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Key messages The deliberate policy of reinforcing the basic training on the morphine auto-injector prior to deployment works.
Two important areas of misunderstanding have been identified: the contraindications of using the auto-injector and that the administration of morphine does not change the triage process.
Confidence in using the auto-injector is high.
Regular medical training in forward locations must continually revise the use of the auto-injector.
Introduction
British personnel deployed in Afghanistan outside Joint Operating Base Bastion on Op HERRICK are issued with two morphine auto-injectors, each containing 10 mg morphine sulphate for intramuscular use. Soldiers are trained to use the auto-injectors for emergency analgesia either for themselves or others when professional medical care is not immediately available.
All soldiers in Afghanistan should have a good understanding of the auto-injector. They are trained in its use on an annual basis as part of the Military Annual Training Tests (MATTs). MATT 3, Battlefield Casualty Drills, follows a set programme designed to deliver 260 min of training on casualty triage and the recognition and immediate treatment of injuries common to the operational environment. It should be delivered as a verbal presentation followed by practical scenarios. MATT 3 instructors do not have to be medics or doctors, they can be any soldier of Lance Corporal rank or higher who has completed the MATT 3 instructor course.
Teaching is revised as part of their pre-deployment training (PDT) and again during deployment by their unit Combat Medical Technicians. Most regiments also aim to train at least one in four soldiers to a higher level on the Team Medics course.
Reason for study
During Op HERRICK 17, Medical Officers in forward locations regularly delivered training to soldiers on the management of trauma casualties. This training included revising the use of the morphine auto-injector. During training sessions, it was noted that some soldiers appeared to lack confidence in knowing when to use the device, its contraindications and basic knowledge about the drug that they were carrying.
The supply and administration of morphine preparations are controlled by the Misuse of Drugs Regulations 2001. 1 Certain specialist nurses and other healthcare professionals can administer controlled drugs in specific situations, 2 but soldiers are expected to recognise the need for and safely administer morphine with...