# Unarmed tactical medics



## matt202 (Dec 19, 2009)

In the UK, tactical medicine is in its infancy. I would be really interested to here the views of those who are involved in providing an EMS response to swat team deployments. Are you doing it armed? If not, has it been tested i.e when the bullets are flying. In the UK we do not let EMS into the hot zone until it is safe. 

Regards

Matt


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## spinnakr (Dec 19, 2009)

The answer to this question is going to vary from department to department.

I think _generally_ armed tac-EMS are employed in a law enforcement capacity when they are armed, but again, this varies from place to place.


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## FF-EMT Diver (Dec 19, 2009)

It's done both way's in these parts and others...I personally would not do it unarmed, that's just me....Send me a PM for more questions and I'll attempt to help you out.


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## DrParasite (Dec 20, 2009)

most Tac medics ARE NOT armed, except if they are sworn and trained law enforcement officers.  They must meet all the physical requirements of the SWAT team members, often train side by side with them, and wear the same PPE and identification (except for maybe medic on their chest) as the rest of the team members during operations. 

but unless they are also cops, and certified law enforcement officers, no, TAC medics do not carry firearms.


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## BLSBoy (Dec 20, 2009)

I am in the process of becoming a Tactical Medic for my project. 
We are not LEOs, and thusly, are unarmed.


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## zmedic (Dec 20, 2009)

My understanding is a lot of tactical medics spend time shooting with the team, even if they don't carry weapons during deployment. The idea is that since there are often weapons on scene they should feel comfortable handling firearms, and it helps with the team building aspects since the operators spend a lot of time shooting.


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## matt202 (Dec 20, 2009)

So if you are doing it unarmed how do you go about getting access to the patient? My reasons for asking are simply this. In the team I work for, we will assign EMS to the nearest point of safety with strict rules that they don't move until we call them. When it goes wrong it is down to the firearms team to deal with the threat and the EMS wait until this is done. Time then becomes the variable. Do your tactical medics act independently or do they wait until the swat make it safe for them to proceed?


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## FF-EMT Diver (Dec 20, 2009)

Ok I'm not going to start the debate again (it has already been debated)....But PLEASE listen to someone that DOES it....I am not a POST certified officer I am a sworn deputy and thus have the powers of a deputy in certain situations.....Again I DO carry and just for the record am the most proficient shot on my team ( which is a big plus for the medic) because sometimes it's easy at 1st for them to consider you band-aid boy instead of an operator....Again Matt you are welcome to PM and I can possibly put you in contact with some folks.


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## FF-EMT Diver (Dec 20, 2009)

matt202 said:


> So if you are doing it unarmed how do you go about getting access to the patient? My reasons for asking are simply this. In the team I work for, we will assign EMS to the nearest point of safety with strict rules that they don't move until we call them. When it goes wrong it is down to the firearms team to deal with the threat and the EMS wait until this is done. Time then becomes the variable. Do your tactical medics act independently or do they wait until the swat make it safe for them to proceed?



The way we do Matt is the medic is typically 5th man in the stack if an officer goes down we either treat in place or extract (if shooter is not contained we treat in place) If shooter is taken down we extract while the rest of the building is cleared.  OFFICERS ARE FIRST PROIORITY!!!!!

Now this scenario is for high risk warrant service/barricaded suspect. If you have an domestic terrorist incident such as shooter going wild in office building with multiple victims the medic proceeds with the team and does not treat anyone regardless he is their for the team only until suspect is elimenated/detained.Once building is secured EMS will come in and begin tx.


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## reaper (Dec 20, 2009)

DrParasite said:


> most Tac medics ARE NOT armed, except if they are sworn and trained law enforcement officers.  They must meet all the physical requirements of the SWAT team members, often train side by side with them, and wear the same PPE and identification (except for maybe medic on their chest) as the rest of the team members during operations.
> 
> but unless they are also cops, and certified law enforcement officers, no, TAC medics do not carry firearms.



Really? Our Tac Medics are not sworn officers or trained LEO. The entire team is armed while preforming their duties. They train with the team and are required to qualifiy on the range. Our Tac Team scores are always higher then the officers on the team.

No, most teams are not armed, but there are some teams that go above the line and are trained for that reason.


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## LondonMedic (Dec 28, 2009)

Is there any evidence supporting the incorporation of paramedics in SWAT/SFO teams?

Or is it just a 'common sense' thing?


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## zmedic (Dec 28, 2009)

There is some decent evidence on the whole golden hour, so if you can have someone who can operate in the "hot zone," triaging and evacuating people before the scene is secure that should reduce the time it takes the wounded to get to surgery. Look at some of the school shootings, where it takes the cops about an hour to clear the school from the time that they enter. That's a long time to be lying wounded without medical attention. 

Haven't seen randomized trials on tactical medicine. But there isn't a whole lot of evidence for much of what is done in EMS.


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## LondonMedic (Dec 29, 2009)

zmedic said:


> There is some decent evidence on the whole golden hour, so if you can have someone who can operate in the "hot zone," triaging and evacuating people before the scene is secure that should reduce the time it takes the wounded to get to surgery. Look at some of the school shootings, where it takes the cops about an hour to clear the school from the time that they enter. That's a long time to be lying wounded without medical attention.


You raise an interesting point, but I understood the golden hour to be time to definitive care (the platinum ten minutes might be a better argument). But, how common are incidents like that in your area? Do you think this is (or would be) worth the cost? The other question your scenario raises is that the school shootings typically had multiple victims, how many tactical medics do you think you should have?


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## spinnakr (Dec 29, 2009)

LondonMedic said:


> You raise an interesting point, but I understood the golden hour to be time to definitive care (the platinum ten minutes might be a better argument). But, how common are incidents like that in your area? Do you think this is (or would be) worth the cost? The other question your scenario raises is that the school shootings typically had multiple victims, how many tactical medics do you think you should have?



If you're talking about an MCI, then your focus is (initially) on triage and incident management, regardless of how many personnel you have available.  Two or three GOOD triagers - trained, practiced, and prepared - can triage 30+ casualties in less than 10 minutes.  A large school shooting is a bad example - the focus is fundamentally different than most tactical actions.  In an MCI the focus is to do the most good for the most people as quickly as possible.  In an isolated incident, the goal is to save _one_ patient.  Huge difference.

Correct me if I'm wrong, but the primary concern of tactical medics is to care for their own people.  In other words, if a SWAT medic is primarily intended to treat members of his team.  There are also "secondary" aspects - functioning as team trainer, etc - that sometimes get involved, but as far as emergent care is concerned, my understanding is that tac medics are there first and foremost for the tactical personnel, NOT bystanders or downed assailants.  IF and ONLY if there's no need to treat team members, then others are treated.


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## DrParasite (Dec 30, 2009)

spinnakr said:


> Correct me if I'm wrong, but the primary concern of tactical medics is to care for their own people...  but as far as emergent care is concerned, my understanding is that tac medics are there first and foremost for the tactical personnel, NOT bystanders or downed assailants.  IF and ONLY if there's no need to treat team members, then others are treated.


Bingo!


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## matt202 (Dec 31, 2009)

Anecdotal accounts are one thing but is there any hard evidence around the time taken from injury to the time the time EMS gets hands on the patient during swat team deployments? Furthermore is there any evidence in relation to unarmed tactical medics moving forward to manage casualties while the swat team is still dealing with the threat? My reasons for asking are that in my experience in the UK if you are not in there as part of the team you don't get in there until it is safe. This is due to a variety of reasons and i'm asking so as to learn from your experiences to improve our system.

Regards

Matt


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## John E (Jan 1, 2010)

reaper said:


> Really? Our Tac Medics are not sworn officers or trained LEO. The entire team is armed while preforming their duties. They train with the team and are required to qualifiy on the range. Our Tac Team scores are always higher then the officers on the team.
> 
> No, most teams are not armed, but there are some teams that go above the line and are trained for that reason.



I want to be sure I fully understand this statement, are you saying that your Medics are not sworn or trained LEO's but they carry and use weapons while on a call? 

I find that nearly impossible to believe. And if it is true, what city and state do you work in that allows non-sworn personnel to carry and use weapons?

JohnE


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## redcrossemt (Jan 4, 2010)

zmedic said:


> There is some decent evidence on the whole golden hour, so if you can have someone who can operate in the "hot zone," triaging and evacuating people before the scene is secure that should reduce the time it takes the wounded to get to surgery. Look at some of the school shootings, where it takes the cops about an hour to clear the school from the time that they enter. That's a long time to be lying wounded without medical attention.
> 
> Haven't seen randomized trials on tactical medicine. But there isn't a whole lot of evidence for much of what is done in EMS.



Could you share with us this decent evidence on the golden hour?


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## Afflixion (Jan 8, 2010)

I would never even consider accepting a position in OEMS without being armed. There's no point to it then, you might a just grab any medic off the street and have them come with you. Yes, there are places that you do not need to be a sworn LEO to carry a weapon, BUT you are trained in with every weapon you are to use and required to qualify on it. 



			
				LondonMedic said:
			
		

> The other question your scenario raises is that the school shootings typically had multiple victims, how many tactical medics do you think you should have?



A tactical medic is well versed in treating multiple casualties with limited resources, The triaging system for a mascal incident is different than that of a normal isolated incident. Each team has one TacMedic, in events over sprawling expanses of land you do not just have one team operating. Most places that do not have a massive use of SWAT have officers trained in SWAT and are otherwise normal officers that carry extra gear in their trunk the rest of the time. The same is true for TacMedics, some places contract out to companies or FDs, and the ones that do are awarded a bonus the ones that hire individual TacMedics are TYPICALLY on a volunteer basis / paid by the incident. You are required to hold a tactical EMT certification noted as an EMT-T title or Emergency Medical Technician - Tactical.


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## Jon (Jan 8, 2010)

John,

There are many different ways folks can legally carry and use firearms. It all depends on different state laws and local policies.

PA, for example, supposedly has some tac-med teams that are armed. Their medics obtain the state's Act 235 card (Lethal Weapons Training Act), as they are using firearms as part of their employment... usually this is the permit an armed guard needs.

Other places may do that. Other places my "deputize" the EMS personnel so that they, as civilians, have limited LEO powers when needed.

Conceivability, in some parts of the county, a Tac-Med medic might need a CCW permit, or might not need any permit at all, depending on how great the right to keep and bear arms has not been infringed.


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## John E (Jan 8, 2010)

*Gosh....*

I had no idea people could carry guns these days...( that was sarcasm for the humor impaired).

I'm well aware that there are ways for people to carry guns, I'd guess that some EMT's even carry guns, what I don't believe and unless someone can provide some actual verifiable sources is that any EMT or Paramedic is allowed to not only legally carry a gun but legally use a gun while working with law enforcement without being a sworn police officer or sheriff's deputy or some other LEO.

It's the use of words like "supposedly" and "usually" and "Other places may do that" and " there are places that you do not need to be a sworn LEO to carry a weapon..." without a single verifiable source that make me wonder if you guys have a clue.

An EMT that's been "deputized" is considered a law enforcement official, that's sort of the whole point of being deputized.

The key word there is "deputized".

The topic at hand has NOTHING to do with anyone's right to bear arms. We're talking about people using a weapon while engaged in law enforcement procedures. 

If anyone can provide a single actual reference to any police dept. that's using Tactical Medics or any other sort of Medic, arming them, and letting them respond to police calls while armed and then letting them use their weapons while on that call without requiring them to be sworn/deputized  police officers, please provide a source. 

I couldn't help but notice that the poster who was bragging about how well his "tac team" can shoot hasn't responded. 

Look, if I'm wrong I'll be the first to admit it but I simply don't believe in this day and age that any police department would take on the liability of allowing a non-sworn person to carry and use a weapon. 

John E


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## spinnakr (Jan 8, 2010)

John E said:


> I had no idea people could carry guns these days...( that was sarcasm for the humor impaired).
> 
> I'm well aware that there are ways for people to carry guns, I'd guess that some EMT's even carry guns, what I don't believe and unless someone can provide some actual verifiable sources is that any EMT or Paramedic is allowed to not only legally carry a gun but legally use a gun while working with law enforcement without being a sworn police officer or sheriff's deputy or some other LEO.


I don't think this is quite the issue at hand.  Carrying a weapon for self-defense presumes the ability to use it.  If a tac medic is serving in an armed capacity, he, almost by definition, can use his weapon.  In other words, _especially_ in a tactical situation, if you are expressly allowed to carry, then you are allowed to shoot.

The legality of carrying a weapon as an EMT or paramedic (non-tac) varies GREATLY, and is a topic that's hotly debated...  not to mention (in this case) irrelevant, since we're talking about tactical medics.


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## John E (Jan 9, 2010)

*Well I don't know what issue...*

you're referring to but I'm referring to what the poster who calls himself "reaper" wrote in his message above in which he referred to medics on his "tac team" carrying and using firearms but not being law enforcement officials.

I don't believe that any police department or other law enforcement agency would allow an EMT or a Paramedic to carry and use a firearm while participating in any law enforcement activities without that EMT or Paramedic being a LEO themselves. 

I'm not splitting hairs about right to carry laws and self defense situations. I'm asking for someone to provide a verifiable reference to a department that allows non-sworn or non-deputized personnel to use firearms while on duty. 

I'm not saying it's impossible, I just find it very hard to believe that as I wrote earlier, that any police department would take on the liability of allowing non-sworn personnel to use a gun. 

The topic of EMS personnel carrying firearms has been beaten to death on this forum many times, I'm not referring to that scenario. I'm referring to the department sanctioned use of a firearm by someone who's not a LEO.


John E


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## spinnakr (Jan 9, 2010)

Sorry, I may not have been the clearest in my post.  I was trying to point out that it seemed you were making a distinction between carrying and using a firearm in a tactical environment;  however, I see no such distinction.



John E said:


> I'm not splitting hairs about right to carry laws and self defense situations. I'm asking for someone to provide a verifiable reference to a department that allows non-sworn or non-deputized personnel to use firearms while on duty.


I realize that, but what I was saying, is that for a tactical medic who is not acting as a LEO, a firearm is a _defensive_ measure (or at least should be).  Again, ultimately, I'm trying to say that there is no difference between carrying a weapon and using a weapon in a tactical situation.  There _may_ me a difference in the capacity in which the medic is used - for example, he may be put in the stack and serve as a LEO, or he may be taking cover in the nearest "warm" zone - but carrying and using is the same thing.  If you carry, and you are threatened, then you will use.  The only distinctions to be made are about the likelihood of firing the weapon.

In my mind, unarmed tactical medics are being put in an extremely perilous situation.  I don't care how much trust you have in your team - if you're in a hot zone, you should be armed.  But that's just my $.02.



John E said:


> I'm not saying it's impossible, I just find it very hard to believe that as I wrote earlier, that any police department would take on the liability of allowing non-sworn personnel to use a gun.


I don't think this is very likely, either - but only for liability reasons.  Let me be clear:  I agree with you (mostly) on this particular point.  Unless we're talking military medics, then if the medic isn't a LEO or deputized (aka LEO), then I can't see him being armed.



John E said:


> The topic of EMS personnel carrying firearms has been beaten to death on this forum many times, I'm not referring to that scenario. I'm referring to the department sanctioned use of a firearm by someone who's not a LEO.


I wouldn't have brought it up, except that I saw this:
"I'm well aware that there are ways for people to carry guns, I'd guess that some EMT's even carry guns"​which to me (possibly a misunderstanding!) was bringing it up.


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## Afflixion (Jan 13, 2010)

John E said:


> It's the use of words like "supposedly" and "usually" and "Other places may do that" and " there are places that you do not need to be a sworn LEO to carry a weapon..." without a single verifiable source that make me wonder if you guys have a clue.



I worked as a TacMedic for 2 years at White Sands Nuclear Missile Range I was armed with an M4 (AR-15) and an XD45 Service Model Handgun. I was not a law enforcement officer, I was however certified as a security officer (different than security guard) and I was required to qualify four times a year on both weapon systems.  So yes I do have a clue and no, in fact there is no set standards on tactical paramedics carrying weapons it varies from department to department. 



John E said:


> An EMT that's been "deputized" is considered a law enforcement official, that's sort of the whole point of being deputized.
> 
> The key word there is "deputized".
> 
> ...



Verifiable source that does not pertain to OEMS per say but Walden Security who provides security on all U.S Military installations are armed and once again are not sworn LEOs. They are once again certified as security officers. Another would be the guards outside Texas state government buildings, they are not LEOs, yet still armed.



John E said:


> I couldn't help but notice that the poster who was bragging about how well his "tac team" can shoot hasn't responded.



The original poster is from the United Kingdom and has different terminology than us Americans.



John E said:


> Look, if I'm wrong I'll be the first to admit it but I simply don't believe in this day and age that any police department would take on the liability of allowing a non-sworn person to carry and use a weapon.



Once again not all in OEMs are part of a police department or Sheriff's Office, and once again every PD varies. I know that Hudspeth County Sheriff's Office does not require their TacMedics to be LEOs as the population and ammount of medics in general in Hudspeth are not high enough that they can pick and choose.


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