TAC EMS peoples

[Mikeyg]

what is your job description enlighten me. Ive heard a bit about it but I want to know more.

[*** CDN BACON ***]

GOALS

Implementation of an effective TEMS program/unit with the following important goals:

1. Provide rapid EMS response to injured individuals within the Tactical theater

2. Enhance Tactical mission accomplishment by assisting in extrication and taking over medical emergency management, thereby freeing up ETU Team members to return to the primary objective.

3. Facilitate a Professional Partnership between Police / EMS

4. Reduce death, injury, illness, and related effects, among officers, innocents, and suspects of the Region

5. Minimize “Risk Management” of Tactical missions

6. Project a favorable image for the Police and Paramedic Services with the citizens and the media

[NCTuskie]

To save the lives of Marines in combat.

[somedic]

TEMS job description?

Pretending to be a COP

Acting like you are in the Cop brotherhood

Making the rounds in the LE agency if you are a particular female "tactical medic"

Forgetting you are a medic when a medic is needed.

Hoping to kill more people than you could ever save.

Wearing black.

A stack is more than an off duty social/physical activity

Flex cuffs work well during swat call outs also.

Water boy/girl...PC term is REHAB

Standing around at a major incident trying to command "regular" EMS folks

Thats just some of it...Go for it Its a great life!!

[Doczilla]

Sorry about copying and pasting, but hey, it's my post, so I'll do what I want.

Tactical EMS (or TEMS) training teaches the medic or tactical operator to provide basic medical care and injury/disease prevention in the tactical (i.e., SWAT, special operations, etc) environment. SWAT teams serve a variety of roles to include hostage rescue, high risk warrant service (you've got that drug dealer who is known to be armed and has assaulted officers in the past, you may want to send SWAT to pick him up rather than your garden variety detectives), personal security detail (PSD), and special security, such as that provided to medical teams that went to areas affected by Katrina. Some SWAT teams have medics on the team who are taught team movement and SWAT operations as a way to understand team ops and provide better care. They may or may not be allowed into a "hot zone" and may or may not be armed. A lot of these medics, particularly if they are not already law enforcement officers, may train with the team but do not go into the "stack" when making entry into a potential hot zone and may not be armed. They may wear body armor and identification but will be staged in the "warm" zone, ready to respond in as needed. Some teams have medics who are also operators, i.e., have a role in the law enforcement aspects of the operation, and therefore carry weapons and arrest suspects, etc. and will go in with the stack. Frankly, having your medic in with the stack is risking an important resource for very little benefit (my opinion, has not yet been shown in randomized prospective trials ).

Many teams do not have medics as part of the SWAT cadre. These teams may stage an ambulance some distance away, ready to respond in to the scene as needed. These medics typically are not tactically trained, and are not really considered "tactical EMS".

From the military standpoint, special ops medics tend to be operators and therefore armed and responsible for aspects of the mission other than just medicine. They also have a larger role in primary care and preventive medicine since the SOF teams may be far removed from definitive care, and evacuation may be impossible or may jeopardize the mission. 18D (Army SF medics) are typically trained not only in advanced trauma care, but dental care, veterinary medicine, and food/water procurement and purification as well. Medicine is an important part of some SF missions, which may involve training indiginous forces. The 18D helps to win hearts and minds by providing some basic medical care to these folks.

Military medics are trained in tactical combat casualty care (TC3), which gives them tactical awareness and medical skills particular to the battlefield for rendering care while still potentially in some amount of danger. With this in mind, the best medical care is overwhelming firepower, and putting rounds downrange is often the most important thing that a medic can do in a hostile fire situation. 91W (combat medics) are trained in this.

Tactical medicine is a combination of several aspects of care. TEMS medics are first and foremost first responders, and trauma care is the cornerstone of care in this environment (traumatic injuries, as you might expect, are common). There is an emphasis on care in austere environments with low light, little space, and little equipment. As the first medics in the door, they must be firmly familiar with triage for care and triage for evac (2 different concepts, really). Team wellness and preventive medicine are important as part of the more global concept of TOMS (Tactical Operations Medical Support), and in the civilian realm this equates to proper rehabilitation of operators on a long standoff and ensuring that everyone is rehydrating properly. The TEMS medic may have to deal with minor illnesses in operators while on a standoff, such as minor cuts and scrapes, headaches, dehydration, etc. The TEMS medic serves in an advisory capacity as well, recommending equipment and policy that may reduce injury among operators. For example, the medic may recommend that operators carry their own "blowout bag" that contains some dressings and other supplies so operators can treat themselves or a fellow operator when the casualty can't be immediately evacuated (due to hostile fire) or the medic can't get to them. He may also recommend rotation schedules for operators to ensure that they are rehabilitating properly, particularly in inclement weather. The medic may also train the operators on some basic self- and buddy-care. He may also make sure that everyone's tetanus shot is up to date, and should be familiar with any underlying chronic illness or injury that the operators have. The medic may be asked to get on the phone in a hostage situation to try to provide some care over the phone to hostages and suspects while negotiators are trying to end the standoff. They may be able to instruct the hostage or suspects in some bleeding control or airway maneuvers as well as basic treatment for shock. This may give the medic an idea of the number of casualties inside and their condition, enabling him to request civilian resources as needed. (I should emphasize that medics are NOT routinely negotiators.) Medics also serve as an on-site consultant to the SWAT team, recommending for or against things like tear gas or distraction devices (flash-bangs) in particular situations if there may be medical concerns with their use.

Situational awareness and self defense are taught from a tactical perspective, and usually involves weapons. There may be some items to glean for civilian EMS use, but this isn't really a "self defense for the street medic" type course.

Hope this sheds some light.

'zilla

62A

[Asysin2leads]

Hee hee, nice somedic. I have a few:

Being attracted to police work for all the wrong reasons.

Putting more hours into esoteric knowledge of firearms than into anatomy and physiology.

Believing that you are some how superior or above other EMS professionals.

Living in your parents basement.

The delusion that tactical EMS is a highly demanded skill that is used everyday in the 'war' that is raging on the streets of America.

Bad tattoos, and lots of them.

[somedic]

TwoLeads: ...How the hell did I forget the bad tattoos! I know one former "tactical medic" that has a star of life with m-16s crossing through it...Totaly redneck, war hero BS He took a job at our local geriatric transport service and now commands wheel chair vans instead of hostage rescue....Good stuff though lets keep it going!

[somedic]

OK two leads: Heres more:

Grocery shopping in your ninja suit with badge.

Whining to your supervisor because you were out all night with LE trying to catch dead beat dads, bad check writers, and wife beaters and you ask to sleep through morning check off on your shift!....not exactly TEMS is it?

Bumper stickers (We kill for peace. From Death comes life oh and Good medicine in bad places) and those little "thin blue line" stickers that imply you are a real LEO.

Thats it for now watch out for those tactical OOMPALOMPAs .We got a female medic that looks just like a tactical version of one of Willie Wonka's little helpers in the chocolate factory when she puts on all the ninja kit...its so cute.

[Asysin2leads]

My idea of tactical medicine: "GET DOWN ON THE GROUND! GET DOWN ON THE GROUND! LAY ON YOUR STOMACH! DON'T MOVE! ARE YOU HAVING ANY CHEST PAINS?"

Okay, now in all seriousness, tactical medicine actually does exist and is even used sometimes, even though it happens less often than say, the Mets winning the $@%ing NCLS series. To give you an idea of how little tactical medics are utilized, lets look at the numbers for the NYPD. Officers: 40,000. ESU (Combination Rescue, SWAT Team, Counterterrorist, etc. etc. bad ass dudes): Around about 60 officers. ESU officers designated as medics: less than 10. You can crunch the numbers and see that one of the world's premiere law enforcement entities does not need tactical medics very often.

In my mind, the best 'care under fire' can be rendered as augmented BLS provided as part of the tactical training of the SWAT officers. If you can learn to rappel and use laser sights and flashbangs and night vision, bleeding control and BVM skills should really not be that hard to learn. We even teach the firefighters how to do it.

The need for advanced life support in the 'hot zone' is dubious at best. Whatever the bad guys do to you when bullets are flying really isn't going to be helped by an IV, and if you expect someone to try and pull off an intubation while worrying about cover and/or concealment, you have another thing coming.

That being said, in my mind, emergency medical procedures are important considerations in a tactical environment. However, any care that is to be provided in the entry area should be done by a cross-trained member of the team, not a field EMS worker who has been given a crash course in how to dress and look like a bad ass.

If an paramedic is really called for, they should be used in a support role, as a safety officer or standby someplace well behind the line of fire. This is the best utilization of resources. It's not going to win any points with people who have drawings of M-16's on them, but then again if you really want to patch up wounded comrades under fire, the Army and Marines would love to have a chat with you. Somedic, tell your ninja I said stop screwing around before she gets hurt, and if she's free friday night we can chat about it over a drink. :wink:

[somedic]

2Leads: ROTFLMAO: This has been so much fun...What did you think of my willie wonka tactical ommpalompa??

yep a cheesy star of life and M-16s tattooed to your ass cheek makes a bad ass not....

I agree that individual operators should be trained to provide certain care. I cant see and major ALS procedures being done like you said...Most TAC crap is really standng around with thumbs up their...well you know trying to look like a bad ass