Tactical EMS

[Ethanol4all]

Has anyone here heard of "Tactical EMS"? I know a lot of retired army medics and future-SWAT team and LAPD EMT's go for it, and certification is pretty tough to obtain.....


anybody got information on it, or is anybody here certified?

 

[ffemt8978]

There are several threads here about Tactical EMS. In addition, we have a couple of members that do this as well (Luno comes to mind).

Try searching the forum for tactical ems and see if any of those topics help you out.

 

[MMiz]

Several members from my service as certified. Generally you need to be associated with a law enforcement agency to go through the training.

 

[Ridryder911]

This area is being highly debated and is a "hot topic" in the EMS arena. Is there really a need for a "medic" to shoot someone, then treat them? As well, can we not train tactical team officers to treat enough for the victim to be moved into a safe area? Since most invasive treatment will be performed in a green/safe area.

I see both points, and really have not made a decision.

For those that are interested in tactical medicine, there is an academy for tactical medics in Texas. One does not have to be associated with a LEA prior to attending. I feel it would be foolish not to be....

R/r911

 

[firecoins]

Considering the North Hollywood shooting, Virginia Tech, Colombine, Oklahoma City, 9/11 and Katrina I am convinced EMS needs to step up.

They need not be shooters per se but to work in a hot zone as a member of the local SWAT team. Keep in mind, not all dangerous situations require guns. Katrina or other natural disasters could use medical units with rescue capabilities. The rescue of hurt people in dangerous situations by trained medical/rescue personel is important.

 

[sandboxmedic]

There are several schools around the country offering this type of program. I know of a couple that are really good. Especially if you arent that familiar with the various aspects in SWAT or combat type medicine. I can say,its been the most fulfilling and intensive training (medic wise) ive been to yet. The assessments are different, your decisions have different considerations to be made, and some of the "other" training i've been able to attend has been priceless (ie bomb schools, FBI meth lab school, various sniper schools...etc).

As far as the comments go about " having a medic shoot someone then treat them..." ...the most likely situation would be this, your called to an incident, rounds start flying a teammember gets hit. Instead of going into a huge discertation on self-aid/buddy-aid, lets just say he's treating himself. My first reaction is to pick up the weapon (as a medic) and return fire until the threat is neutralized or we gain fire superiority, leaving ME then, the ability to assess and treat the casualty. As much as this goes against OUR instinctive reaction, Im no good if im leaning over treating a guy, and get shot in the back by the threat(s). And even though im a medic,i have no problem with fixing someones "lead deficiency", in multiple doses of 5.56, 7.62, or 40mm LOL. If you were at columbine, and an officer is bleeding in front you, and you here gunshots getting louder as they get closer to you, what would you do? Run? leave the officer? or pick up his weapon, try and find cover (drag him), and get ready to send someone to the "eternal care unit". Lots of kids doing shooting these days, if your called to a school tomorrow, are you ready?

Keep in mind, 2 Main Rules of Tactical EMS are this:
The best medicine in any firefight is fire superiority.
Tactics and GOOD medicine, will always be at odds with each other.

--peace

 

[BossyCow]

Lots of kids doing shooting these days, if your called to a school tomorrow, are you ready?

I've been called to a school shooting, I wasn't ready and having been through it, I can guarantee I won't be ready next time. I refuse to accept that this is something we need to normalize into our culture and prepare for in our work. We shouldn't be ready for that kind of call. We should be shocked, dismayed, overwhelmed and deeply, deeply disturbed by it no matter how often it happens.

 

[sandboxmedic]

school shootings and lessons learned

I do agree, on the fact of disbelief-dismay-sadness involved. But, to say you dont think being prepared for such a call...worries me more actually. If the state of EMS is an ever growing culture, thats ever growing in medicines, treatments, AND scenarios...often worst case. Just because of 9-11, should we pretend it will never happen again, or learn from the lessons of that day?, the PAINFUL LESSONS paid for by the BRAVE Rescue Community who died that day?
To me, Lessons learned by BLood and Loss of life should be taken to heart, and steps to avoid them , or HANDLE them better next time.

A couple thoughts on the school shooting scenario. If you get called to another one. How about putting together a small Mass-Cal bag for entry into the area. Small, belt hangable MCI tags, so its easier to ID and extricate the victims would be a good lesson id think. I bet every OTHER EMS/FIRE/LE agency around the world will be paying closer attention to scenes like that for 2ndary explosive devices, like was present at columbine. Before, that was relatively unheard of. Most police agencies dont just show up with only a shotgun now, but better firepower to meet the needs. A shotgun wont win against an assailant with an automatic weapon. Also, better planning for getting kids out of the 2nd and 3rd levels is being utilized now, instead of having them climb through half broken windows, basically gutting themselves onthe glass, and then having the joy of falling 30 feet to the ground....and thats ALL after already being shot a couple times.
To NOT learn from these lessons, and be better prepared, is a travesty to those kids, and the public. Thats almost like saying, " Im not going to learn the new ACLS guidlines because im deeply saddened over people having heart attacks".

There isnt exactly a decrease in violent crime these days, especially involving weapons.

I think your quote falls perfectly into this discussion...its very point of fact.

"Good judgement comes from experience. Experience is the result of poor judgement"

 

[firecoins]

in the post 9/11 world MCIs need to be prepapred for. We could all use some tactical training when it comes to terror attacks, mass shooting and other acts of crime/war.

 

[jmaccauley]

Without going into too much detail, during active shooter/school violence situations, police officers are trained to quickly locate and neutralize the shooter. This may, and often will, involve stepping over or around possibly critically injured victims. Trained tac medics are usually used to accompany officers into a hot zone, but not necessarily to stop along the way for patient care. If you are a medic and called to such a tragedy, be prepared to triage and treat patients as the areas are secured or victims are brought out. There is no room for emotional responses until after the treatmentis administered. then, feel free to be as upset as you need to be.

 

[sandboxmedic]

I couldnt have said it any better myself.....

 

[BossyCow]

The call I was on was not an MCI. It was one student who threatened a classroom with a gun then turned it on himself. We were lucky in that regard.

My comment about not wanting to prepare perhaps was mis-stated and misinterpreted. I think there is an illusion that we can prepare for those kinds of events in some way that will mitigate the horror of the event.

We had law enforcement on scene for our shooting. The lone 'gunman' was a middle school boy that I had known since he was in kindergarten. There is no level of tactical training that will prepare anyone for the emotional backlash of a call of that nature.

I think there are those suited for Tactical EMS. It is definitely a skill set that has value in today's society. I do not see it as a basic skill that all should develop but rather a specialty better left to those with law enforcement training.

 

[jmaccauley]

My comment was not directed at BossyCow directly, but there is a sense that it takes a certain degree of fortitude to not be affected by such tragic events. The truth is, not everyone can do it. Fortunately, most providers are professional and will perform to the best of their ability during the crisis and put their personal feelings aside until after. I have seen tough street cops break down in tears after a particularly horrible experience (myself included). I have gone home at the end of a shift and kissed my sleeping children and either thanked God that I was able to prevent a tragedy or cursed a "world gone mad." That is our burden, our responsibility and contribution.

Tac Medics are a special breed and do indeed need advanced skills and abilities. However, they are often like the tow truck driver who appears during a storm to get you and the car to a garage. We still need excellent mechanics!

 

[Luno]

Wow, disappear for six months, and it all goes to....

Just kidding... ish...
Ethanol4all
Tactical EMS simply refers to the training necessary to care in a non-permissive environment. It's a combination of "tactics" and medicine. There are various courses that instruct Tactical EMS, but for an pseudo-certification, you need to attend CONTOMS, who's graduates are EMT-Ts. Also, there are different kinds of Tac Medics/EMTs, there are your SWAT/SRT/ERT medics, which are trained to enter with the teams, or working with a secondary medical reaction team, i.e. medic up, there are military medics, and then there are PMC medics, which encompass parts of both, but aren't really either one. Anyway, Tac Med is a big term encompassing a lot of different specialties, but primarily concerned with life sustaining care under fire.

Rid
Wow, it seems that I probably agree with you more, the older I get. The barebones of it, if there is going to be a medic on the team, they absolutely need to be able to shoot. There is a question of how far outside to hold a non-tactical team though. When is the scene safe? etc... However, the majority of the initial care is BLS, could team members be trained to administer BLS care? Hmmmm, Combat Lifesaver comes to mind... There are pros and cons to both sides of the issue, the cons are obviously, life taking medics, the pros are you have medical care onsite immediately after a shooting, there are several documented cases of the tac medic saving the suspect's life, after the suspect has been shot. Remember, it's not shooting to kill, it's to stop the threat, when they're no longer a threat, they become a patient, and look here's the medic now. Hmmmmm, options options....

Sandbox Medic
Okay, just a stab in the dark here, but prior/current mil? Civi is moving more towards the 37mm, but I believe 40mm is still in the civi armory... Anyway, I think that one of the biggest assets of the tac medic, on the civi side is treating the suspect post threat stoppage. SWAT/ERT is a life saving tool, not a life taking tool. Once the threat is stopped, having the medic on scene immediately increases the suspect's chances of living. However, this also calls into question, exactly what is stopping the threat, and when compared to saving the suspect's life, are the two goals mutually exclusive? Your first tactical rule I agree with entirely, your second, I absolutely do not.
Good Tactics is Good Medicine, there is nothing better that you can do for your patient than to remain serviceable to help them. It's just a different type of triage... BTW, there is a serious decrease in violent crime, however the publicity of it has grown... I saw your quote, isn't that from Dr. Brown???

Jmaccauley
I do agree that Tac Med takes a special personality, but not to treat your own team, that's just a given, where it becomes a "special" skill is trying to save the life of the person who maybe 15 seconds ago was trying to take yours.