Unarmed Tactical Medics

[matt202]

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.

[chbare]

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.

There is a fairly recent thread on this very topic. It is a very dynamic topic; however, I dare say that medicine has no real place in the hot zone save for self care and extracting team mates out of the line of fire. I worked with a team as an unarmed medical provider and advisor, I trained with the team; however, I would not be involved in the "operational" aspects. However, I dare say most of the job of the tactical medic should include "non-operational" concepts. Before even thinking about stacking up with the team with your weapon, you need to consider more important medical concepts:

1) Do you have comprehensive medical dossiers on each of your team mates?

2) Do your team mates have buddy and self aid SOP's?

3) Are your team mates trained in IAD's and self/buddy aid modalities?

4) Do you have a comprehensive MTA in place for your theatre of operations?

5) Have you met with local, state, and federal resources and have SOP's and mutual aid plans in place?

6) Do you have accurate weather and disease hazard information on file?

7) Do you have SOP's for working in inclement conditions?

8) Do you have work/rest rotation SOP's in place for extended operations?

9) Do your team mates have needed buddy/self aid equipment and SOP's on where that equipment is placed?

10) Do you have backup plans in place?

Just to name a few "non-operational" but critical concepts to consider.

Take care,

chbare.

[tniuqs]

Then add to that the British military model, many of the "medics" are conscientious objectors just a historical perspective. Heck even Bobbies carrying a handgun is relatively "new concept" although the recent terrorism in London did change some traditionalists minds a bit. That said shooter medics are used extensively in the Sandbox for CPS (close protection support) or contracted EOD teams as back up sniper / medic.

IMHO if I were to be called up to a non secure Hot Zone without having the ability to return fire, well count me out of that one thanks, even with vests level 3 and all the badges your just cannon fodder, the objective is eliminate the threat first.

Yes I am aware that ARMED MEDICS is controversial but thats my take, no bullets, then bring the patient to a secure area.

cheers

[Kiwiology]

Here in New Zealand there is a small tactical/speciality group of ambo's called SERT (special emergency response team) that work with the Armed Offenders Squad and Special Tactics Group of the Police as well as do high angle rescue, CBRN etc.

They are not armed and probably (99.99999%) never will be.

[armymedic571]

In my area we have done both.....

Providing tactical medical care in both the military and civilian settings, I can say that haeing medics on your team works either way.

As chbare already stated. 97% of a tactical medics works is done in the planning process, preforming day-to-day routine care for the team, preparing the medical threat assessment, and ensuring that your team mates are fit to do their jobs. If you are on a team that employees medics that stack. I find that most common theme is that these providers are cross-trained.

Specifically, in my area we (Medics) train with the LEO, and up to a certain point must have professional LEO training (to include lethal weapons training). When we started this, our medics did not carry, but becuase we had trained with our counterparts, we knew that if we needed to utilize a weapon, then we were properally trained and proficient on that piece of equipment.

Now that some of us are fully trained, we carry when ever we are performing as SWAT Medics.

Once again, your SOP's and procedures need to be set. Cross training is key. I always argue for having medical personnel associated with the team carrying a weapon, because the best medical care under fire is fire superiority.......

At least that is my $0.02....

[croaker260]

Ok first of all, any thoughts on weather medics should be armed or unnarmed is NOT an ethical consideration...to place BS ethics imposed by someone far removed in a suite who will never be in the thick is ...well ....BS...in my mind.

It is however an operational and functional consideration.

Currently our TAC MED medics are not armed, this may or may not change but they havent been for the past 10 years. They are fully armored, and they always advance just behind the SWAT/ERT guys at the "point of last safety". Practically put, as an entry team clears a room the Tac Med guys are just outside the room. They currently have one or two officers with them for security.

There have been at least two cases where being this close was needed, including a patient with a shotgun wound to the abd of a hostage, I believe.

The pro's of the armed discussion is mainly that the TAC MED guys dont have to have two officers tasked to provide security for them. Arming the medics would give them the ability to defend themselves. And the issue of arming medics should be best approached as a safety issue ( it sucks to be the only guy in a room with out a gun!) NOT A DESIRE TO HAVE THE MEDICS PLAY COP (unless they are a cop )

The cons are liability of training and non sworn status. Armed medics should be trained to the same standard as the rest of the team for liability, as well as respect, issues.

The issue of wether the medics are also securing prisoners, clearing rooms, etc is a functional one determined by each team, but in my mind causes problems overloading a vital function of a medic.

"role blurring", or the BS about "medics dont cary guns" is indeed ridiculous and doesnt (or shouldnt) come in to the issue. This is about providing safety equipment to medics operating in a specialized enviroment, not about the everyday medic on the street..unless your everyday medic works streets of Bagdad. The discusion should be objective, not emotional.

BTW, there is medical care under fire (Tactical casualty care), but it is different from tradional medical care, and is mostly BLS airway and bleeding control. Plenty has been writtten about it, GOOGLE is your friend.

Edited December 24, 2009 by croaker260

[Richard B the EMT]

When a "Warrant Service" is performed, the NYPD/FDNY EMS Command protocols are, the EMD tells the involved crews (one each BLS and ALS) to "look at your screen", as to not give away an address. They usually then head to the involved precinct, and wait, kind of a first staging area. The nearest field supervisor, usually a lieutenant, joins them there.

On arrival, we load up all equipment we might be using (spinal longboard, 2 each of all splint sizes, O2 bag with BVM, Defib, and Paramedics add the drug bag to theirs) on top of the stretcher, and then walk into the roll call room in the precinct house, usually joining, or soon thereafter joined by, the NYPD Emergency Services Units with the heavy body armor and long barreled weaponry (if we EMSers have them, we put on our Soft Body Armor. Some of us elected not to have them assigned to us. I have, and will use).

An NYPD supervisor will tell us which NYPD team to follow, and we then return to our vehicles, and proceed in a convoy, no L&S (!) to the actual scene. EMS stays with the team we were assigned to follow, and end up around the corner from where any shooting might happen, and wait.

Hopefully, we won't get called nearer to the action, which would mean someone, including the suspect(s) got hurt. On all the "services" I have been on, EMS was not needed.

When we are no longer needed, the team we were told to follow tells our Lieutenant, and we go back available to the 9-1-1 system.

[armymedic571]

Croaker....

Didn't realize that this was such an emotional issue for you..... . I re-read all the posts, and don't see where this was an emotional issue?

I am not really sure what you are getting at?

[croaker260]

Croaker....

Didn't realize that this was such an emotional issue for you..... . I re-read all the posts, and don't see where this was an emotional issue?

I am not really sure what you are getting at?

I guess I should have been clearer. I was un-clearly referencing previous discussions that have surfaced over the years on almost every internet forum about arming medics (both in and outside the "tactical enviroment"). Most of those arguments have centered around "emotional" (as opposed to objective) discussions about carrying guns at all, doing no harm, and other philosophical/ethical stuff.

I apologize for not being clearer

[Dustdevil]

There have been at least two cases where being this close was needed, including a patient with a shotgun wound to the abd of a hostage, I believe.

How do you come to the conclusion that immediate medical care was imperative to the patient's survival?

You don't think s/he would have done just as well if the cops had simply dragged him/her out to a waiting ambulance?