Ministry of Defence

Defence Standard 02-106 (NES 106)

Issue 1 Publication Date 01 April 2000

Requirements For Medical And

Dental Organization In HM Surface
Ships And Submarines
Part 3
Specific Requirements - Medical
Organization For Action In
HM Surface Ships

Incorporating NES 106 Category 2

Issue 1 Publication Date July 1993

AMENDMENT RECORD
Amd No

Date

Text Affected

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.

Signature and Date

Ministry of Defence

Naval Engineering Standard

NES 106

Part 3
Issue 1
(Reformatted)

July 1993

REQUIREMENTS FOR MEDICAL AND DENTAL ORGANIZATION IN HM

SURFACE SHIPS AND SUBMARINES
PART 3
SPECIFIC REQUIREMENTSMEDICAL ORGANIZATION FOR ACTION IN
HM SURFACE SHIPS

This NES Supersedes

DGS 89
DGS 90

Record of Amendments
AMDT
1
2
3
4
5
6
7
8
9
10

INSERTED BY

DATE

NAVAL ENGINEERING STANDARD 106

PART 3
ISSUE 1 (REFORMATTED)
REQUIREMENTS FOR MEDICAL AND DENTAL ORGANIZATION IN
IN HM SHIPS AND SUBMARINES
SPECIFIC REQUIREMENTSMEDICAL 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 Architecture
Procurement Executive, Ministry of Defence
Foxhill, Bath BA1 5AB
i

ii

NES 106
Part 3
Issue 1 (Reformatted)

SCOPE
1.

This part of the NES defines the Specific Requirements for Medical Organization for Action
in HM Surface Ships.

iii

NES 106
Part 3
Issue 1 (Reformatted)

iv

NES 106
Part 3
Issue 1 (Reformatted)

FOREWORD
Sponsorship
1.

This Naval Engineering Standard (NES) is sponsored by the Procurement Executive, Ministry
of 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 informed

in 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 be
made to the MOD and those directly applicable to a particular contract are to be dealt with
using 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 similar
terms, 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 indicated
by a vertical sideline. Deletions will be indicated by 000 appearing at the end of the line
interval.

8.

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

9.

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

10.

This NES has been issued to reflect changes in technical requirements and supersedes DGS
89 and 90.

Conditions of Release
General
11.

This Naval Engineering Standard (NES) has been prepared for the use of the Crown and of
its contractors in the execution of contracts for the Crown. The Crown hereby excludes all
liability (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.

NES 106
Part 3
Issue 1 (Reformatted)

12.

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

13.

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

MOD Tender or Contract Process

14.

This NES is the property of the Crown and unless otherwise authorized in writing by the MOD
must be returned on completion of the contract, or submission of the tender, in connection
with which it is issued.

15.

When this NES is used in connection with a MOD tender or contract, the user is to ensure that
he 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 of
the local MOD(PE) Quality Assurance Representative or the Authority named in the tender
or contract.

16.

When NES are incorporated into MOD contracts, users are responsible for their correct
application 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 and
Annex A can be obtained as follows:
a

British Standards

British Standards Institution

389 Chiswick High Road,
London W4 4AL

Defence Standards

Directorate of Standardization and Safety Policy,

Stan, 1 Kentigern House, 65 Brown Street,
Glasgow G2 8EX

Naval Engineering Standards

CSE3a, CSE Llangennech, Llannelli,

Dyfed SA14 8YP

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 relevant
MOD Invitation to Tender or Contract Number and date, together with the sponsoring
Directorate and the Tender or Contract Sponsor.

19.

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

Health and Safety

Warning
20.

This NES may call for the use of processes, substances and/or procedures that may be injurious
to health if adequate precautions are not taken. It refers only to technical suitability and in

vi

NES 106
Part 3
Issue 1 (Reformatted)

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

vii

NES 106
Part 3
Issue 1 (Reformatted)

viii

NES 106
Part 3
Issue 1 (Reformatted)

CONTENTS
Page No
TITLE PAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SCOPE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

iii

FOREWORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sponsorship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Conditions of Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
MOD Tender or Contract Process . . . . . . . . . . . . . . . . . . . . . . . . . .
Related Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Warning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

v
v
v
v
vi
vi
vii
vii

CONTENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ix

SECTION

1.
1.1
1.2

MEDICAL ORGANIZATION FOR ACTION . . . .

Secondary Medical Facilities . . . . . . . . . . . . . . . . . . .
Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.1
1.1
1.1

SECTION

2.
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8

SECONDARY MEDICAL POSITION . . . . . . . . . .

Layout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cupboards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating Table Light . . . . . . . . . . . . . . . . . . . . . . . .
Bulkhead Lining . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Switch Sockets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Communications . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
FIGURE 2.1 TYPICAL LAYOUT OF SECONDARY
MEDICAL POSITION . . . . . . . . . . . . . . . . . . . . . . .
TABLE 2.1 SECONDARY MEDICAL POSITION
EQUIPMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.1
2.1
2.1
2.1
2.1
2.1
2.1
2.1
2.1
2.2
2.2

SECTION

3.

EMERGENCY WARD . . . . . . . . . . . . . . . . . . . . . . . .

3.1

SECTION

4.

CASUALTY SORTING AREA . . . . . . . . . . . . . . . . .

4.1

SECTION

5.
5.1
5.2
5.3

FIRST AID POST . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Master Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5.1
5.1
5.1
5.1

SECTION

6.
6.1
6.2

FIRST AID BOXES . . . . . . . . . . . . . . . . . . . . . . . . . .

Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Master Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.1
6.1
6.1

SECTION

7.
7.1
7.2

STRETCHERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Neil Robertson Stretchers . . . . . . . . . . . . . . . . . . . . .
Transport Stretcher . . . . . . . . . . . . . . . . . . . . . . . . . .

7.1
7.1
7.1

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NES 106
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7.3

General Service Stretcher . . . . . . . . . . . . . . . . . . . . .

7.1

SECTION

8.
8.1
8.2

UPPER DECK MEDICAL STATION . . . . . . . . . . .

Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Compartment Size and Equipment . . . . . . . . . . . . .

8.1
8.1
8.1

ANNEX

A.

RELATED DOCUMENTS . . . . . . . . . . . . . . . . . . . .

A.1

ANNEX

B.

DEFINITIONS AND ABBREVIATIONS . . . . . . . .

B.1

NES 106
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1.

MEDICAL ORGANIZATION FOR ACTION

a.

1.1

The medical organization for Action (MOFA) incorporates the Secondary

Medical Facilities that provide cover under emergency conditions by the
distribution of Medical material throughout the ship and the provisioning of
locations from which First Aid Parties may operate.

Secondary Medical Facilities

a.

The Secondary Medical Facilities to be provided are as follows:

(1)

(2)

1.2

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)

In addition to the above facilities Class A and B ships are to be provided

with an Emergency Ward.

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 the
following parameters:
(1)

as near as possible to midships;

(2)

on or above the Main Communications Deck;

(3)

readily accessible to all members of the ships company;

(4)

at a height such that the ships 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 of
a General Service Stretcher are 2300 mm 590 mm requiring a clear
opening of 700 mm and a minimum turning radius around corners of 3000
mm;

(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 the
lift.

1.1

NES 106
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1.2

NES 106
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2.

SECONDARY MEDICAL POSITION

a.

2.1

Layout
a.

2.2

2.5

2.6

2.8

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

Operating Table
a.

A folding Operating Table is to be provided and to have deck securing

arrangements for the working position.

b.

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

Operating Table Light

a.

An Operating Table Light is to be provided and fitted centrally over the

Operating Table working position.

b.

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

c.

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

Bulkhead Lining
a.

2.7

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

Cupboards
a.

2.4

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

Equipment
a.

2.3

The Secondary Medical Position (SMP) to be provided is to be a designated area

within a Wardroom or Ratings Dining Room where permanent fittings are
partitioned off from the adjacent area.

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

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 and
bulkhead mounted.

c.

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

mounted.

d.

Switch sockets are to be secured against unauthorized use.

Communications
a.

A telephone connected to the Ships Main Exchange is to be provided for the

SMP if the requirements of the primary use of the compartment does not call
for one.

2.1

NES 106
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Issue 1 (Reformatted)

b.

The Ships main broadcast system in the compartment is to be volume

controlled.

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

FIGURE 2.1 TYPICAL LAYOUT OF SECONDARY MEDICAL POSITION
EQUIPMENT

Item No

QTY

Operating Table

Operating Table Light (Overhead)

Clinical Sink with Cupboard

Splashback and Toilet Tray

Towel Rail

Cupboard

Instrument Sterilizer

Splashguard

Stowage Area for Operating Table

10

Transfusion Hooks

11

Curtain and Track (as required)

TABLE 2.1 SECONDARY MEDICAL POSITION EQUIPMENT

2.2

A/R

NES 106
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3.

EMERGENCY WARD
a.

An Emergency Ward is to be provided in Class A and B Ships, adjacent to the

SMP 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 for

use during emergency conditions.

c.

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

3.1

NES 106
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3.2

NES 106
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Issue 1 (Reformatted)

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 cleared

of portable/stackable furniture.

4.1

NES 106
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4.2

NES 106
Part 3
Issue 1 (Reformatted)

5.

FIRST AID POST

5.1

Location
a.

5.2

(1)

Accessible from manned stations and quarters without obstructing other

traffic 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.

Equipment
a.

5.3

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

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, to

retain the cabinet key.

(3)

Stretcher and blanket cabinet.

(4)

First Aid Box, bulkhead mounted, with a glass fronted key box built into
the First Aid Box door.

Master Key
a.

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

5.1

NES 106
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5.2

NES 106
Part 3
Issue 1 (Reformatted)

6.

FIRST AID BOXES

a.

6.1

6.2

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

Location
a.

The boxes are to be bulkhead mounted with their bases 1250 mm above the deck
and positioned so that the injured person may easily access them, ie without
reaching over hatches or leaving walkways.

b.

Boxes are not to be located in narrow passageways or congested spaces where

traffic may be impeded.

c.

Additional boxes for routine use in Galleys, Workshops and Battery

Compartments are to be provided in compliance with NES 101 and NES 121
Parts 1 and 2 together with Eye Wash Bottles.

Master Key
a.

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

6.1

NES 106
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6.2

NES 106
Part 3
Issue 1 (Reformatted)

7.

STRETCHERS
a.

7.1

7.2

7.3

Neil Robertson, Transport and General Service Stretchers are to be provided

throughout the ship in quantities as detailed in Part 1 of this NES.

Neil Robertson Stretchers

a.

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

b.

At each site a cupboard is to be provided for the stowage of stretchers and

blankets.

Transport Stretcher
a.

A lightweight Transport Stretcher is to be provided on all ships and stowed in

the Hangar, its immediate vicinity or close to the Upper Deck.

b.

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

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 be
provided.

7.1

NES 106
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7.2

NES 106
Part 3
Issue 1 (Reformatted)

8.

UPPER DECK MEDICAL STATION

a.

8.1

Location
a.

8.2

Two Upper Deck Medical Stations (UDMS) are to be provided for treatment of
casualties that have been evacuated to the Upper Deck due to untenable
conditions within the ship.

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

Compartment Size and Equipment

a.

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

8.1

NES 106
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8.2

NES 106
Part 3
Issue 1 (Reformatted)

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 of

Workshops Maintenance Spaces and Engineering
Stores for HM Surface Ships
Part 1: Common Requirements
Part 2: Specific Requirements

6.1.c.

NES 121

Requirements for Galleys and Associated Spaces

Part 1: Common Requirements
Part 2: Specific Requirements Surface Ships

6.1.c.

NES 130

Requirements for Decorative Linings and Composite Bulkheads

Part 1: Decorative Linings
Part 2: Composite Bulkheads

2.6.a.

A.1

ANNEX A.

NES 106
Part 3
Issue 1 (Reformatted)

ANNEX A.

A.2

NES 106
Part 3
Issue 1 (Reformatted)

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
Classification of Medical and
Dental Facilities

The area within a minimum deck height to the

underside of the deck head lining of 2135 mm.
Class A CVS
Class B LPD/LPH
Class C DD/FF/OSV/MCMV
Class D Minor War Vessels

B.1

ANNEX B.

NES 106
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ANNEX B.

B.2

Inside Rear Cover

 Crown Copyright 2000

Copying Only as Agreed with DStan

Defence Standards are Published by and Obtainable from:

Defence Procurement Agency
An Executive Agency of The Ministry of Defence
Directorate of Standardization
Kentigern House
65 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 correct
application and for complying with contractual and statutory requirements. Compliance with
a 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 that
users of Defence Standards should ascertain that they are in possession of the latest issue or
amendment. Information on all Defence Standards is contained in Def Stan 00-00 Standards
for Defence Part 3 , Index of Standards for Defence Procurement Section 4 Index of Defence
Standards and Defence Specifications published annually and supplemented regularly by
Standards in Defence News (SID News). Any person who, when making use of a Defence
Standard encounters an inaccuracy or ambiguity is requested to notify the Directorate of
Standardization (DStan) without delay in order that the matter may be investigated and
appropriate action taken.