Tactical medic protocols?

[ccfems540]

Can anyone send me copies of your current tactical medical protocols? My department is starting a SWAT medic program and we are starting from scratch. Also, what are the requirements to qualify to become a team member. We are considering CONTOMS as a starting point.

 

[akflightmedic]

1. Extract patient from scene
2. If bleeding do A or B or Both.
A. Apply Celox
B. Apply tourniquet
3. If not breathing...Ventilate with BVM
4. If tension pneumo is present, decompress AFFLICTED side
5. Insert King LT when able
6. Insert IV if needed
7. Hand off to Local EMS for transport who is staging down the road

Consider C-spine but a scoop and soft collar are just as good these days and will be the next wave of future EMS changes.

 

[mycrofft]

Protocols are like navels..except it doesn't take a plastic surgeon to change 'em.

1. Look for multiple affected unmarked victims.
1.a. If seen , move upwind and uphill and call for fans.

 

[MrBrown]

Our Special Emergency Response Team uses the standard Clinical Procedures.

 

[ExpatMedic0]

ccfems,
one of my partners at work helped start the SWAT medic program here in Portland Oregon way back when. Hes retired now, reverted his medic to basic and only works doing event stand by part time with me... but feel free to PM me your email and I can pass it along if you like.

 

[LondonMedic]

TACTICAL MEDICAL PROTOCOL V.1

1. Dress all in black.
2. Wear aviators.
3. Eat donuts.
4. Err, that's it.

 

[MrBrown]

TACTICAL MEDICAL PROTOCOL V.1

1. Dress all in black.
2. Wear aviators.
3. Eat donuts.
4. Err, that's it.

Only Brown may wear aviators, what with having a suitable degree and base of experience

"...yes good morning its Westpac Rescue, mile and a half south for entry direct Auckland City Hospital, not above 1,500; ... hang on"
<CLICK>
"...yes good morning its Dr Brown speaking from the helicopter emergency medical service, we're about eight minutes away from you ...."

 

[Melclin]

TACTICAL MEDICAL PROTOCOL V.1

1. Dress all in black.
2. Wear aviators.
3. Eat donuts.
4. Err, that's it.

Haha.

I was going to be more diplomatic: What exactly is the role of a "tactical medic". What more do you need other than first aid? Presumably they all have first aid certs anyway (or whatever your equivalent is) if they're coppers.

TMP V1.2 : After you finish your doughnut, position airway, arrest bleeding, drag pt to the care of someone who isn't a copper.

 

[Afflixion]

Haha, seems easy correct? yeah now try doing all that with rounds flying overhead and the adrenaline making your fine motor skills go out the window... don't poke fun at tactical / combat medicine unless you've been there.

With that out of the way, your protocols are going to very from region o region, as do regular EMS protocols. No one online could give you any except their own, Your level of care is only semi-affected by the cert you hold because I doubt your going to be lugging around a geezer squeezer if your a paramedic. Most of it is penetrating trauma that you will see which is unlike civilian ems where most trauma they see is blunt. Yes, most of it is hemorrhage control and splinting and such, if not close to 80-90% of it.

 

[Melclin]

Haha, seems easy correct? yeah now try doing all that with rounds flying overhead and the adrenaline making your fine motor skills go out the window... don't poke fun at tactical / combat medicine unless you've been there.

I'm not having a go at the military medics, that's a different matter. We are talking about police right? Training to be medics? We're talking about "scope of practice" for coppers. I'm having a go at the idea of making it more complicated than it needs to be. What "scope" do they have? They already have first aid certs, what more do they need?

I would have thought that the obvious problem of how hard those skills are to perform under fire is a good reason not to complicate those first aid basics with some BS about spinal immobilization and trying to get coppers to do anything other than get a pt to the care of someone who knows what they're doing.

 

[ccfems540]

Melcin- You need to do a little research. You have no idea what a tactical medic is.

 

[FF-EMT Diver]

I'm not having a go at the military medics, that's a different matter. We are talking about police right? Training to be medics? We're talking about "scope of practice" for coppers. I'm having a go at the idea of making it more complicated than it needs to be. What "scope" do they have? They already have first aid certs, what more do they need?

I would have thought that the obvious problem of how hard those skills are to perform under fire is a good reason not to complicate those first aid basics with some BS about spinal immobilization and trying to get coppers to do anything other than get a pt to the care of someone who knows what they're doing.

No Buddy we're talking about Bona fide EMS Professionals going into the line of fire with the Police and treating them and anyone else that may get harmed in the apprehension of violent criminals, We have standard protocols that are followed in the line of fire and that is the discussion at hand.

As was stated due some research BEFORE you do a lot of off hand commenting.

And if I'm taking your post out of context accept my apology and I look forward to your explanation.

 

[Melclin]

Melcin- You need to do a little research. You have no idea what a tactical medic is.

Yes I know, the idea is quite foreign to me. And it doesn't make a great deal of sense for the reason I put forward. Hence my original question:

What exactly is the role of a "tactical medic". What more do you need other than first aid?

With some googling I have seen how scarily paramilitary that whole world appears to be, how oddly fragmented law enforcement is in America and I was also reminded how much EMS seems more conceptually aligned with emergency services than with healthcare. My question was originally why do you need anything more than first aid. I saw the curriculum for a few courses and it was basically an extended first aid course (with the exception of surgical cric and chest decomp and I would still question the wisdom of that, but I can't really be arsed arguing about it), so it makes more sense now. I had this absurd picture of you trying to teach police how to be health care professionals, but I see how its not that, so I'll tag out.

 

[mycrofft]

Tactical Medics...four is five.

Tactical medics arise administratively from two directions: the uncommon need to retrieve live victims from dangerous areas during potentially contested areas, and the success of organic medical support in armed forces during war (e.g., Green Berets). It is fueled by fears of liability if civilian caregivers enter the area, and the testosterone swollen nature of young LE's into the whole TAC thing. (Worked LE for twenty years, so please don't question my personal observaton based upon experience). The macho (for both genders) is necessary, but not for program decison making.

As it is, taken overall, SWAT has proven to be very poor at catching and arresting people, very good at standing around behind cars and specialized vehicles staring at buildings allegedly holding suspects, and setting up cordons/traffic blocks.

"Tactical Medics" can't practice the out-of-bounds stuff battle medics do in war zones, they mostly wear armor and wait for their boss to wave them in then drag unstablized people to "safer ground" when often the bad guys are already gone. The image is inflated, that is ok, but the strutting and warrior macho are wearing to everyone else.
See reply #1.

PS: Law Enforcement people train up as medics pretty much as well as non-LE's, but the questions about medical control and etc. are usually brushed aside. Are there legal standards posted by medical authority anywhere?

 

[FF-EMT Diver]

Melcin I see your new post, disregard the smart tone in my post.

Again our officers are trained in first aid, some are 1st responders and all carry IFAKS on their armor and are familiar with using on themselves and teammates.

 

[Melclin]

"Tactical Medics" can't practice the out-of-bounds stuff battle medics do in war zones, they mostly wear armor and wait for their boss to wave them in then drag unstablized people to "safer ground" when often the bad guys are already gone. The image is inflated, that is ok, but the strutting and warrior macho are wearing to everyone else.
See reply #1.

Now I know I said I'd tag out, but this is exactly what seemed to me to be the case. I just figured I didn't understand it because I'm in health care, perhaps I still don't but its nice to see someone who knows better share that view.

EDIT >> FF-EMT Diver: It seems perfectly fine to have them be FRs or whatever, but I had this picture of some copper getting a a couple of days of training and then sitting there trying to RSI a bloke, when he really should have just taken him to an actual healthcare professional.

 

[mycrofft]

Addendum

I respect the professionalism and potential courage these folks have, but the basis is medical provision in a civilian world, not something akin to the fiction on TV.

 

[Chimpie]

EDIT >> FF-EMT Diver: It seems perfectly fine to have them be FRs or whatever, but I had this picture of some copper getting a a couple of days of training and then sitting there trying to RSI a bloke, when he really should have just taken him to an actual healthcare professional.

Being able to leave an active scene is not always possible.

 

[FF-EMT Diver]

Melcin I see where you are coming from....And some teams do not have any medics and in their case the guys either secure the area and bring in EMS when scene is neutral or bring their guys out to EMS.

Mycroft I'm not sure how SWAT is in your area but it must be different than here, The medics here are on the entry team and SWAT in our area does a good bit of arresting and very little standing around looking cool.....Also all that I am familiar with have a medical director that has sat down with the lead medic and designed a set of "special Protocols".

 

[FF-EMT Diver]

Being able to leave an active scene is not always possible.

Good point Chimpie and one that I meant to bring out, We carry enough gear in a backpack (Blackhawk Stomp II) that we can treat in position if necessary.