Unarmed tactical medics

[matt202]

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

 

[spinnakr]

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.

 

[FF-EMT Diver]

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.

 

[DrParasite]

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.

 

[BLSBoy]

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

 

[zmedic]

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.

 

[matt202]

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?

 

[FF-EMT Diver]

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.

 

[FF-EMT Diver]

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.

 

[reaper]

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.

 

[LondonMedic]

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

Or is it just a 'common sense' thing?

 

[zmedic]

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.

 

[LondonMedic]

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?

 

[spinnakr]

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.

 

[DrParasite]

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!

 

[matt202]

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

 

[John E]

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

 

[redcrossemt]

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?

 

[Afflixion]

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.

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.

 

[Jon]

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.