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 January 1995

Requirements For Medical AndDental Organization In HM Surface

Ships And Submarines

Part 4Medical And Dental

Facilities In Submarines

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 4 Issue 1 dated January 1995.

Ministry of Defence

Naval Engineering Standard

NES 106 Part 4 Issue 1 January 1995

REQUIREMENTS FORMEDICAL AND DENTAL ORGANIZATION

IN HM SURFACE SHIPS AND SUBMARINES

PART 4

MEDICAL AND DENTAL FACILITIES IN HM SUBMARINES

This NES Supersedes

Record of Amendments

AMDT INSERTED BY DATE

1

2

3

4

5

6

7

8

9

10

i

NAVAL ENGINEERING STANDARD 106

REQUIREMENTS FOR MEDICAL AND DENTAL

ORGANIZATION IN HM SURFACE SHIPS AND SUBMARINES

PART 4

ISSUE 1

MEDICAL AND DENTAL FACILITIES

IN SUBMARINES

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 DefenceSea Systems, Foxhill, Bath BA1 5AB

ii

NES 106Part 4

Issue 1

iii

SCOPE

1. This Part of the Naval Engineering Standard (NES) defines the specific Medical and DentalRequirements for Submarines.

NES 106Part 4Issue 1

iv

NES 106Part 4

Issue 1

v

FOREWORD

Sponsorship

1. ThisNaval Engineering Standard (NES) is sponsored by theProcurement Executive, Ministryof Defence, Director Naval Architecture (DNA).

2. This NES comprises:

Part 1 Common Requirements—Medical and Dental Facilities

Part 2 Specific Requirements—Medical and Dental Facilities in HM Surface Ships

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

Part 4 Specific Requirements—Medical and Dental Facilities in HM Submarines

NOTE: The Specific Requirements are to be read in conjunction with the CommonRequirements (Part 1).

3. If it is found to be technically unsuitable for any particular requirement the Sponsor is to beinformed in writing of the circumstances with a copy to DNA 145.

4. The user of this NES either within the Ministry of Defence or in industry may propose anamendment to it. Proposals for amendments which are:

a. not directly applicable to a particular contract are to be made to the Sponsor of theNES;

b. directly applicable to a particular contract are to be dealt with using existing proceduresor as specified in the contract.

5. No alteration is to be made to this NES except by the issue of a formal authorised amendment.

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

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

8. This NES has been issued to reflect changes in Technical requirements and supersedesDGS 89 and 90.

Conditions of Release

General

9. 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.

10. 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.

NES 106Part 4Issue 1

vi

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

MOD Tender or Contract Process

12. 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.

13. 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.

14. 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

15. 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 Institution,389 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, Llanelli,Dyfed SA14 8YP

d. Other documents Tender or Contract Sponsor to advise.

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

16. 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.

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

Health and Safety

Warning

18. 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 inno 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.

NES 106Part 4

Issue 1

vii

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 vi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Warning vi. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONTENTS vii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 1. ORGANIZATION 1.1. . . . . . . . . . . . . . . . . . . . . . . . . . .1.1 SSNs 1.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.2 SSBNs 1.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 2. FACILITIES 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.1 Primary Facilities 2.1. . . . . . . . . . . . . . . . . . . . . . . . . . . .

FIGURE 2.1 HOOKS—OVERHEAD 2.2. . . . . . . . . . .FIGURE 2.2 BERTH—MEDICAL 2 TIER 2.3. . . . . .

2.2 SSBNs 2.4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.3 Secondary Facilities 2.4. . . . . . . . . . . . . . . . . . . . . . . . . .2.4 First Aid 2.4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.4.1 SSNs 2.4. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FIGURE 2.3 FIRST AID BOX WITH INNERCONTAINER 2.5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.4.2 SSBNs 2.5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.5 Medical Store 2.6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.5.1 SSNs 2.6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.5.2 SSBNs 2.7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.6 Atmospheric Monitoring Equipment 2.7. . . . . . . . . . . .

SECTION 3. ADMINISTRATION 3.1. . . . . . . . . . . . . . . . . . . . . . . . .3.1 SSNs 3.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.2 SSBNs 3.1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

NES 106Part 4Issue 1

viii

NES 106Part 4

Issue 1

1.1

1. ORGANIZATION

1.1 SSNs

a. The space required within the Submarine and the volume of medical storescarried will be the same for all SSNswhether they carry aMedical Officer or not.They are to be regarded as the minimum requirements whichmay be enhancedwhere space is available.

1.2 SSBNs

a. The space required within the Submarine and the volume of medical storescarried will be the same for all SSBNs. They are to be regarded as theminimumrequirements which may be enhanced where space is available.

b. The Medical and Dental Facilities required are structured as follows:

(1) Primary Facilities;

(2) Secondary Facilities;

(3) First Aid;

(4) Medical Store;

(5) Administration.

NES 106Part 4Issue 1

1.2

NES 106Part 4

Issue 1

2.1

2. FACILITIES

2.1 Primary Facilities

a. A dedicated space for the consultation and treatment of patients is to beprovided and is to be achieved by utilizing, when necessary, a nominatedMedical Branch Rating’s Bunk Space. The bunk is to be:

(1) a 2-tier bunk, as detailed in FIGURE 2.2, with full length end panels andstorage lockers. The upper bunk, of the folding type is to be at a heightappropriate for the examination of a patient lying in a bunk(900−950mm).

(2) sited for accessibility and maximum privacy (eg forward bunk space);

(3) capable of being screened off from the adjacent bunk space;

(4) sited where noise, motion and extremes of temperature are at an optimalminimum;

(5) within easy access to sanitary spaces.

b. In addition to the requirements of Clause 2.1a. the following are to be provided:

(1) stretcher accessibility;

(2) local lighting to be enhanced to a minimum of 300 Lux;

(3) overhead hooks as detailed in FIGURE 2.1;

(4) additional secure lockable stowage of 1.5m3 capacity sited in the nearvicinity.

NES 106Part 4Issue 1

2.2

NOTES:

1. Hooks to be either Stainless Steel or Chromium plated.

2. In emergency, operating station hooks to be moveable ie tapped into plate and stowed,when not in use, in medical equipment cupboard or clipped into light recess.

FIGURE 2.1 HOOKS—OVERHEAD

NES 106Part 4

Issue 1

2.3

FIGURE 2.2 BERTH—MEDICAL 2-TIER

NES 106Part 4Issue 1

2.4

2.2 SSBNs

a. The Sick Bay is to be a self-contained dedicated area providing examination,treatment and dispensary facilities; it is to be a special care unit consisting ofa single berth bunk with resuscitation and medical administration facilities.

2.3 Secondary Facilities

a. A casualty sorting area for the centralization of large numbers of casualties isto be provided and is to include the Secondary Medical Position (SMP). Asuitable area would be a Dining Hall/Recreation Space or Wardroom, but itmust be ina different location from theDamageControl Headquarters (DCHQ).Stretcher access must be provided to the area selected.

b. The minimum requirements for the SMP are:

(1) a McVicar Mk II operating table complete with accessories ie lights andinfusion supporting rods (6530−99−212−0750) demanded from MODMedical Supply Directorate (SO 2MEDSup). Adequate deck fixing pointsfor the table are to be provided. These points are to be covered by easilyaccessible removable tapped base plates.

(2) free deck area of approximately 8m2; all chairs and tables are to bestackable;

(3) adequate local lighting, at least 300 Lux.

(4) water on site, or adjacent;

(5) adequate Emergency Breathing System (EBS) couplings;

(6) telephone;

(7) stowage (at least 0.5m3) for resuscitation and operating equipment.

2.4 First Aid

2.4.1 SSNs

a. A First Aid Post containing intravenous (IV) equipment, Resuscitation Bag, andgeneral First Aid equipment is to be sited fore and aft of the ReactorCompartment (RC).

b. An adequate number of First Aid Bags (as advised by FOSM) are to be sitedthroughout the submarine.

c. First Aid Boxes are to be sited in theGalley and in theWardroom Pantry. Detailsof the Box are at shown in FIGURE 2.3. Special First Aid Boxes are also to besited in the fore and after escape compartments.

d. Two Neil Robertson stretchers in canvas bags are to be provided and securedto bulkheads by quick release straps. They are to be sited fore and aft of the RC.

NES 106Part 4

Issue 1

2.5

FIGURE 2.3 FIRST AID BOX WITH INNER CONTAINER

e. Emergency Eyewash Stations consisting of 3 bottles each are to be sited at thefollowing locations:

(1) Adjacent to Air Purification Spaces.

(2) Main Machinery Spaces.

(3) Chemical Dosing Stations.

(4) Galley.

(5) Health Physics Laboratory.

(6) Battery Compartment.

2.4.2 SSBNs

a. A First Aid Post containing intravenous (IV) equipment, Resuscitation Bag, andgeneral First Aid equipment is to be sited fore and aft of the RC.

NES 106Part 4Issue 1

2.6

b. An adequate number of First Aid Bags (as advised by FOSM) are to be sitedthroughout the submarine.

c. First Aid Boxes are to be sited in the Galley, the Missile Compartment and intheWardroom Pantry.Details of the box are shown inFIGURE 2.3. Special FirstAid Boxes are also to be sited in the fore and after escape compartments.

d. Four Neil Robertson stretchers in canvas bags are to be provided and securedto bulkheads by quick release straps. They are to be sited:

(1) Deck —Passageway outside WT Office—AMS 3

(2) Deck —Outside Sickbay—Centre of Missile Compartment

e. Emergency Eyewash Stations containing 3 bottles each are to be sited at thefollowing locations:

(1) Adjacent to Air Purification Spaces.

(2) Main Machinery Spaces.

(3) Chemical Dosing Stations.

(4) Galley.

(5) Health Physics Laboratory.

(6) Battery Compartment.

2.5 Medical Store

2.5.1 SSNs

a. The volume of stowage required, in addition to the primary and secondaryfacilities, is 4m3 of usable space. The stowage(s) are to be capable of beingpositively secured.

b. Separate cupboard stowages which are to be double and single lockedrespectively are to be provided for all controlled and accountable drugs andprecious metals. Secure accommodation is also to be provided for items ofmedical equipment.

c. The larger items which require stowage include:

(1) McVicar Mk II operating table and accessories.

(2) Microscope set.

(3) Defibrillator.

(4) WBGT.

(5) Blood Transfusion Outfit.

(6) Dental First Aid and General Purpose Kit.

(7) Sterilizer.

(8) Resuscitation Box.

(9) ECG equipment.

NES 106Part 4

Issue 1

2.7

2.5.2 SSBNs

a. The Sick Bay is to provide separate cupboard stowages which are to be doubleand single locked respectively are to be provided for all controlled andaccountable drugs. Secure accommodation is also to be provided for items ofmedical equipment.

b. A secure Bulk Medical Store (at least 3m3) is to be provided and fitted out inaccordance with current standards remote from the Sick Bay.

c. The larger items which require stowage include:

(1) McVicar Mk II operating table and accessories.

(2) Microscope set.

(3) Defibrillator.

(4) WBGT.

(5) Blood Transfusion Outfit.

(6) Dental First Aid and General Purpose Kit.

(7) Sterilizer.

(8) Resuscitation Box.

(9) ECG equipment.

2.6 Atmospheric Monitoring Equipment

a. Both SSNs and SSBNs carry Atmospheric Monitoring Equipment (AME).These fall broadly into the following categories:

(1) Portable Gas detection kits (10) which are to be bulkhead-mounted ona bracket. These are to be co-located with the First Aid Bags.

(2) Stored Stowage space (0.67m3 ) is required for the remainder of theAME.

NES 106Part 4Issue 1

2.8

NES 106Part 4

Issue 1

3.1

3. ADMINISTRATION

3.1 SSNs

a. Medical administration is to be provided in the Health Physics Laboratory.Stowage for the books listed in the Medical Library Afloat scales is to beprovided. The layout of a suitable bookcase is detailed on drawingSDN 003503732.

3.2 SSBNs

a. Sufficient desk space and medical documentation stowage facilities are to beprovided in the Sickbay for medical administration.

NES 106Part 4Issue 1

3.2

NES 106Part 4

Issue 1

A.1 ANNEX A.

ANNEX A.

RELATED DOCUMENTS

A.1 The following document is referred to in this NES:

See Clause

SDN 003503732 Bookcase 3.1a.

NES 106Part 4Issue 1

A.2ANNEX A.

NES 106Part 4

Issue 1

B.1 ANNEX B.

ANNEX B.

DEFINITIONS AND ABBREVIATIONS

B.1 For the purpose of this NES the following Definitions apply:

Primary Facilities A dedicated space for the consultation and treatment ofpatients

Secondary Facilities A casualty sorting area for the centralization of largenumbers of casualties

B.2 The following abbreviations are used in this NES:

DCHQ Damage Control Headquarters

EBS Emergency Breathing System

MDG(N) Medical Director General (Navy)

RC Reactor Compartment

SMP Secondary Medical Position

WBGT Wet Bulb Globe Thermometer

NES 106Part 4Issue 1

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

DStan Helpdesk

Tel 0141 224 2531/2 Fax 0141 224 2503

Internet e-mail enquiries@dstan.mod.uk

File Reference

The DStan file reference relating to work on this standard is D/DStan/69/02/106.

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.