# Tactical EMS



## skyemt (Dec 9, 2007)

Hi...

some of our corps in interested in tactical ems training...

i seem to think some out here have had this training... would it be beneficial to ems skills?  was it worthwhile training?


thanks


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## medic001918 (Dec 9, 2007)

I don't think that tactical EMS training is a worthwhile venture.  Maybe if you live in a large area that has a lot of tactical involvement, it could be justified.  In most cases though, this isn't the case.

As far as changes to patient care in a tactical environment, one of the largest focuses in a tactical situation where someone goes down should be extraction as opposed to patient care.  For many teams, they use armed officers as their medical on the entry team and they'll extract the person to EMS in a safe zone for further treatment.

I think there are better uses of training funds rather than tactical training.  Your milage may vary.

Shane
NREMT-P


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## skyemt (Dec 9, 2007)

thanks for the input...

you say there are better uses for training funds...
would you mind listing some ideas you feel are most important...


thanks


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## medic001918 (Dec 9, 2007)

Any program that will increase a knowledge base to provide more thorough assessments.  Anatomy & physiology are huge towards providing care.  Vehicle operations are a large area that we lack safety as a profession.  A class on writing run forms is good, since that's a large liability to any service and provider.  These are some areas that you are likely to see a benefit from on most (if not all) calls that your service responds to.

Shane
NREMT-P


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## ffemt8978 (Dec 9, 2007)

Moved to appropriate forum.


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## triemal04 (Dec 9, 2007)

Sorry, this is a touchy subject for me, so don't take this personally.  

Do you respond with your local/regional SWAT team as part of the team?  If yes, then yeah, you need a TEMS course, and hopefully have been put through one by your team.  If no, then no, you in no way need a TEMS course.  Don't waste your time or anyone elses.

A good way to use the money would be on a BTLS course, PHTLS (if you can get a good instructor...actually that goes for each course), ACLS, or AMLS (though I've never heard much good about this one, but still could be good for BLS providers).  Depending on the level of your service you might want to think about getting someone to come in an lecture on various topics; advanced airway if you carry them, specific medical problems, or general topics (trauma, respiratory, cardiac).

If you've got a lot of money, there is a driver training service out there (forgot the name but I'll try and find it) that is very worthwhile to get, but also pretty expensive; they'll bring a simulator to you and put you through a course that's worth the time and money.


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## medic001918 (Dec 9, 2007)

triemal04 said:


> Do you respond with your local/regional SWAT team as part of the team?  If yes, then yeah, you need a TEMS course, and hopefully have been put through one by your team.  If no, then no, you in no way need a TEMS course.  Don't waste your time or anyone elses.



Just responding with the SWAT team is not sufficient enough to warrant a tactical course.  I think a tactical course is only needed if you're part of the entry team.  Otherwise, all of the patient care should occur in a safe zone with extraction performed by the entry team.  Otherwise, it's just like any other call.

Shane
NREMT-P


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## Luno (Dec 9, 2007)

*Interesting views...*

I guess every so often I have to show up, and throw my .01 in here, the advice is free, and worth every penny you paid for it...   Anyway, in my opinion, the truth is always shades of grey, and here is my relative viewpoint...  



> I don't think that tactical EMS training is a worthwhile venture. Maybe if you live in a large area that has a lot of tactical involvement, it could be justified. In most cases though, this isn't the case.
> 
> As far as changes to patient care in a tactical environment, one of the largest focuses in a tactical situation where someone goes down should be extraction as opposed to patient care. For many teams, they use armed officers as their medical on the entry team and they'll extract the person to EMS in a safe zone for further treatment.



I'm gonna have to differ with Medic001918 on some points here, tactical EMS training is a worthwhile venture, however, the worth depends on the deployment method...  If you are working actively with a tactical team, then there is immeasureable worth, if you're not working with a tactical team, you might play paintball a little better, that's worthwhile for someone, right?  And as a second point, there are mulitiple deployment uses for tactical medics, including within the stack, in the hotzone, not in the stack, on special extraction teams staged either in the hot or warm zone, or standard EMS in the cold zone.  These variations are based on the needs of the team, and of course politics in the agencies, so to say that it's worthless, paints a rather broad stroke.  And that's just looking at the standard LE use, not to mention protective details, counter-terrorism, etc... where the medics are embedded.



> I think there are better uses of training funds rather than tactical training. Your milage may vary.


I absolutely agree with Medic001918, I've seen so many people who want the "coolguy" factor, but their basic skills are abysmal at best.  If you are not involved with a tactical team, the money is much better spent on other things.  If your agency is looking to pitch the "tactical medicine" angle, then maybe the training would be worthwhile, but to have, just to have, is like having a Ferrari for a Quick Response Vehicle, really cool, really fast, completely useless for day to day operations....



> Do you respond with your local/regional SWAT team as part of the team? If yes, then yeah, you need a TEMS course, and hopefully have been put through one by your team. If no, then no, you in no way need a TEMS course. Don't waste your time or anyone elses.


Yeah, I'd agree with triemal04 about 99%, while there are other opportunities for people with tactical medical training, the key here is that you need to have a good reason to do it, you are going to need a team that you can train and practice with, the equipment isn't cheap, so if you're not agency sponsored, you're going to have a little education, and no way to expand it.  Look at it this way, it's like when you went to EMT school, if you never got to work on patients, how long do you think you'd be able to retain that knowledge and maintain proficiency?  



> Just responding with the SWAT team is not sufficient enough to warrant a tactical course. I think a tactical course is only needed if you're part of the entry team. Otherwise, all of the patient care should occur in a safe zone with extraction performed by the entry team. Otherwise, it's just like any other call.



I'm going to have to disagree with Medic001918 on this one, if you're responding with a tactical team, you most definitely should take a course.  Given the way events unfold, there is the distinct possibility that the cold zone becomes the hot zone very quickly, also there are 101 possibilities of things that can go wrong, and if you're trained, it gives the onscene command the ability to adjust accordingly, rather than having a static asset.  

There are much better choices for training other than Tactical Medical training, I never thought about it, but both medic and tri are right, driving (a huge liability), report writing, A&P, etc...  These will help you in your everyday job, rather than that one pie in the sky event that may or may not happen, if you're not actively affiliated with someone who needs that highly specialized training.


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## thowle (Dec 16, 2007)

I would agree that tactical training paired with EMS training (whether it be EMT-B, or EMT-P) would be extremely beneficial, especially in the setting described.

I mean, really there isn't really a "draw-back" out there, unless I'm skipping over something?  They would both compliment each other quiet well, and as said; be very beneficial in the field and on the job.


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## medic001918 (Dec 16, 2007)

thowle said:


> I would agree that tactical training paired with EMS training (whether it be EMT-B, or EMT-P) would be extremely beneficial, especially in the setting described.
> 
> I mean, really there isn't really a "draw-back" out there, unless I'm skipping over something?  They would both compliment each other quiet well, and as said; be very beneficial in the field and on the job.



I still say if you're going to pursue this type of training, it should be after you've covered all the other additional training that will have a day to day impact.  Tactical involvement is not a daily occurrence for 99% of the providers out there.

Training dollars should be spent to maximize the good impact they'll have.  And there are plenty of day to day skills that don't get reviewed or are lacking in the first place.

Shane
NREMT-P


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## thowle (Dec 16, 2007)

Shane does have a good point.  Work on other training that would directly benefit your day-to-day routines first, and then move on to advanced training that would only be used in special operations and events.

However, with this I suppose the wheel changes if you are doing EMT-B or EMT-P for a military oriented purpose, or another defined tactical operatable group.


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## Jon (Dec 24, 2007)

thowle said:


> Shane does have a good point. Work on other training that would directly benefit your day-to-day routines first, and then move on to advanced training that would only be used in special operations and events.
> 
> However, with this I suppose the wheel changes if you are doing EMT-B or EMT-P for a military oriented purpose, or another defined tactical operatable group.


Exactly.

Next time a Tactical Medicine course is offered nearby, I'll probably take it - for my own personal knowledge. I work for a security company and am licensed to carry a firearm for work... In the event that my workplace goes armed (probably not going to happen) having some extra training on the EMS side isn't a bad thing, as I'm one of 2 firearms-qualified EMT's on the account.

***DISCLAMER*** Please note that I am not working in an EMS envroment... I'm working in a security enviroment as a first responder... so No, I don't plan on stuffing an AR behind the seat in the ambulance!


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## wildmedicspm (Dec 28, 2007)

*Good Foundation*

I believe that we would all agree that NO ONE should persue tactical or wilderness jobs until they have a high level of competency in regular EMS.
Nothing beats a solid foundation before you throw in the wrench into the works with the additional hazards and limitations that tactical and wilderness situations place on the provider.  I have the great pleasure of working in both the tactical (military/civilian) and the wilderness environments--there is absolutely nothing better---However, it is the foundational medicine learned in the street that provides the provider (whether BLS or ALS) with the competencies needed to have tactical/wilderness successful outcomes.

THAT BEING SAID---Focus on the street---and then once you are confident and competent (it's dangerous to have one without the other)---go for the gusto!!!!!!!!!!!!!!!!!!!


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## cfrench (Feb 12, 2008)

I know I am just a newbie here (just found the forum) but, the original post was asking about his LEOs getting some EMS training. It was not about him. I think some kind of CLS training would be very helpfull. It does need to be anything offcial. All SWAT operators should carry some kind of IFAK on their vest. Teach them to use the contents of a kit and what to do about self care for when they go down in a very hostile enviroment where help is not coming in the next few seconds (tourniquets, etc). If you are now or going to be an Active TEMS provider go find the best TEMS class you can find. If you are not then keep playing paintball (unless you need lots of CEH's and want something very different).
FWIW, YMMV


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## sandboxmedic (Mar 12, 2008)

i agree with LUNO, if your with a team, or entering one get the training but ONLY if you are competent and confident with your street skills.Truth be told its easier to teach a medic how to shoot than a LEO how to become a medic, generally speaking of course.

As far as the comment made " tactical training" is a "waste" and victims should be extracted by the entry team,....You dont have any experience in this field I take it.  Gunfights happen, people get pinned down and cant move from hard cover if they were so fortunate to find it and get behind it in time. Tactical-medicine and good tactics WILL ALWAYS be at odds with each other, so, WE, The Medics learn both, adapt/overcome and try and fluidly solve ANY problem.
In a perfect world as soon as someones shot the entry always can call "time out" and extract everyone to the "green zone" , Right?, some 100yds away to an ambulance with a trauma surgical team in the back?? yea, i saw that at columbine, LA shootout, Va tech,.........


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## arnold panganiban (Apr 3, 2008)

*Police-ems In The Philippines Need Assistance!*

Good day to you all!

I am  a police senior inspector (Polce Captain) in the Philippine National Police, and at the same time a Registered Nurse. Last year, I and two fellow police officers (a nurse and a doctor) organized the first police EMS in our country. At first our aim was to provide a emergency team within the police camp, but later we became more involved in different emergency respond with in metro manila (during civil unrest, attempted cout de tat, evacuation of wounded police and civilian victims, and others). We currently planning to create a Tactical EMS composed of police personnel to be trained as EMS in tactical field. I would like to seek anyone and party that assist use to developed as plan of instruction (POI), or with manual or procedures or extrication techniques for injured police or civilian personnel during fire fight. We will appreciate your respond.

Thank you,


Arnold Panganiban RN
Police Medic
PNP-EMS


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## sandboxmedic (Apr 24, 2008)

I might be able to help you in your training,..how involved do you want this to be? what assests do you have to enable training ( SAFE guns, buildings, training facilities,)


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