In dangerous situations, medical workers are critical to the survival of emergency response units. However, these key individuals are often held back from the action until the area is deemed safe to enter. While this is done for the safety of the medics, delays can lead to extensive health problems and even death for individuals injured in the hot zone.
A tactical medical team consists of first responders who are trained in special operations and basic EMT skills. Being trained in both areas allows tactical medics to attend to the wounded as quickly as possible, even when a scene is not secure.
By outfitting a crisis response team with at least one of these multifunctional individuals, agencies can save precious time and, as a result, lives.
Increased danger means greater impact for medics
Tactical medical care originated over 200 years ago. In the late 18th century, Napoleon ordered French troops to keep a “flying ambulance” close to the battlefield, allowing doctors to provide immediate care to wounded soldiers.
The Los Angeles Sheriff’s Office brought the practice to law enforcement in 1969 by training its first tactical medic. More than two decades later, failures at the deadly Waco raid prompted the ATF to expand its own medical resources. As the number of extraordinary emergency scenarios increases, so does the impact of quick medical attention to first responders.
While officer deaths are in decline, the number of assaults committed against police officers remains high. Colorado law enforcement, for example, endured three straight years of increasing incidents of violence against police. FBI statistics show that 1 in every 10 officers is assaulted, and 1 in 52 high-risk police operations will result in an officer-related injury. Among emergency workers felled by firearms, ambush attacks remain a leading cause of death. Because these circumstances involve being taken by surprise, medical workers may not be able to easily reach the scene, resulting in a delay of care.
Emergency situations are also dangerous for bystanders. A local news outlet credited San Antonio’s tactical medical programs with saving hundreds of lives within the city. Less than two years after the program’s launch, tactical medics had treated approximately 180 city workers and 65 civilians.
There are now tactical medical teams in more than 600 departments across the nation. These teams operate in many contexts, such as the FBI, Border Patrol, U.S. Army and in individual cities like San Antonio. The benefits associated with cultivating tactical medics are numerous, and many organizations are seeing the advantages firsthand.
Every minute counts
According to the U.S. National Library of Medicine, the “Golden Hour” is the period of time immediately following a traumatic injury. The more care a patient gets during this time, the greater the odds of survival. EMS World reported 90 percent of battlefield deaths occur in the pre-hospital phase of emergency response, about half of which are due to hemorrhage. With prompt treatment, critical injuries are less likely to become fatalities.
Tactical medical teams are effective at reaching the wounded in the field because they understand the inner workings of both emergency response and medical care. Although most of the medics are certified EMTs, they must undergo the same crisis response training as their fellow officers: meet physical conditioning standards, attend SWAT school, and complete weapons and field medicine training. In addition to being able to analyze situations on the fly, it is vital for medics to understand the full scope of resources at their disposal.
A comprehensive training plan is an integral part of building a tactical medical unit.
High-risk warrants lead to dangerous circumstances under which to apply medical care. Studies show that building up tolerance is key. Tactical medics must learn to operate in extreme heat and inclement weather, as well as stressful places with poor visibility and little communication. Training under these hazardous conditions helps the officers acclimate themselves more quickly to similar situations in the future, improving their cognitive awareness in those moments.
Another important consideration is the medic’s level of familiarity with SWAT officers and other peacekeepers.
Jim Winham, a captain in the National Guard and the Emergency Medical Services Authority’s director of clinical services, emphasized the importance of establishing a rapport with fellow emergency workers before a crisis. In Houston, the tactical team trains its medics with local units to foster trust between groups and ensure both sides have a complete understanding of protocols. Knowing the procedures and safety measures that other officers on the scene will employ can prevent costly miscommunication in the field.
Medical training is an investment in survival
Although the cost of training a specialized medic ranges up to $120,000, this expense is often offset in other areas. For example, implementing a tactical medical team can reduce costs associated with deploying a separate EMS unit for each mission. Since grants are available to help fund expanded preparedness in emergency situations, the net cost of training one or two medics per operations team is small compared to the benefit of bringing officers home alive.
A complete emergency response program calls for a joint effort from police, fire, rescue and special operations forces, and agency strategies should consider the medical needs of each of these units. A key component of disaster readiness involves training officers who fit multifunctional roles.
The implementation of a tactical medical team is an investment in personnel that can save time, money and lives.
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- Direction of first bystander call for help is associated with outcome from out-of-hospital cardiac arrest (Nehme et al, 2014)
- The Golden Hour: Scientific fact or medical “urban legend”? (Lerner & Moscati, 2008)
- Lessons learned from the ATF Waco raid (Clinton, 2013)
- EMSA educators help train National Guard medics (Bland, 2014)
- Crime in the U.S. 2012: Violent Crime (FBI, 2013)
- Tactical paramedic jobs: Providing critical care in hostile environments (Ellis, 2012)
- Law enforcement fatalities dip to lowest level in six decades (Groeninger, 2013)
- Cop assaults on the rise: Violence against Boulder officers has left deep scars, frustration (Byars, 2013)
- SAPD unit trained in trauma care credited with saving lives (Mondo, 2013)
- SAPD trains officers to take part in Tactical Medical Team (Grace, 2013)
- HFD and HPD Tactical Medical Team: Overview (Persse, 2012, presentation)