Closing the Care Gap: The kit for the First Seconds of an Emergency
On the 22nd of May 2017, the Manchester Arena Bombing shook the foundations of not just the UK but the entire world. The attack took the lives of 22 people, the youngest being just eight years old. In total, 1,017 people were injured by the blast of the bomb, made with nuts and bolts to act as shrapnel.
The attack had a drastic effect on Manchester hospitals and emergency services. Eight hospitals across Manchester were filled with casualties as doctors worked back-to-back shifts to tend to critically injured victims. Meanwhile, other injured people waited at the scene of the attack for hours to be tended to by paramedics.
More recently, in Southport, children attending a dance class were subject to a knife attack, which left three children dead and eight injured, with two adults also in critical condition. Several members of the public rushed to the aid of those injured at the scene before the arrival of paramedics.
When an emergency occurs, there is a ‘care gap’ between the incident and the arrival of medical professionals. The care gap depends on several factors, from the distance between paramedics and the incident site to the number of paramedics available versus the demand. In a terrorist attack, when there are multiple casualties or the site is not yet safe for police to allow paramedics to enter, the care gap presents a life-threatening barrier—unless someone already at the scene can provide support.
The Arena and Southport attacks have shown members of the public to be forthcoming with help to those around them in a crisis. But when someone is critically injured, you need first aid supplies more than anything. Having access to first aid supplies during or immediately after a terror attack can dramatically increase someone’s chances of recovery and survival.
On July 31st, 2024, Manchester Council, in partnership with Steroplast Healthcare and CityCo, launched a scheme to address the care gap with Public Access Trauma (PAcT) First Aid Kits, specially designed kits that enable members of the public to help casualties before paramedics can. Read this guide to learn about the care gap, PAcT kits, and what individuals and businesses can do to help save lives.
What is the ‘care gap’?
The care gap is the time between an incident that causes a medical emergency and the arrival of professionals who can treat the casualty.
When an emergency occurs, people expect an ambulance to be immediately deployed, arrive in a matter of minutes, and for the casualty to receive medical attention immediately upon arrival.
But when a mass casualty event occurs, there are often too many casualties and too few paramedics, so some casualties have to wait to be treated. Further to this, during a terror attack, paramedics and emergency medical services (EMS) are often not allowed to enter the incident site until the police declare it safe. This is because they must prioritise searching for additional threats, securing evidence, and managing any ongoing risks to ensure it is safe for EMS and other first responders.
Until this is done, paramedics must wait, often nearby but not at the actual scene of the incident, unable to attend to the casualties. In this time, a lot can happen.
Severe Arterial Bleeding
Victims with severe arterial bleeding can bleed to death in as little as 5 minutes if not treated promptly.
The Golden Hour
Receiving definitive trauma care within one hour (the "golden hour") significantly increases the chances of survival for severe injuries.
Blood Loss
Losing over 40% of blood means the body can no longer compensate for blood loss. With catastrophic injury, a person could lose 40% of their blood in 3–4 minutes.
Cardiac Arrest
The survival rate for cardiac arrest drops by 10% for each minute without defibrillation and CPR.
The Manchester Arena Inquiry Volume 2 included accounts from people who were in the City Room at the time of the explosion. These documents provided insight into how urgently casualties needed trauma supplies. Casualties can’t wait for the care gap to pass. This led to the conception of a supporting measure that allows those at the emergency site to help, if they can.
The Scheme that Prepares You For Emergencies
The Manchester Arena Inquiry made in response to the 2017 attack identified the care gap. In the Inquiry, PAcT kits were raised as a necessary measure to support first aid in this critical time:
R146 The Department of Health and Social Care should take
steps to ensure that Public Access Trauma kits contain
the equipment that is necessary to enable first responder
interventions to be undertaken. 20.213
R147 The Home Office and the Department of Health and Social
Care should consider how to ensure Public Access Trauma
kits are available in all locations where they are most likely
to be needed. 20.215
Manchester City Council, in partnership with Steroplast Healthcare and CityCo, held an event to launch a crucial scheme addressing the care gap identified in the inquiry. This was the culmination of hard work, public awareness campaigning, and even advocacy from King Charles.
Timeline of events
Thanks to tireless campaigning by Figen Murray, including a 200-mile walk starting at the place where her beloved son was killed and ending at 10 Downing Street intended to urge the Government to adopt Martyn’s Law, and government commitment thanks to urging from the King to adopt anti-terrorism laws, organisations are becoming aware of the vital importance of these measures. On July 31st, Manchester City Council purchased 180 PAcT kits from Steroplast to distribute to entertainment and hospitality venues across every part of the city.
At the event, with Figen Murray also in attendance, Steroplast presented the PAcT kits and demonstrated their use with trained medical professionals.
As seen in the media...
The Manchester City Council, Steroplast, and CityCo’s launch of 180 PAcT kits throughout Manchester city centre has been seen across multiple media outlets. Learn more about the ongoing mission in our article, Closing the Care Gap: The kit for the First Seconds of an Emergency.
About The Public Access Trauma (PAcT) First Aid Kit
The PAcT First Aid Kit was conceived by the National Counter Terrorism Security Office in collaboration with medical experts. It has been designed to offer essential first aid for terror attacks. The kit considers the potential severity of injuries, such as lacerations and loss of limbs, and protects the first aid provider.
Benefits of PAcT First Aid Kit:
What’s in the PAcT kit?
We offer three variations of the kit: with a C-A-T, S.T.A.T., or SOF tourniquet. Find out the difference here:
| Tourniquet | Key Features | Best For |
| C-A-T Tourniquet | Uses a windlass system for tightening, suitable for one-handed application in tactical settings. Widely used by the military and first responders for its reliability and effectiveness in controlling severe bleeding. | Individuals with some training or knowledge of using tourniquets, looking for a proven, reliable option used by professionals |
| STAT Tourniquet | Includes a digital timer to record application time, aiding in precise medical tracking. Features a quick-release mechanism for rapid adjustments and easy application in emergencies. | Those with minimal training, who value precise tracking and need a user-friendly option during emergencies. |
| SOF Tourniquet | Constructed with a durable aluminum windlass for reliable tightening. Suitable for both self-application and use on others, even under severe conditions. Features a robust buckle to ensure it remains securely in place during use. | Users with some experience or training, needing a durable, versatile option that performs well under extreme conditions. |
Each kit comes with instructions on how to use the items inside. A QR code can also be scanned for video guidance to show untrained people how to provide first aid with the kit.
On larger orders, we can package kits with a bespoke label showing information of your choice, including your business logo, colours, and other details.
Get your logo printed on
Own Branded First Aid Kits
A range of family-friendly first aid kits that can display your company branding.
How can businesses be prepared for emergencies?
Both private and public sector businesses have been strongly recommended to enhance their first aid preparedness and response planning, taking into account the potential magnitude of a terrorist attack.
In addition, new anti-terror legislation, Martyn’s Law, will be implemented in the near future, requiring certain businesses to demonstrate reasonable safety measures.
Martyn’s Law will apply to your business if you:
- Have a maximum capacity of over 100
- Have a business premises that is open to the public
Certain ‘qualifying activities’ mean businesses, including those in entertainment, hospitality, education, and transport, fall within the scope of Martyn's law.
Prepare with Adequate Supplies
While the Health and Safety (First-Aid) Regulations 1981 require that employers provide adequate equipment and facilities to their staff in a first aid emergency, there isn’t yet a legal requirement to offer publicly available first aid supplies. The HSE strongly recommends that non-employees be included in first aid assessment and provision, and the introduction of the PaCT Kit is the first step in changing this.
Check your medical supplies. Venues should be equipped with well-stocked workplace first-aid kits that are easily accessible to all staff. Many businesses also install defibrillators in the event of a cardiac arrest—another life-threatening situation that often requires action before paramedics arrive. Trauma bags should also be readily available in certain high-risk workplaces, containing life-saving bleed control products and trauma equipment. Quick action could save a life.
Our definitive guide to workplace first aid explains everything you need to know about first aid provisions as a business owner and includes a free assessment to find out what you should install.
Visit our
Interactive First Aid Guide
Demystify workplace first aid & find out exactly what your business needs.
Learn How to Use the PAcT Kit
ProtectUK, the national counter-terrorism and security advice body in the UK, is a government-recommended source of guidance and free training for businesses that want to install PAcT kits and be more prepared.
Watch this video to find out about NaCTSO guidance for administering first aid during a terrorist attack.
Steroplast developed its PAcT kit with the help of emergency medical professionals, and we provided a professional demonstration of its use at the July 31st launch. We recommend that those adopting the kit check out Action Counter Terrorism’s (ACT) E-Learning course for comprehensive training on counterterrorism and increased security awareness.
View E-Learning Courses from ProtectUK >
Find out more information about the PAcT kit from ProtectUK >
Spread the Word
Improving venue security will result from a combined effort by all venue owners, businesses, and organisations that hold large events. We urge all businesses, organisations, and individuals to spread the word on PAcT kits, encouraging businesses to adopt them and individuals to understand how to use them. Anyone, anywhere, could be that person who needs to perform life-saving first aid.
Being prepared can be the difference between life and death. Equip your business with a PaCT kit now to ensure you can offer people essential support when they need it most.
It’s the kit we hope you never need to use, and the one you’ll never regret having.
The Manchester City Council, Steroplast, and CityCo’s launch as seen on the media:
- BBC News: Venues to get life-saving kits in anti-terror scheme
- Manchester City Council: Emergency trauma kits to be rolled out city wide so that anyone can be a lifesaver
- Yahoo News: Going out in Manchester just changed for the better
- UK Times: Manchester venues to get life-saving kits in anti-terror scheme
- I Love Manchester: Emergency trauma kits to be rolled out city wide so that anyone can be a lifesaver
- The Manc: Hundreds of emergency ‘trauma kits’ are to be installed across Manchester city centre
- British Bulletin: Emergency trauma kits to be rolled out city wide so that anyone can be a lifesaver
