# Should Tactical Medics be armed?



## CWATT (Jul 27, 2017)

***see POLL above***

In my area, tactical medics are a 'newer thing' with each city and its local EMS service taking a slightly different approach to the selection process and how they are implemented.  The general consensus is that Tac medics are employed by and report for duty to their local EMS service and are dispatched on request of the tactical team (at which point they will rendezvous at location).  One perspective is this makes them medics first, tactical unit members second, so a firearm is not necessary to render emergency first aid.  Another perspective is that the role of a Tac medic requires a firearm in lieu of the hazards it presents. . 

I suspect the majorty of the forum members here are in the USA which has a strong pro-gun culture, so I'm hoping you can comment objectively on the role and scope of a tactical medic.  (Personally, I'm not a fan of guns but I am in the camp that tactical medics should be armed). 


- C


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## VFlutter (Jul 27, 2017)

If you are a tactical medic that just deploys with the team and stages at the command post then I see no reason to be armed. If you are part of the team and stacking on the door then you should be armed like everyone else. However I do not really see a point to the latter. Any member of the SWAT team should be able to provide the basic medical care until they can extract the victim to relative safety. You do not need a medic kicking down doors.


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## DesertMedic66 (Jul 27, 2017)

Pretty much what Chase said. If they are staged in the cold or the warm zone then no they do not need to be armed. If they are with SWAT when they breach the door and are going interior then IMO they need to be armed and need to be shooters first and medics second. In a high risk operation you do not want to be out gunned.

If I am going interior on the intial breach I do not want to be placing myself in several kill zones or fatal funnels without some sort of way to defend myself.

As for the poll, I can’t answer due to my answer being “it depends”.


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## Akulahawk (Jul 27, 2017)

I also can't answer the question because the answer "depends" upon the expected role of the medic. If the medic is part of the stack that's doing the entry, everyone in the stack must be armed and well-trained in clearing rooms and buildings. That's a "shooter-first, other role, second" scenario. If the medic is not part of the entry stack and only goes after all is clear OR injured people are brought out of the hot zone, then the medic doesn't need to be armed.


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## CALEMT (Jul 28, 2017)

Like the above posts I to believe that its situationally dependent. The "standard" barricaded suspect in a home scenario which I'm guessing is what we are all assuming here is going to depend if the medic is on the entry team or the perimeter team. Entry team yes, absolutely. Like Akulahawk has stated the primary mission or the main focus is "shooter-first" or eliminating/ incapacitating the threat. In essence the main mission is security. Example being a 2 man entry team. Guy 1 enters the door (aka fatal funnel) and gets shot. Guy 2's response is to eliminate the threat then tend to his partner. 

The perimeter team on the other hand is where I'm split of armed vs unarmed. High risk call outs involve a higher risk of getting shot at and getting hit. Speaking from the stories that my dad (LEO of 29 years SWAT for 15 of those years) has told me there is just as much risk on the perimeter. So I'm split and can go either way. 

In the dynamic shooter scenario where the shooter is mobile and actively moving hell yes is my answer. In those scenarios there is no "real" security and with the treat still out there you should be armed to have the ability to defend yourself and to defend others.


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## Akulahawk (Jul 28, 2017)

CALEMT said:


> In the dynamic shooter scenario where the shooter is mobile and actively moving hell yes is my answer. In those scenarios there is no "real" security and with the treat still out there you should be armed to have the ability to defend yourself and to defend others.


This is the one situation where I would say that a person outside what would be normally considered the "hot zone" to be armed because in this specific situation there are no defined zones. In the active, mobile shooter, any armed asset that can respond to stop the threat should be allowed to do so. That's a "shooter-first" situation. 

Of course I'm referring to on-duty stuff. Off-duty is an entirely different matter. When I'm off-duty, my primary duty is the safety/security of myself and my family, everything else is secondary. I'll be armed when I deem it necessary and few will be able to tell. If I'm working where EMS is allowed to be armed while on duty, I'd make that decision to carry concealed for exactly the same reason: security for self and partner.


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## CWATT (Jul 28, 2017)

I suppose my thought is if the Tactical Medic is required to wear body arnour due to risk of being shot, I believe having the ability to protect ones self with the same force is only appropriate.   Thoughts?


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## NysEms2117 (Jul 28, 2017)

Chase shares my opinion. Situations are hairy enough with fully trained SWAT or SORT(in my state, which i belong to) officers. All medics would do is get in the way if they are stacked with us(thus arming them), and that can't happen. also there is a simple fix for this:


CWATT said:


> I suppose my thought is if the Tactical Medic is required to wear body arnour due to risk of being shot, I believe having the ability to protect ones self with the same force is only appropriate. Thoughts?


Stay in the warm zone, or cold zone(my preference).

I ranted on this in another thread but heres the short simple solution. Find people like myself and plenty others out there who HAPPEN/ COINCIDENTALLY happen to be an EMT or a medic. Give us 4 TQ's or pick a number, an bag of OPA/NPA to put in a pocket somewhere, if something goes down let us do 5-10 seconds of medical care and move on to find whoever did it. Remember  its better to get definitive care faster (short of clear life or death situations) and to do that you need to clear the area.

Bottom line: I don't want somebody being armed with myself on a situation like that unless they are trained to the level i am or above. Any paramedic I have met that primarily practices as a paramedic and not a LEO/SWAT/ military, officer/soldier cannot do that.

EDIT: Desert also brought up a good point about possibly getting yourself killed because you walked in a fatal funnel without proper training. Nobody wants that.


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## CALEMT (Jul 28, 2017)

NysEms2117 said:


> Bottom line: I don't want somebody being armed with myself on a situation like that unless they are trained to the level i am or above. Any paramedic I have met that primarily practices as a paramedic and not a LEO/SWAT/ military, officer/soldier cannot do that.



I can't speak for every SWAT medic and/ or physician but for RSO the physician trained closely with the SWAT team. Better team dynamics and more of a rapport makes for a better system when SHTF. I don't know if the physician was armed or not but I believe that every SWAT medic should train with the team. Not just medical training, but entry techniques and small unit tactics (moving and communication) should be practiced as well.


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## DesertMedic66 (Jul 28, 2017)

CALEMT said:


> I can't speak for every SWAT medic and/ or physician but for RSO the physician trained closely with the SWAT team. Better team dynamics and more of a rapport makes for a better system when SHTF. I don't know if the physician was armed or not but I believe that every SWAT medic should train with the team. Not just medical training, but entry techniques and small unit tactics (moving and communication) should be practiced as well.


I just watch YouTube videos


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## Akulahawk (Jul 28, 2017)

NysEms2117 said:


> I don't want somebody being armed with myself on a situation like that unless they are trained to the level i am or above. Any paramedic I have met that primarily practices as a paramedic and not a LEO/SWAT/ military, officer/soldier cannot do that.


One doesn't have to be trained as a LEO /soldier first before learning how to function as part of an entry team. I'm also not saying that a lot of training isn't required. One also doesn't have to continuously train every day in SWAT/Entry tactics, even those teams don't do daily practice to maintain proficiency. So, one can be primarily a medic as part of the "day job" but also be on an entry team as long as all training requirements are met just as the rest of the team is required to do. This, for any team member, is a huge requirement and responsibility. 


CALEMT said:


> I believe that every SWAT medic should train with the team. Not just medical training, but entry techniques and small unit tactics (moving and communication) should be practiced as well.


Yep. 


Akulahawk said:


> If the medic is part of the stack that's doing the entry, everyone in the stack must be armed and well-trained in clearing rooms and buildings.


Just to show I also brought this up... you don't have to know all parts of being a police officer or soldier to be trained in dynamic entry techniques. The medic being trained for this needs to be able to shift their mindset to something along the lines of what's taught in TCCC and be able to do it. Once the shooting has stopped, then you can tend to the wounded because it's now safe for you to do it. In the process of getting there, you might just have to shoot back effectively to stop the threat.


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## FiremedicSC (Aug 1, 2017)

Sometimes the best medicine I can give will be rendered out of the business end of a Glock or 1911.  However I am a special case 


Sent from my iPhone using Tapatalk


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## Luno (Aug 3, 2017)

Yes, they should have the ability to protect themselves and their patient.


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## CWATT (Aug 3, 2017)

Here's one such example of how tactical paramedics are being used...

Equipment list:
http://ottawacitizen.com/news/local...l-paramedics-are-using-war-zone-devloped-gear
*note the lack of a side-arm

Unit Integration:
http://ottawacitizen.com/news/local-news/five-ottawa-first-responders-injured-in-training-exercise

I cannot comment specifically on the exact role/scope/policies of this agency, but I feel it's a safe guess that if they are close enough to sustain injuries during a breaching exercie, they are well-within the 'hot zone' (no pun intended).  Do people feel these paramedics are being underequipped?  Can paramedics be integrated into the line / breaching crew if provided with training on how to conduct themselves and maintain personal safety without being armed?


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## Luno (Aug 8, 2017)

Based on their published role, I don't think that they are underequipped, they have a similar role to the model put forward by cypress creek many years ago of a warm zone existence and entrance only when called/escorted.  I really like the emphasis on the planning and knowledge piece, it's something that most "tacticool" medics miss out on.Their role in planning and decision making makes them the value add to the team rather than as an add on to the stack.  As the medical subject matter expert, they advise the scene/tactical commander on medical and evacuation considerations.  As far as not being armed, it isn't a huge stretch, since once you're occupied with patient care, you're pretty much out of the fight anyway.


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## NysEms2117 (Aug 8, 2017)

didn't even think a place like Ottawa would have them. 


CWATT said:


> Can paramedics be integrated into the line / breaching crew if provided with training on how to conduct themselves and maintain personal safety without being armed?


I think that right there is the key. Medics are training in medicine... LEO and SWAT are training in safety and threat neutralization. Paramedics could actually do more harm then good by getting in the way.

However, i feel this will be a "touchy topic" that nobody will agree on. As somebody that is actively employed on both sides, my opinion in 1 word is NO.


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## DrParasite (Aug 9, 2017)

CWATT said:


> I suppose my thought is if the Tactical Medic is required to wear body arnour due to risk of being shot, I believe having the ability to protect ones self with the same force is only appropriate.   Thoughts?


I think that's a fair statement (and one I think it's one @NysEms2117 disagrees with me on).  If there is a high possibility that I might be shot, or shot at, to the point that I am wearing body armor (in this case, more than just a vest), than I want a way to defend myself, should the situation require it.  
Do I want to shoot back?  hell no, i'd rather the professionals do it.... but if they get taken out by the bad guy, and then he takes aim at me, I would want to have some way to defend myself, because if the bad guy has no issues shooting a bunch of cops, he will have no issue shooting a medic.  And he might shoot me, might even kill me, but I don't want to make it easy, and I want to inflict as much damage on him before I take my last breath.


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## NysEms2117 (Aug 9, 2017)

DrParasite said:


> I think that's a fair statement (and one I think it's one @NysEms2117 disagrees with me on).  If there is a high possibility that I might be shot, or shot at, to the point that I am wearing body armor (in this case, more than just a vest), than I want a way to defend myself, should the situation require it.
> Do I want to shoot back?  hell no, i'd rather the professionals do it.... but if they get taken out by the bad guy, and then he takes aim at me, I would want to have some way to defend myself, because if the bad guy has no issues shooting a bunch of cops, he will have no issue shooting a medic.  And he might shoot me, might even kill me, but I don't want to make it easy, and I want to inflict as much damage on him before I take my last breath.


I just look at it from a logic perspective. If Medics want plate carriers, GREAT, they want helmets, GREAT, but the carnage that would need to occur to take out a SWAT team (or in my case a SORT team), would be crazy. To be completely honest, if they take out the folks that are trained to neutralize threats, my money is going on they will take out the folks that are trained to be medical providers. Not to mention there are also perimeter control(normal street officers) that are also armed(and would most likely have eyes on the warm zone). To me all of it can be avoided by not becoming a tactical medic, and just having normal paramedics either wait in the cold zone where everything is safe(relative), OR have certain individuals that volunteer to put on a vest and go into the warm zone, where most protocols state casualties/injuries have to be moved to anyway... 
Below is my true stance and tbh I think makes the most sense:


NysEms2117 said:


> Find people like myself and plenty others out there who HAPPEN/ COINCIDENTALLY happen to be an EMT or a medic. Give us 4 TQ's or pick a number, an bag of OPA/NPA to put in a pocket somewhere, if something goes down let us do 5-10 seconds of medical care and move on to find whoever did it. Remember its better to get definitive care faster (short of clear life or death situations) and to do that you need to clear the area.



I can't speak for this point first hand since I never served in the military, but look at what they do, they get the casualty and get said individual to cover first. They don't treat them in the open. Thus why i don't see a need for medics to stack up with the special response breaching folks. 
Again, I do in fact understand and see your point that if your risking your life by being a tactical medic you would like to be able to defend it, but just think about the levels of carnage that would have to occur to get to that point.


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## DrParasite (Aug 9, 2017)

NysEms2117 said:


> To be completely honest, if they take out the folks that are trained to neutralize threats, my money is going on they will take out the folks that are trained to be medical providers.


I'm inclined to agree with you.  I still want to be armed so I had get lucky and wing him and he stands over me to deliver the execution shot.  Agree to disagree on this one?


NysEms2117 said:


> To me all of it can be avoided by not becoming a tactical medic, and just having normal paramedics either wait in the cold zone where everything is safe(relative), OR have certain individuals that volunteer to put on a vest and go into the warm zone, where most protocols state casualties/injuries have to be moved to anyway...


 or just eliminate tactical medics, train the cops to be EMTs, with a medic in the cold zone, and they can bring any injuries to us.  If there is an elevated chance I might be shot at, I want to be able to defend myself.





NysEms2117 said:


> I can't speak for this point first hand since I never served in the military, but look at what they do, they get the casualty and get said individual to cover first. They don't treat them in the open. Thus why i don't see a need for medics to stack up with the special response breaching folks.


And the military can shoot back if needed.

But with the new recommendation that the unarmed people be in the warm zone (in the building where active shooting is taking place, but not in the same room), and the fact that I want to go home at the end of my shift, than I want to have the same protection that the cops have when they go inside, and includes a way to defend myself should it come to that.



NysEms2117 said:


> Again, I do in fact understand and see your point that if your risking your life by being a tactical medic you would like to be able to defend it, but just think about the levels of carnage that would have to occur to get to that point.


You ever been in a shootout without your gun?  or been shot at, or heard gunfire near by?  on duty, off duty, it doesn't matter.  Because I am pretty sure one of your first thoughts was "I need to find safety for me and my family, and I hope those bullets don't get any closer because I don't have a thing I can do about it... and I really wish I had my gun on me, just in case the bad guy ended up between me and safety..."


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## NysEms2117 (Aug 9, 2017)

DrParasite said:


> than I want to have the same protection that the cops have when they go inside, and includes a way to defend myself should it come to that.


then as a LEO i want to be able to get ketamine and intubate people??? If you want the duties of a law enforcement officer, become one. The same as if i want the duties of a paramedic i'll become one. 


DrParasite said:


> or just eliminate tactical medics, train the cops to be EMTs, with a medic in the cold zone, and they can bring any injuries to us. If there is an elevated chance I might be shot at, I want to be able to defend myself.


which is what i suggested  WE AGREE!!!! 
The rest of your points can be avoided mostly by common sense IMO (and mostly is used because anything can happen anywhere theoretically)


DrParasite said:


> But with the new recommendation that the unarmed people be in the warm zone (in the building where active shooting is taking place, but not in the same room), and the fact that I want to go home at the end of my shift, than I want to have the same protection that the cops have when they go inside, and includes a way to defend myself should it come to that.


Also correct. However, in NYS the state SORT team also posts a minimum of 2 officers in whatever room/lobby/area is designated. Meaning 2 more people with higher paper qualifications to own and operate a firearm successfully. *yes i'm sure theres a paramedic somewhere that can outshoot a cop somewhere*.


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## GMCmedic (Aug 9, 2017)

NysEms2117 said:


> then as a LEO i want to be able to get ketamine and intubate people??? If you want the duties of a law enforcement officer, become one. The same as if i want the duties of a paramedic i'll become one.



Cops get narcan! I at least want a taser.



Sent from my SAMSUNG-SM-G920A using Tapatalk


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## bakertaylor28 (Aug 9, 2017)

There's two ways of looking at this- depending upon how you define "tactical" medic- If one means within the sense of military service, it is illegal under international law for the medical corps of any country to be armed. The reason why is because medical units are automatically considered "non-combatants" and may not intentionally be fired upon, so long as they wear clear medical insignia. 

If we're talking within the sense of civilian tactical operations, the issue gets blurred with a quickness. For starters, I am of the opinion that anyone whom carries a weapon should at least be credentialed as BLS and more importantly how to handle weapons-related injuries in the basic sense. (at least knowing what NOT to do- and this is coming from someone whom has responded to a gunshot call where someone tried to use SUPER GLUE as a clot activator.) - A great deal of BLS should be common sense- but oddly enough people these days seem to be lacking in that. Hence, cross training is always a good idea. 

However, giving paramedics GUNS is not an answer to problems that SHOULD be under control by law enforcement. But, this depends upon how one defines "tactical medic" (as opposed to the majority of us)  for purposes of civilian non-military use.


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## bakertaylor28 (Aug 9, 2017)

GMCmedic said:


> Cops get narcan! I at least want a taser.
> 
> 
> 
> Sent from my SAMSUNG-SM-G920A using Tapatalk



Cops with narcan really isn't the best idea, in my book, unless we train them when NOT to use it. I know of at least one case where a cop used narcan to try to counteract IV Tramadol. The result WASN'T good, to say the least.


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## bakertaylor28 (Aug 9, 2017)

CWATT said:


> ***see POLL above***
> 
> In my area, tactical medics are a 'newer thing' with each city and its local EMS service taking a slightly different approach to the selection process and how they are implemented.  The general consensus is that Tac medics are employed by and report for duty to their local EMS service and are dispatched on request of the tactical team (at which point they will rendezvous at location).  One perspective is this makes them medics first, tactical unit members second, so a firearm is not necessary to render emergency first aid.  Another perspective is that the role of a Tac medic requires a firearm in lieu of the hazards it presents. .
> 
> ...



Under this definition- this is a situation where in all reality, this poses liability issues- because the courts will tend to define you as an adjunct to law enforcement if you in any way involve yourself with a tactical team such as SWAT etc. This means that effectively, Miranda will apply to you just as much as the rest of the team, and you might not be able to ask a patient the proper questions without placing a case in legal limbo.


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## VFlutter (Aug 9, 2017)

bakertaylor28 said:


> Cops with narcan really isn't the best idea, in my book, unless we train them when NOT to use it. I know of at least one case where a cop used narcan to try to counteract IV Tramadol. The result WASN'T good, to say the least.



What was the result? Inappropriate Narcan administration shouldn't cause any harm is  far outweighed by the much more frequent benefit from treating actual narcotic overdoes.


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## bakertaylor28 (Aug 9, 2017)

Chase said:


> What was the result? Inappropriate Narcan administration shouldn't cause any harm is  far outweighed by the much more frequent benefit from treating actual narcotic overdoes.



Narcan in the presence of Tramadol is well-documented to cause seizures and more rarely  status elipticus. It mimics TCAs in a lot of ways, yet also has opioid effects as well. The particular case in question resulted in status elipticus and consequential arrest.


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## DesertMedic66 (Aug 9, 2017)

bakertaylor28 said:


> Narcan in the presence of Tramadol is well-documented to cause seizures and more rarely  status elipticus. It mimics TCAs in a lot of ways, yet also has opioid effects as well. The particular case in question resulted in status elipticus and consequential arrest.


There are studies that are both sides of that fence. Some state it may cause the seizures to come on faster while others state there were less patients with seizures after Narcan admin. Let’s also not forget that seizures are a side effect of tramadol overdose.


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## VFlutter (Aug 9, 2017)

Based off a quick search I definitely wouldn't consider it "well documented" and as @DesertMedic66 said the literature is not conclusive. Correlation does not equal causation. Massive Tramadol overdoes are likely to seize and become apneic regardless. 

The only study I could find that supports the claim that Narcan lowers the seizure threshold in Tramadol overdoes still states "The findings do not suggest that naloxone should be withheld, but that the potential for seizure should be noted and any forthcoming seizure dealt with. More research is needed to further define the factors that affect the seizurogenicity of naloxone in tramadol overdose."
http://eprints.arums.ac.ir/3741/1/Naloxone.pdf

But regardless even if that was the case a few rare incidents do not outweigh the benefits. Opioid overdoses are far more likely than Tramadol and most of the time we do not know what the patient overdosed on and commonly is polypharmacy.


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## Dustoff707 (Aug 10, 2017)

Not 100% sure how TECC works but TCCC's first step is suppressing the threat before rendering any care to your patient. Can't do that if you're not armed. Another gun in the fight to end it faster to provide better care in a tactical field care situation rather than a care under fire situation where care is very limited is more desirable.


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## Luno (Aug 10, 2017)

bakertaylor28 said:


> There's two ways of looking at this- depending upon how you define "tactical" medic- If one means within the sense of military service, it is illegal under international law for the medical corps of any country to be armed. The reason why is because medical units are automatically considered "non-combatants" and may not intentionally be fired upon, so long as they wear clear medical insignia.


Ok, I've gotta see this one... Please cite international law and applicability...


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## bakertaylor28 (Aug 10, 2017)

Luno said:


> Ok, I've gotta see this one... Please cite international law and applicability...



Luno, did you really just question that? NOTICE that I specifically restricted what I said to "military combat" situations: 

"In 1864, sixteen European states adopted the first-ever Geneva Convention to save lives and alleviate the suffering of wounded and sick persons in the battlefield. As well as to protect trained medical personnel as non-combatants, in the act of rendering aid.

Chapter IV, Article 25 of the Geneva Convention states that: "Members of the armed forces specially trained for employment, should the need arise, as hospital orderlies, nurses or auxiliary stretcher-bearers, in the search for or the collection, transport or treatment of the wounded and sick shall likewise be respected and protected if they are carrying out these duties at the time when they come into contact with the enemy or fall into his hands." Article 29 reads: "Members of the personnel designated in Article 25 who have fallen into the hands of the enemy, shall be prisoners of war, but shall be employed on their medical duties insofar as the need arises."

According to the Geneva Convention, knowingly firing at a medic wearing clear insignia is a war crime.[2]

In modern times, most combat medics carry a personal weapon, to be used to protect themselves and the wounded or sick in their care.[3] When and if they use their arms offensively, they then sacrifice their protection under the Geneva Conventions. These medics are specifically trained.[4]" 

Source: https://en.wikipedia.org/wiki/Combat_medic (internal references omitted.) I think that represents a good overview of that side of things. :-D 

As for the other part of that, It's fairly basic constitutional law combined with the common law doctrine that "the hand of one is the hand of all",  Therefore the paramedic whom engages in questioning of a person whom is subject to a criminal investigation could be considered subject to Miranda where that paramedic traveled to the scene as any part of any law enforcement team. This even extends 
to more everyday situations we might encounter- if you ask an OD subject "what did you take" in the presence of a law enforcement officer, or you in any way tell the law enforcement officer what the individual took, you've violated that individual's fifth amendment right to have an attorney present before any questioning. Conversely, it doesn't violate the right so long as I take steps to remove the officer from the immediate area to prevent the officer from overhearing confidential information, and I don't tell the officer that confidential information. 

We have to remember that EVERYTHING that comes out of the patients mouth is potential PHI - and handing PHI over to law enforcement without the required civil process WILL get you sued.


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## Medic27 (Aug 10, 2017)

It's easy for the cops, have some common sense and they won't kill anyone with Narcan. Pinpoint pupils, there goes the Naxaloneeeee.

Now you got a pissed patient that ain't happy you saved his life. Lol, welcome to EMS.


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## bakertaylor28 (Aug 10, 2017)

Chase said:


> Based off a quick search I definitely wouldn't consider it "well documented" and as @DesertMedic66 said the literature is not conclusive. Correlation does not equal causation. Massive Tramadol overdoes are likely to seize and become apneic regardless.
> 
> The only study I could find that supports the claim that Narcan lowers the seizure threshold in Tramadol overdoes still states "The findings do not suggest that naloxone should be withheld, but that the potential for seizure should be noted and any forthcoming seizure dealt with. More research is needed to further define the factors that affect the seizurogenicity of naloxone in tramadol overdose."
> http://eprints.arums.ac.ir/3741/1/Naloxone.pdf
> ...




Correlation doesn't equal causation, but yet where there's smoke there's fire. Interesting thought process, there.


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## SandpitMedic (Aug 10, 2017)

Wikipedia as a source... hmm. 
Never thought of that


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## bakertaylor28 (Aug 10, 2017)

Medic27 said:


> It's easy for the cops, have some common sense and they won't kill anyone with Narcan. Pinpoint pupils, there goes the Naxaloneeeee.
> 
> Now you got a pissed patient that ain't happy you saved his life. Lol, welcome to EMS.



On second thought- when we consider the potential for opioid withdraw effects, yeah... why not? So long as I ain't the one who has to end up  dealing  with it. :-D And Just to think, the waive all started with Judy Garland dying on the porcelain God from a combination of bulimia and an overdose of seconal.


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## SandpitMedic (Aug 10, 2017)

If the answer is no, then they are not a tactical medic. You have to have the ability to be "tactical" not tacticool.

Period.

A vest and helmet does not make a tactical medic. It is the training in tactics, firearms, and medicine in combo that does make a tactical medic.


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## Medic27 (Aug 10, 2017)

bakertaylor28 said:


> On second thought- when we consider the potential for opioid withdraw effects, yeah... why not? So long as I ain't the one who has to end up  dealing  with it. :-D And Just to think, the waive all started with Judy Garland dying on the porcelain God from a combination of bulimia and an overdose of seconal.


Dude around these parts if the patient is swinging his hands open handed, you just call fire. We let fire and LE deal with the ****. Because, I don't have too, Lol.


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## bakertaylor28 (Aug 10, 2017)

SandpitMedic said:


> Wikipedia as a source... hmm.
> Never thought of that



Yeah it's a go to when your not in the mood to pull extensive research on the non-technical mundane, especially when your at least 90 per cent sure your right.


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## SandpitMedic (Aug 10, 2017)

bakertaylor28 said:


> Yeah it's a go to when your not in the mood to pull extensive research on the non-technical mundane, especially when your at least 90 per cent sure your right.



90% huh? No need to investigate or research because you're so sure you're right...Not bad...


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## bakertaylor28 (Aug 10, 2017)

Medic27 said:


> Dude around these parts if the patient is swinging his hands open handed, you just call fire. We let fire and LE deal with the ****. Because, I don't have too, Lol.



Right....until said patient slaps the taste out of your mouth while in the back of your rig while your going down the street. Not much the LEOs are going to do about that, really.


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## Medic27 (Aug 10, 2017)

bakertaylor28 said:


> Right....until said patient slaps the taste out of your mouth while in the back of your rig while your going down the street. Not much the LEOs are going to do about that, really.


Then you just give them 70-80 per kg of versed then it's night-time when their eyes roll back into their head.


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## SandpitMedic (Aug 10, 2017)

Medic27 said:


> Then you just give them 70-80 per kg of versed then it's night-time when their eyes roll back into their head.



"70-80 per kg of versed"?

Are you two even medics?!
Why don't you guys Wikipedia some proper medication doses.

This thread is jumping the shark.


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## DrParasite (Aug 10, 2017)

NysEms2117 said:


> then as a LEO i want to be able to get ketamine and intubate people??? If you want the duties of a law enforcement officer, become one. The same as if i want the duties of a paramedic i'll become one.


What harm could come to you if you don't get those items?  Not the patient, you personally.  That's the difference.  I don't want a firearm to help anyone else other than keep my own *** from suffering from high velocity lead poisoning.  

But I will gladly give you 4 TQ and a trauma dressing when we go into an active shooter, so if you do get shot, you have a better chance of surviving.  


NysEms2117 said:


> Also correct. However, in NYS the state SORT team also posts a minimum of 2 officers in whatever room/lobby/area is designated. Meaning 2 more people with higher paper qualifications to own and operate a firearm successfully. *yes i'm sure theres a paramedic somewhere that can outshoot a cop somewhere*.


If I'm not mistaken, you are referring to the Casualty Collection point right?  cool, so they are providing security (which is what they should be doing.  That's a much different environment when compared to moving down a hall with a PD escort, or being with a SWAT team that is taking a door while shooting may take place (you know, doors might be the focal point of the gunfire, but I don't think the walls that you are hiding behind are as strong


Medic27 said:


> Dude around these parts if the patient is swinging his hands open handed, you just call fire. We let fire and LE deal with the ****. Because, I don't have too, Lol.


I'm guessing your in an area where you get paid poorly, Fire runs everything, and you are just a horizontal taxi service?  and BTW, why is fire dealing with this, as it appears to be an EMS or LEO issue??


Derek Steinnerd said:


> Not 100% sure how TECC works but TCCC's first step is suppressing the threat before rendering any care to your patient. Can't do that if you're not armed.


better tell that to all those navy corpmen that work with the marines that they can't care for people if they are armed..... and all those cops who act as first responders and perform any intervention before EMS arrives, you need to take off your gun because you can't help people with it on you 


Derek Steinnerd said:


> Another gun in the fight to end it faster to provide better care in a tactical field care situation rather than a care under fire situation where care is very limited is more desirable.


Hypothetically, if I'm the tactical medic with a bunch of cops, and a firefight starts, I'm going to let the cops shoot at the bad guys while I try to find cover, or retreat to a safe location.  But if, during the process of my retreating, I come across the other bad guy (because drug people always work solo), and he wants to harm me using the gun he has in his hand, what do you suggest I do, other than soil myself?


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## NysEms2117 (Aug 10, 2017)

DrParasite said:


> What harm could come to you if you don't get those items? Not the patient, you personally. That's the difference. I don't want a firearm to help anyone else other than keep my own *** from suffering from high velocity lead poisoning.


well i won't have painkillers when i get shot... because there won't be a medic next to me .


DrParasite said:


> If I'm not mistaken, you are referring to the Casualty Collection point right? cool, so they are providing security (which is what they should be doing. That's a much different environment when compared to moving down a hall with a PD escort, or being with a SWAT team that is taking a door while shooting may take place (you know, doors might be the focal point of the gunfire, but I don't think the walls that you are hiding behind are as strong


not sure what your getting at here... yes bullets go through walls(if thats what you were asking). Casualty collection points are usually where theres limited access points, so you can secure them properly, and have a solid chance at defending it.


DrParasite said:


> Hypothetically, if I'm the tactical medic with a bunch of cops, and a firefight starts, I'm going to let the cops shoot at the bad guys while I try to find cover, or retreat to a safe location. But if, during the process of my retreating, I come across the other bad guy (because drug people always work solo), and he wants to harm me using the gun he has in his hand, what do you suggest I do, other than soil myself?


thus causing more harm then good, because as i'm sure you know this isn't the battle of bunker hill here... we don't stand in a line, and shoot. Thus 1 individual running the opposite way of gunfire, puts you in harm of friendly fire meaning we can't neutralize the threat...  I also know what your not going to do, your not going to draw your gun, while running and being surprised by a foe, while your foe already has guns up, get accurate shots on target and neutralize the target. This ain't a Rambo movie, and your not John Wayne. Chances are if your in close range, your best bet since you dont have guns up already would be to tackle said foe.

Dr. P as a side note, i genuinely don't know here and i'm asking a question not taking a stab at medics, but what can a paramedic do that an EMT/SWAT/SORT officer with TQ's OPA NPA. We're talking GSW's and Possibly stab wounds. I'm also talking life saving measures, not comfort things. What benefits does having a paramedic give, as opposed to somebody like myself or thousands of others that are an EMT and also happen to be on special response teams.


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## Medic27 (Aug 10, 2017)

DrParasite said:


> What harm could come to you if you don't get those items?  Not the patient, you personally.  That's the difference.  I don't want a firearm to help anyone else other than keep my own *** from suffering from high velocity lead poisoning.
> 
> But I will gladly give you 4 TQ and a trauma dressing when we go into an active shooter, so if you do get shot, you have a better chance of surviving.
> If I'm not mistaken, you are referring to the Casualty Collection point right?  cool, so they are providing security (which is what they should be doing.  That's a much different environment when compared to moving down a hall with a PD escort, or being with a SWAT team that is taking a door while shooting may take place (you know, doors might be the focal point of the gunfire, but I don't think the walls that you are hiding behind are as strong
> ...


No we get compensated better than the national average, and not super poor areas... We pick on fire, it's a brother-sister thing. Fire around here a majority are paramedics too, pretty good partnership. However, we give them ****.


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## luke_31 (Aug 10, 2017)

NysEms2117 said:


> well i won't have painkillers when i get shot... because there won't be a medic next to me .
> 
> not sure what your getting at here... yes bullets go through walls(if thats what you were asking). Casualty collection points are usually where theres limited access points, so you can secure them properly, and have a solid chance at defending it.
> 
> ...


Very good point on just tackling the guy rather then trying to draw your weapon. As far as the question you asked, there is no proven benefit to have a paramedic vs. the others you listed. The only expanded scope in that scenario is a needle decompression for tension pneumothorax, which can be taught and have a medical director sign off on them using the skill. I know our medical director has signed off on the tactical EMTs in our fire department to do needle decompression as needed in that scenario.


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## Luno (Aug 10, 2017)

What you said was...


bakertaylor28 said:


> If one means within the sense of military service, it is illegal under international law for the medical corps of any country to be armed. .



What you replied with was that if the weapons of medical personnel is used offensively, they lose their protected status.  Again, not exactly the same thing...   So again, please cite law and applicability...


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## CALEMT (Aug 10, 2017)

SandpitMedic said:


> "70-80 per kg of versed"?
> 
> Are you two even medics?!



Go big or go home?

On a side note I thought this thread was about armed tactical medics... not drug doses and narcan...


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## DesertMedic66 (Aug 10, 2017)

If it’s illegal for any miliatary medic to carry a weapon why are our military medics carrying and using weapons?


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## DesertMedic66 (Aug 10, 2017)

Medic27 said:


> Then you just give them 70-80 per kg of versed then it's night-time when their eyes roll back into their head.


Holy ****. I could give 70-80/Kg to a rock and I would still end up killing it. Hopefully you are meaning more in the 0.1-0.2mg/kg range..


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## bakertaylor28 (Aug 10, 2017)

Luno said:


> What you said was...
> 
> 
> What you replied with was that if the weapons of medical personnel is used offensively, they lose their protected status.  Again, not exactly the same thing...   So again, please cite law and applicability...


I'm sorry, but I Intended for that to be meant within the confines of the military / combat situation. Under the Geneva conventions, etc. if you offensively use a weapon you become a combatant, meaning you can be fired upon by enemy troops. Therefore, shooting back in such situations isn't smart.

In the sense of ordinary EMS, the civil self defense law applies- which can be quite problematic. Namely, because self defense is an affirmative defense, meaning you have to prove self defense by preponderance of the evidence. Especially when you combine it with the "duty to flee" before resorting to "Deadly force" still  imposed in some states on non-LEOs.


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## MonkeyArrow (Aug 11, 2017)

bakertaylor28 said:


> I'm sorry, but I Intended for that to be meant within the confines of the military / combat situation. Under the Geneva conventions, etc. if you offensively use a weapon you become a combatant, meaning you can be fired upon by enemy troops. Therefore, shooting back in such situations isn't smart.


Enemy troops will fire on you regardless. You think ISIS gives a crap about the Geneva convention? In fact, military medics often do not wear medical insignia because that makes them a bigger target to get shot at. Also, an overwhelming majority of the time, a combat medic is not going to be offensively using a weapon, but rather, in self defense (ie. sees enemy troop with rifle pointed at him, opens fire).


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## Jim37F (Aug 11, 2017)

Starting from scratch here: my thought process is that if you have a fairly controlled isolated situation, i.e. the traditional "Perp is holed up in that house, we got 50 cops on a perimeter and SWAT is gonna go bust down the door" type situation.....the medics should be in the cold zone, prob don't even need a vest and helmet, and no need to be armed. Someone gets shot/stabbed/falls 0ff the 2nd floor balcony/swallows all their drugs at once to get rid of the evidence/has a heart attack from the sudden action/etc....SWAT can secure the scene, apply TQ/direct pressure and either haul the patient to the medics, call the medics into the secured scene as needed. Regular ol street medics without any TCCC or other fancy training/special gear can handle these kinds of calls all day long.

ON THE OTHER HAND, you've got an Active Shooter loose in the area, possibly terrorism with multiple shooters.....whatever, but a much more complex, fluid environment where there is no clearly defined hot or warm zone and even the cold zone boundaries are fuzzy....now in that situation LEOs need to hunt down and stop the shooter(s). Best way to prevent more casualties.....but they cannot do that and pull out casualties at the same time. Nor is there any guarantee the situation will be resolved quickly....i.e. even if you have the cop toss a TQ or pressure bandage to a casualty, you either leave a casualty there to potentially die from a treatable wound, or pull cops out of the hunt to evacuate the wounded, thus potentially allowing the shooter(s) more ability to create even more casualties (since there's now fewer cops working to stop them).

THAT'S the situation I think it makes most sense to have tactical medics with vests and helmets and some basic tactical specific training that can maneuver into the poorly defined warm zone to previously marked casualties and pull them out....and in my mind, this also requires them to be armed and proficient enough with their weapon that if they do encounter the shooter(s) they can return fire (hopefully supress and even woubd/kill/stop the threat) while retreating back to cover. 

Even of you dedicate 2 cops to escort a 4 man tactical medic team, that's still half the number of cops dedicated to medical vs keeping the medics away and using only cops in that role. 

We got fairly lucky with San Bernardino....as bad as that was the attack was over relatively quick and the cops stopped the shooters before they could cause even more carnage....but there were only 2 terrorists in San Bernardino. 9 terrorists killed 130 (and wounded 368 more) over the course of 4 hours in Paris in 2015. 9 terrorists killed 164 and wounded 308 over the course of 3 DAYS in Mumbai in 2008. There's all sorts of 3 letter agencies doing their damndest to keep that from happening here, and they've apparently been fairly successful....but the ugly truth is that tomorrow a similar attack could easily happen in Los Angeles or Honolulu or New York or Camden or wherever.

Either you write off patients with survivable injuries, pull cops who are better off securing the threat to medical duties while keeping the medical team on the sidelines because they're not trained for such a tactical environment, or you send them in.

I think the threat is real enough (if a once in a career level recurrence) that you need medics trained to maneuver in such scenarios, and they need to be able to defend themselves in a pinch (if their only tactical goal is to suppress the threat in order to break contact and retreat back to cover and safe(r) area)

Just like statistically the vast majority of cops will never actually fire their weapons at someone, but are still universally trained and equipped to do so (some significantly more trained than others granted, but even the least trained cops still have a modicum of training on shooting) I think there's room for tactical medics to be trained to shoot back and never actually have to use said training....and chill out on the perimeter with the command post on the majority of their tactical call outs while SWAT goes in a few blocks away.


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## Jim37F (Aug 11, 2017)

Somewhat related to some of the recent ancillary discussion in resent posts on this thread, no particular order,

The Geneva conventions and whatnot only actually apply when two (or more) signatories are at war with eachother. ISIS, the Taliban, al Qaeda, etc etc are not signatories. Thus, legally speaking, the conventions do not apply to the wars in Iraq/Syria/Afghanistan/etc......and I'm pretty sure they have absolutely zero legal jurisdiction over anyone's internal domestic law enforcement and counter terror stuff.

Interestingly enough, even though every single 68W and 18D I've ever met have always been armed with a rifle and basic ammo load, and have been expected to engage the enemy should they be able to do so....Army Medevac helicopters, the DUSTOFFs, are not armed, something somewhat related to the Laws of Armed Conflict and that they have Red Crosses on them. That means that if a Soldier is critically wounded, but the enemy is still in the area, the DUSTOFF has to wait for an armed escort (usually an AH-64). There's more missions than helicopters, there's not always an Apache on standby ready to roll with the Medevac....so they have to sit and wait if need be. There are those who believe this has led to WIAs turning into KIAs.....
Now the Air Force Pararescue (PJs) helicopters, the PEDROs, do NOT have Red Crosses on them (despite being primarily Medevac birds for the Pararescue Jumpers).....and thus they are armed, often not just with the door guns, but often times an M2 .50 in the rear compartment as well....they do not have to wait on an Apache escort and can jump straight into a potentially hot LZ to evacuate the wounded while still defending themselves

Hmm...actually, I wasn't thinking it when I started typing, but yeah, that little comparison between the Dustoffs and the Pedro's is very relevant to the conversation IMO...


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## Medic27 (Aug 11, 2017)

DesertMedic66 said:


> Holy ****. I could give 70-80/Kg to a rock and I would still end up killing it. Hopefully you are meaning more in the 0.1-0.2mg/kg range..


Lol! See this is why I am an EMT, I don't push versed for a reason.


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## NysEms2117 (Aug 11, 2017)

@Jim37F i agree with most of your responses, my question would be... What if the medics needed to render medical care? now you have 2 cops watching over them, while 4 people crowd in a huddle around a person? (i know what should happen, but often times it doesn't)

I'd be super interested to know what other state level special tactics teams do if anybody is on or works with one. I only know NYS and NJ. 
We have Officer EMT's. where our primary goal is to be a SORT officer and neutralize the threat. secondary is to do medical treatment to our designated training level. One officer happens to be a paramedic. We have a sniper/spotter team, forced entry team, security team, and then k-9. The only difference between myself and other people on the team is our load-out, i have a small backpack(duffle bag size) to put bleeding control and basic airway equipment in.


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## EpiEMS (Aug 11, 2017)

Jim37F said:


> Somewhat related to some of the recent ancillary discussion in resent posts on this thread, no particular order,


Fascinating stuff, Jim! Thanks!


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## DrParasite (Aug 12, 2017)

NysEms2117 said:


> not sure what your getting at here... yes bullets go through walls(if thats what you were asking). Casualty collection points are usually where theres limited access points, so you can secure them properly, and have a solid chance at defending it.


you misunderstood. the medic in a CCP shouldn't be armed, nor do you need to be able to be a tactical medic to treat in a CCP.  any provider can be.  I was referring to idea of an unarmed medic being part of the rescue task force who are going down the halls either treating people in the open (which is generally not a great position to be in, and can go south unexpectedly)





NysEms2117 said:


> thus causing more harm then good, because as i'm sure you know this isn't the battle of bunker hill here... we don't stand in a line, and shoot. Thus 1 individual running the opposite way of gunfire, puts you in harm of friendly fire meaning we can't neutralize the threat...  I also know what your not going to do, your not going to draw your gun, while running and being surprised by a foe, while your foe already has guns up, get accurate shots on target and neutralize the target. This ain't a Rambo movie, and your not John Wayne. Chances are if your in close range, your best bet since you dont have guns up already would be to tackle said foe.


Agree to disagree.  You don't want the medic armed, and you don't want them fleeing to safety.  and if you think the medic comes upon an armed bd guy, they should just tackle said foe (which may or may not be what a cop would do)....  There doesn't seem to be any good position for the medic to be in..


NysEms2117 said:


> Dr. P as a side note, i genuinely don't know here and i'm asking a question not taking a stab at medics, but what can a paramedic do that an EMT/SWAT/SORT officer with TQ's OPA NPA. We're talking GSW's and Possibly stab wounds. I'm also talking life saving measures, not comfort things. What benefits does having a paramedic give, as opposed to somebody like myself or thousands of others that are an EMT and also happen to be on special response teams.


You want my honest opinion?  and this is just my opinion, not my agency's, not any standard at all, and just my opinion:  Paramedics have no place being on a SWAT team.  There are very few ALS interventions you are going to give under gun fire.  if you want a "tac medic", than grab an experience EMT who has experience with trauma (either former military medic who has been deployed and dealt with real injuries or someone who just extensive time working in cities with an active knife and gun club), and have them train alongside the said cops, every step of the way.  Same PT, same qualifications, heck, if you are training on breaching a door, and they are in the stack, put them up front and shoot at them so they know that the guy in the front goes through (in training only, not in a real thing).  If you don't have a full time SWAT unit (and many departments don't), than being a full time LEO isn't mandatory, but all the SWAT guys (including the tac medic) should train together.  If you insist on having a medical person with the team, they should do that (so they can do initial treatments under fire or whatever).  I do think you should have a paramedic ambulance nearby for every SWAT operations, but keep them in the cold zone, and if **** goes down hill, the cops bring out the injured people to the gun free zone.

People like having paramedics be part of Tac teams because there are some really stupid EMTs who thing paramedics have god like powers; these are usually the same EMTs that can't fart without a paramedics directing them on what to do, and how to do it.  and higher ups don't trust their EMTs to do bleeding control because they think that only a paramedic can do it.  i know of one suburban BLS agency that had 3 medics on staff (working as EMTs, they had been EMTs before going to paramedic school), and in the event of a SWAT deployment, their job was to pick up a van and meet the team on scene.  In the event that the cop got shot, their job was to grab them, throw them in the back of the van and drive really fast to the hospital.  Don't really need to be a medic to do that, but if gave someone from above a warm and fuzzy feeling.

The biggest advantage I can see to having a Tac medic with the team is in case **** does do downhill, you have one person whose sole job is to be treating the injured officer iwhile the others are shooting at the bad guy, instead of having an officer be forced to choose between taking out the threat and treating his fellow officer.

By the way, the City of Newark NJ (which has a very active knife and gun club) has a "medical person" on every SWAT call out, and 95% of the time that person is an EMT.... but they also keep a paramedic unit in the area just in case.

But if you are in that stack, and in that warm zone, and there is an elevated chance that you will have bullets fired at you, than you should be able to defend yourself just like everyone else in that group.  After all, if you (as the cop) was in charge of forcing the door, and then letting others clear the room, would you do it without a firearm on your person?  so why should a medic who is with you have to?


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## NysEms2117 (Aug 12, 2017)

DrParasite said:


> But if you are in that stack, and in that warm zone, and there is an elevated chance that you will have bullets fired at you, than you should be able to defend yourself just like everyone else in that group. After all, if you (as the cop) was in charge of forcing the door, and then letting others clear the room, would you do it without a firearm on your person? so why should a medic who is with you have to?


i think the difference is the job descriptions.... its my job to clear rooms and stack up, and have the elevated chance on having bullets fired at me. It's a medics job to provide healthcare to patients. 

It's ironic this topic has become rather hot lately, since i just had drills/re qualifications today. I still remain on the point of: im cool having paramedics calling themselves tactical and what not, if you can perform to the standards of the rest of the team. Same way as the military does it. I want to know that the people next to me have the same training and precision as i do, when my life is dangling by a tiny thread. If they want to carry ET tubes and been all paramedic AF after they qualify and prove precision like i have to, welcome to the team pal. but if you cant perform to the standards we have to I don't want you having a firearm. 

Also logically speaking.... wouldn't it be easier to take somebody who's already on the team, and already an EMT, send them to a hospital for a week to master needle decomps, and then have them stay on the team? instead of training somebody all of the tactics, fatal funnels, firearm proficiency, callsigns and signals, and everything else that goes along with a team?

I FULLY AGREE there should be paramedics waiting in the cold zone, hell there should probably be multiple ambulances there along with said medics as well. Bottom line is i just don't want my life to get jeopardized because i have to babysit some paramedic that wanted to be cool so he got tactical written on his vest.


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## luke_31 (Aug 12, 2017)

NysEms2117 said:


> i think the difference is the job descriptions.... its my job to clear rooms and stack up, and have the elevated chance on having bullets fired at me. It's a medics job to provide healthcare to patients.
> 
> It's ironic this topic has become rather hot lately, since i just had drills/re qualifications today. I still remain on the point of: im cool having paramedics calling themselves tactical and what not, if you can perform to the standards of the rest of the team. Same way as the military does it. I want to know that the people next to me have the same training and precision as i do, when my life is dangling by a tiny thread. If they want to carry ET tubes and been all paramedic AF after they qualify and prove precision like i have to, welcome to the team pal. but if you cant perform to the standards we have to I don't want you having a firearm.
> 
> ...


You hit the nail on the head that is how it should be, as far as people in the stack. It's nothing more then BLS until the cold zone anyway, so training up a paramedic to be in the stack is useless as far as efficienty goes. Warm zone operations as far as rescue and removal of patients doesn't need to be paramedics either, but vests and Kevlar helmets should be worn for protection since there is always the chance for a warm zone to go hot. But that is also why rescue teams move with security escort to where the patients are.


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## DrParasite (Aug 12, 2017)

NysEms2117 said:


> If they want to carry ET tubes and been all paramedic AF after they qualify and prove precision like i have to, welcome to the team pal. but if you cant perform to the standards we have to I don't want you having a firearm.


and if they can't perform to the standards you have, they have no business being in the hot zone.... or the warm zone.... they should stay in the cold zone, and let the cops bring the injured to them.  Maybe not to your standards (esp since I think you said you go above and beyond the requirements), but to the standards that are applied to everyone on the team.  This we totally agree on.  





NysEms2117 said:


> Also logically speaking.... wouldn't it be easier to take somebody who's already on the team, and already an EMT, send them to a hospital for a week to master needle decomps, and then have them stay on the team? instead of training somebody all of the tactics, fatal funnels, firearm proficiency, callsigns and signals, and everything else that goes along with a team?


sure.... if you want a poorly trained EMT or paramedic, who does it very rarely, barely trains in EMS, and does EMS on the side when needed (maybe once or twice a year), sure.  Nothing against you personally (since you are on the ambulance once a week), but if a cop (or firefighter, or anyone for that matter) isn't on an ambulance on a regular basis, how sharp are his skills? BTW, we have the same issue with career firefighters who have issues taking manual blood pressures reliably, performing accurate patient assessments, or who have never spent more than three ride along shifts in EMT class as an observer actually being with the patient to the ambulance when they go to the hospital...But that's a topic for another day...





NysEms2117 said:


> I FULLY AGREE there should be paramedics waiting in the cold zone, hell there should probably be multiple ambulances there along with said medics as well. Bottom line is i just don't want my life to get jeopardized because i have to babysit some paramedic that wanted to be cool so he got tactical written on his vest.


Bottom line is I won't want my life to get jeopardized because I'm going into a warm or hot zone with a bunch of armed cops, who are armed for a reason, usually to keep themselves alive (often by taking out the bad guy), but I'm not allowed be carry a firearm despite being exposed to the same threats that they are.


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## TheBestRobert (Aug 15, 2017)

Trauma treatment during a fire fight should be limited to massive hemorrhage control. Everyone in the team should be trained in hemorrhage control techniques and equipment, such as applying the tourniquet. The ability to neutralize the threat is more important than advanced medical skills at this stage. 
Once the imminent threat has been neutralized, and the casualty in en route to the hospital, then the medic should be performing more advanced treatments such as needle chest decompression, IV or IO, airway, etc. 
So yes, the tactical medic should be armed and trained to the level of the other tactical members.


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## Tigger (Aug 15, 2017)

Here the county's team has a paramedic on it. He is armed and went through the same training as the rest of the guys. While most truly time sensitive interventions don't need a paramedic, he takes care of all the team's medical aspects as well. He coordinates their training, works with them on personal injuries, and makes sure their missions factor in medical evac planning.


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## Luno (Aug 23, 2017)

bakertaylor28 said:


> I'm sorry, but I Intended for that to be meant within the confines of the military / combat situation. Under the Geneva conventions, etc. if you offensively use a weapon you become a combatant, meaning you can be fired upon by enemy troops. Therefore, shooting back in such situations isn't smart..



Again, not quite accurate...  Shooting back in such situations is defensive.  As a military medic, you are assigned a weapon for defense of yourself and your patient.   Care to correct?


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## Luno (Aug 23, 2017)

Jim37F said:


> Interestingly enough, even though every single 68W and 18D I've ever met have always been armed with a rifle and basic ammo load, and have been expected to engage the enemy should they be able to do so....Army Medevac helicopters, the DUSTOFFs, are not armed, something somewhat related to the Laws of Armed Conflict and that they have Red Crosses on them. That means that if a Soldier is critically wounded, but the enemy is still in the area, the DUSTOFF has to wait for an armed escort (usually an AH-64). There's more missions than helicopters, there's not always an Apache on standby ready to roll with the Medevac....so they have to sit and wait if need be. There are those who believe this has led to WIAs turning into KIAs.....
> Now the Air Force Pararescue (PJs) helicopters, the PEDROs, do NOT have Red Crosses on them (despite being primarily Medevac birds for the Pararescue Jumpers).....and thus they are armed, often not just with the door guns, but often times an M2 .50 in the rear compartment as well....they do not have to wait on an Apache escort and can jump straight into a potentially hot LZ to evacuate the wounded while still defending themselves
> 
> Hmm...actually, I wasn't thinking it when I started typing, but yeah, that little comparison between the Dustoffs and the Pedro's is very relevant to the conversation IMO...



There is a much larger difference between PJs and medevac, firstly that the one is medevac and the other isn't...  Now onto the rest, while the medevac helicopter is not armed the crew most definitely is if they are flying in a combat theater.  Yes, standing orders were that medevac has an escort... The PJs, their helicopter and their mission is not medevac, they pick up medical evacuation missions, but they are a combat search and rescue asset.  Finally, I had to google this one, "M2 in the rear compartment" because for the life of me, I couldn't remember a pavehawk with a rear compartment, and was pretty sure the pavelows were retired.  Well, there might be one mounted on the ospreys, but haven't seen it yet...


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## noarguy (Aug 24, 2017)

Yes they should be armed


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## rhstanford (Dec 20, 2017)

bakertaylor28 said:


> Narcan in the presence of Tramadol is well-documented to cause seizures and more rarely  status elipticus. It mimics TCAs in a lot of ways, yet also has opioid effects as well. The particular case in question resulted in status elipticus and consequential arrest.


What research are you basing your post on? Just out of curiosity.


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## CWATT (Dec 20, 2017)

NysEms2117 said:


> Dr. P as a side note, i genuinely don't know here and i'm asking a question not taking a stab at medics, but what can a paramedic do that an EMT/SWAT/SORT officer with TQ's OPA NPA. We're talking GSW's and Possibly stab wounds. I'm also talking life saving measures, not comfort things. What benefits does having a paramedic give, as opposed to somebody like myself or thousands of others that are an EMT and also happen to be on special response teams.





NysEms2117 said:


> i think the difference is the job descriptions.... its my job to clear rooms and stack up, and have the elevated chance on having bullets fired at me. It's a medics job to provide healthcare to patients.
> 
> 
> Also logically speaking.... wouldn't it be easier to take somebody who's already on the team, and already an EMT, send them to a hospital for a week to master needle decomps, and then have them stay on the team? instead of training somebody all of the tactics, fatal funnels, firearm proficiency, callsigns and signals, and everything else that goes along with a team?




You have a LOT of really good discussion points here.  Here in Canada, the federal agency — Royal Canadian Mounted Police (RCMP) takes members with previous medical experience and provide them with training in such medical interventions as you’ve listed.  It’s their position that current members of the tactical units have the appropriate training and tools for the hazards the role presents. 

The problem is that the majority of agencies in Canada who do employ tactical paramedics disagree.  The Ontario Provincial Police (OPP) utilize Advanced Care Paramedics (ACPs) which are equivalent to EMT-Ps who are employed full-time on a service.  The belief being that full-time EMS employment will ensure knowledge and skills proficiency that a clinical rotation in a hospital simply cannot provide.

My personal belief is that if there are going to be paramedics in a tactical unit, they should be full-time tactical members and complete role-specific physical fitness standards and law-enforcement education.  However, they should also be routinely working on an EMS service.  There are a few ways to achieve this too which offers flexibility.


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## RocketMedic (Dec 30, 2017)

I think that, for most needs, it is both more efficient and more effective to train a team for CLS or _maybe_ EMT than it is to have a tactical paramedic.


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## FireDog19 (Mar 3, 2018)

Okay, so small town USA here. My entire country really, but due to growing tension and threats we have planned for the worst. Eg. school shooting, county sheriff's office sends a team in with an unarmed TAC Medic to triage and render emergency care while clearing the building. In these situations it has been decided that the TAC Medic is just that a medic and the sole responsibility of the LEOs is to neutralize the threat. A second team will follow to pull victims according to triage tags. I am pro gun, but not in this case, it'll only get in the way.


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## FireDog19 (Mar 3, 2018)

Note, in my county we're mostly volunteer fire EMT, paid EMS so while a medic is likely to go in at this point we at pushing to send volunteer EMTs in efforts to have all ambulances running transport.


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## VFlutter (Mar 3, 2018)

Being armed and actively being involved in the tactical aspect of the situation are two different things. These situations are fluid and I for one would not want to be unarmed. Yes carrying a long gun is unnecessary and probably will get in the way but no reason they shouldn't have a sidearm just incase be it your normal CCW or whatever. 



Oh and AFSOC Ospreys' have .50s


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## 06Unltd (Aug 14, 2018)

CWATT said:


> I suppose my thought is if the Tactical Medic is required to wear body arnour due to risk of being shot, I believe having the ability to protect ones self with the same force is only appropriate.   Thoughts?



I concur


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## RocketMedic (Oct 4, 2018)

I reckon a Colt SAA or 1911 would be a good idea.


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