5 Operating Table Light

a. An Operating Table Light is to be provided and fitted centrally over theOperating Table working position.

b. The light is to be in the deckhead lining with a recess closed off by a removablepanel. The panel is to be suitably tallied.

c. A control unit for the light is to be provided and bulkhead mounted. The unitis to be secured to prevent unauthorized use.

2.6 Bulkhead Lining

a. The bulkheads in the area designated for the permanent fittings of the SMP areto be lined with aluminium backed HPL in compliance with NES 130 Parts 1and 2.

2.7 Switch Sockets

a. 115 V and 240 V switch sockets and plugs are to be incompatible.

b. Three 15 A 115 V 60Hz single phase switch sockets are to be provided andbulkhead mounted.

c. One 15 A 240 V 60Hz single phase switch socket is to be provided and bulkheadmounted.

d. Switch sockets are to be secured against unauthorized use.

2.8 Communications

a. A telephone connected to the Ship’s Main Exchange is to be provided for theSMP if the requirements of the primary use of the compartment does not callfor one.


2.2

b. The Ship’s main broadcast system in the compartment is to be volumecontrolled.

FIGURE 2.1 TYPICAL LAYOUT OF SECONDARY MEDICAL POSITION

Item numbers, description and quantities are tabulated in TABLE 2.1.

Item No EQUIPMENT QTY

1 Operating Table 1

2 Operating Table Light (Overhead) 1

3 Clinical Sink with Cupboard 1

4 Splashback and Toilet Tray 1

5 Towel Rail 1

6 Cupboard 1

7 Instrument Sterilizer 1

8 Splashguard 1

9 Stowage Area for Operating Table 1

10 Transfusion Hooks 4

11 Curtain and Track (as required) A/R

TABLE 2.1 SECONDARY MEDICAL POSITION EQUIPMENT

NES 106Part 3


3.1

3. EMERGENCY WARD

a. An Emergency Ward is to be provided in Class A and B Ships, adjacent to theSMP by the utilization of a large Mess Deck during emergency conditions.

b. The compartment is to be provided with a 240 V 60 Hz single phase supply foruse during emergency conditions.

c. 240 V and 115 V switch sockets and plugs are to be incompatible, quantities asadvised by MDG(N).


3.2

NES 106Part 3


4.1

4. CASUALTY SORTING AREA

a. A Casualty Sorting Area adjacent to the SMP is to be provided.

b. The area designated is to be a suitable Wardroom or Dining Area readily clearedof portable/stackable furniture.


4.2

NES 106Part 3


5.1

5. FIRST AID POST

5.1 Location

a. First Aid Posts (FAPs) are to be sited, in the quantities shown in Part 1 of thisNES, within the following criteria at sites designated by MDG(N).

(1) Accessible from manned stations and quarters without obstructing othertraffic or compromising the watertight integrity of the ship.

(2) Adequate working space of 3000 mm × 2500 mm.

(3) Easy access for stretchers.

(4) Protection from weather, flooding, blast and shrapnel splinters.

(5) Close to hot and cold fresh water supplies.

(6) Close to sanitary facilities.

(7) Good ventilation and lighting including emergency lighting.

5.2 Equipment

a. Each FAP is to be provided with the following:

(1) First Aid Cabinet, bulkhead mounted, in a readily accessible position.

(2) A glass fronted key box, bulkhead mounted alongside the cabinet, toretain the cabinet key.

(3) Stretcher and blanket cabinet.

(4) First Aid Box, bulkhead mounted, with a glass fronted key box built intothe First Aid Box door.

5.3 Master Key

a. A master key to all the First Aid Cabinets is to be provided. The key, clearlyidentified, is to be stowed in Medical Reception.


5.2

NES 106Part 3


6.1

6. FIRST AID BOXES

a. First Aid Boxes, in the quantities detailed in Part 1 of this NES, are to be sitedthroughout the ship, as designated by MDG(N), to provide initial treatment forcasualties.

6.1 Location

a. The boxes are to be bulkheadmounted with their bases 1250mmabove the deckand positioned so that the injured person may easily access them, ie withoutreaching over hatches or leaving walkways.

b. Boxes are not to be located in narrow passageways or congested spaces wheretraffic may be impeded.

c. Additional boxes for routine use in Galleys, Workshops and BatteryCompartments are to be provided in compliance with NES 101 and NES 121Parts 1 and 2 together with Eye Wash Bottles.

6.2 Master Key

a. A master key to all the First Aid Boxes is to be provided. The key, clearlyidentified, is to be stowed in Medical Reception.


6.2

NES 106Part 3


7.1

7. STRETCHERS

a. Neil Robertson, Transport and General Service Stretchers are to be providedthroughout the ship in quantities as detailed in Part 1 of this NES.

7.1 Neil Robertson Stretchers

a. Neil Robertson Stretchers are to be sited at FAPs and other locations in the shipas advised by MDG(N).

b. At each site a cupboard is to be provided for the stowage of stretchers andblankets.

7.2 Transport Stretcher

a. A lightweight Transport Stretcher is to be provided on all ships and stowed inthe Hangar, its immediate vicinity or close to the Upper Deck.

b. The stretcher is to be supplied complete with safety harness and cushion.

7.3 General Service Stretcher

a. The General Service Stretchers are to be sited at locations advised by MDG(N).

b. At each site a cupboard for the stowage of the stretcher and a blanket is to beprovided.


7.2

NES 106Part 3


8.1

8. UPPER DECK MEDICAL STATION

a. Two Upper Deck Medical Stations (UDMS) are to be provided for treatment ofcasualties that have been evacuated to the Upper Deck due to untenableconditions within the ship.

8.1 Location

a. One UDMS is to be sited forward of the ship and the other aft in all classes ofship.

8.2 Compartment Size and Equipment

a. The compartment size and equipment are to be advised by MDG(N).


8.2

NES 106Part 3


A.1 ANNEX A.

ANNEX A.

A. RELATED DOCUMENTS

a. The following documents and publications are referred to in this NES:

See Clause

NES 101 Requirements for Design and Fitting out ofWorkshops Maintenance Spaces and EngineeringStores for HM Surface ShipsPart 1: Common RequirementsPart 2: Specific Requirements

6.1.c.

NES 121 Requirements for Galleys and Associated SpacesPart 1: Common RequirementsPart 2: Specific Requirements Surface Ships

6.1.c.

NES 130 Requirements for Decorative Linings and Compos-ite BulkheadsPart 1: Decorative LiningsPart 2: Composite Bulkheads

2.6.a.


A.2ANNEX A.

NES 106Part 3


B.1 ANNEX B.

ANNEX B.

B. DEFINITIONS AND ABBREVIATIONS

For the purpose of this NES the following apply:

a. Abbreviations

AEL Automatic Emergency Lanterns

CSA Casualty Sorting Area

DNDS Director Naval Dental Service

FAP First Aid Post

HLP High Pressure Laminate

RFA Royal Fleet Auxiliary

MDG(N) Medical Director General (Navy)

QAWT Quick Acting Watertight

S03 (MED(P&P)) Staff Officer 3 Medical Policy and Plans

SPM Secondary Medical Position

SR(Sea) Staff Requirement (Sea)

SRE Sound Reproduction Equipment

UDMS Upper Deck Medical Station

VDU Visual Display Unit

Vessels

CVS Carrier

DD Destroyer

FF Frigate

LPD Landing Platform Deck

LPH Landing Platform Helicopter

MCMV Mine Countermeasure Vessel

OSV Ocean Survey Vessel

b. DEFINITIONS

Utilizable Space The area within a minimum deck height to theunderside of the deck head lining of 2135 mm.

Classification of Medical andDental Facilities

Class A − CVSClass B − LPD/LPHClass C − DD/FF/OSV/MCMVClass D − Minor War Vessels


B.2ANNEX B.

Inside Rear Cover

© Crown Copyright 2000

Copying Only as Agreed with DStan

Defence Standards are Published by and Obtainable from:

Defence Procurement AgencyAn Executive Agency of The Ministry of Defence

Directorate of StandardizationKentigern House65 Brown Street

GLASGOW G2 8EX

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File Reference

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Contract Requirements

When Defence Standards are incorporated into contracts users are responsible for their correctapplication and for complying with contractual and statutory requirements. Compliance witha Defence Standard does not in itself confer immunity from legal obligations.

Revision of Defence Standards

Defence Standards are revised as necessary by up issue or amendment. It is important thatusers of Defence Standards should ascertain that they are in possession of the latest issue oramendment. Information on all Defence Standards is contained in Def Stan 00-00 Standardsfor Defence Part 3 , Index of Standards for Defence Procurement Section 4 ‘Index of DefenceStandards and Defence Specifications’ published annually and supplemented regularly byStandards in Defence News (SID News). Any person who, when making use of a DefenceStandard encounters an inaccuracy or ambiguity is requested to notify the Directorate ofStandardization (DStan) without delay in order that the matter may be investigated andappropriate action taken.

NES 106 Part 3 Requirements for Medical and Dental Organization in HM Surface Ships and Submarines

Documents

Transcript of NES 106 Part 3 Requirements for Medical and Dental Organization in HM Surface Ships and Submarines