matt202

IMHO you are of no use to anyone if you are in there and dead because you cannot protect yourself. Please tell me what is the difference between somebody else taking a life to protect you, rather than you doing the same?

Can carry 9mm SLP, MP5 carbine, G36c or k. Shotgun, Taser, L1A1 Baton gun and a lot of attitude. X

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

Would really like your views on the above. In the UK tactical medicine is in it's infancy. I am aware that there are many variations in relation to the topic in the US. Are there any of you out there that are providing support to swat teams, working in the hot zone (where bullets are flying) doing it unarmed? If so, has this ever been tested? Where I work my bosses would not let EMS into the scene until it was safe. As a police officer and paramedic I would really appreciate your experiences.

I agree fully. I think you misunderstood me. The role of the team medic is about the team and everything that relates to the team and the deployment but that is just the first link in the chain. The next bit is about having the appropriate EMS response ready to receive the patient. That may be an ambulance around the next block, but it may also include a doc and one, two or more ambulances or helicopters for that matter with docs on board at appropriate landing sites close to the incident. It depends on the job and the medical threat assessment that relates to that job.

chbare. Agree fully, with your comments. It is essential that EMS provide an appropriate response to tactical operations at a location outside of the immediate threat. This however is poles apart from the role of the tactical paramedic/s working as part of the team. Regards Matt

I've spent 18 years working on the UK equivalent of a SWAT team and on that basis feel pretty qualified to add my $0.02 worth to this thread!!!

IMHO any medic that goes into a tactical situation without the ability to protect themselves is asking to get killed. To me whats even worse than that is they are asking another team member to put their life on the line to protect them.

As akflightmedic has said, casualty evacuation. IMHO having access to such a vehicle is an essential part of any tactical medical response. regards Matt

Are the vehicles kitted as a dedicated casevac platform, i.e stretcher and ambulance equipment or are they just armoured vehicles with the rear seats removed?

Would be interested to know whether or not those of you working with the police swat teams have the use of armoured casevac vehicles?

Now I know I'm not going to be popular with this response, but in the UK there have been two incidents of this type in the last 25 years. Michael Ryan in Hungerford and Thomas Hamilton in Dunblain. The UK government banned handguns and made it very difficult to obtain any other type of firearm legally. Since then there have been no other incidents of this type. I think that in the US you have to accept that if you make firearms available to the general public, eventually, this type of scenario will occur.

I carry a sig 2022 slp plus either H&K MP5 or H&K G36C.

Would be interested to know how many of you out there, who support police tactical teams, are armed for your own protection?

I recently used the x26 on a suspect. The effect was stunning.(Excuse the pun) Great piece of kit in the right circumstances but you can poke trying on yourself where the sun doesn't shine.

"If you have the manpower." Big question, especially when you may well be one, two or more down as a result of the firefight. If the medic is armed they can operate as part of the team, within the team. Giving them a gun means they are at the sharp end, not at the last point of cover and concealment. Under these circumstances I do think that an armed medic will get to the patient quicker as they are closer and may not need escort. As to getting the patient to definitive care, it's difficult to generalise on the wide variety of scenarios you may be faced with, but remember that any rescue needs planning and the best plan may be to hold off on the rescue and deal with the bad guy. It may well be that you are stuck with your patient. Aggressive early intervention may be all they require at this stage. If you are there you can make assessment/treatment decisions regarding your patient and if you are lucky provide definitive care. Dragging them back through the team may not be necessary. Safest thing may be to just hold in cover, communicate what you've got and let the team deal. Big thing for me is that the medic needs to be within the team. If you are at the sharp end, everyone within the team should be able to protect themselves.

My problem is that if you make the tactical medic unarmed you put them out of the danger area and then the question is how do you get them in? The team may well have a man down so who's going to escort you? If you are armed for you own protection you are part of the team not just an add on.

Sig 2009 9mm and a choice of either HK MP5 9mm or G36C 5.56.

You and me both mate!!!

I agree with your comments with regard to trauma being the focus when it comes to kit. I was just interested to know the drugs you consider to be essentials on entry. Over here we keep general stuff in the packs at the door and just have a leg bag with trauma kit, LMA, some analgesic, sedation and narcan.

So, no pain relief, no sedation???

The way we do it over here is to select previously trained nurses/para's/military medics who have joined the police service and then train them as team medics and that includes all the firearms training. Each team member must also have completed basic trauma course. This provides close quarter medical support with a conventional response from the EMS services at the last point of cover and concealment. In the UK it is against the law for non-police officers to carry weapons, that's why we train the police as medics. regards Matt

When it comes to working in the tactical environment the carriage of EMS kit becomes a case of what do I need and what can I leave behind. I would be interested to know what drugs are carried as a matter of course on tactical operations by you guys/girls.

As I have said before TEMS is a fairly new concept in the UK, so I was trained as a team member before qualifying as a Paramedic. Bottom line is that if you are the only medic on the team you will be in a support role but still part of the entry team. If there is more than one medic on the team you are aloud to get to the sharp end.