Dangerous Precedent: Paramedics to no longer wait and stage during active-shooter

[sinister]

I am not a cop nor fireman so this is from a military assaulter's perspective.

My A-detachments have 18D Special Forces Medics. When they are assaulters they're assaulters. A B-Team guy may have a full, big-ass med trauma bag on his back but he's an assaulter as well.

I don't want soft or unarmed medics (or anyone else who has to be tended and defended) in amongst my troops while they're taking care of business. We'll patch you as we go but we're there for a specified mission. We'll call you up once we're done. If we're not done and it's not safe to bring you up with full ATLS/ACLS/Trauma suite and gurney we're not ready.

Cool your jets -- if it's not safe to apply aid we're not done. If it's me or one of my guys, yes we want a doc -- but we also don't want to lose our doc.

[Hmac]

I am not a cop nor fireman so this is from a military assaulter's perspective.

I for one appreciate the perspective, but military operations ≠civilian EMS or SWAT.



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[T2C]

I for one appreciate the perspective, but military operations ≠civilian EMS or SWAT.



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We can take some aspects of the way the military deals with casualties and apply them to a mass casualty incident in the civilian world.

I would agree with an incident commander sending EMS into an area that is inactive, but has not been declared safe, which would necessitate Paramedics be armed or armed personnel assigned to protect them. If SWAT is still actively engaging threats in the kill zone, EMS should be held until the armed engagement stops.

Not everyone would agree with this point of view, but sending EMS into an active area would add to the final body count. We all want to save innocent lives, but not with a high probability of the loss of life of EMS personnel.

I think most can agree that qualified Paramedics should be given the opportunity to carry a side arm to protect themselves, but they are not strikers.

[Hmac]

We can take some aspects of the way the military deals with casualties and apply them to a mass casualty incident in the civilian world.

I would agree with an incident commander sending EMS into an area that is inactive, but has not been declared safe, which would necessitate Paramedics be armed or armed personnel assigned to protect them. If SWAT is still actively engaging threats in the kill zone, EMS should be held until the armed engagement stops.

I'm not talking about mass casualty fantasies. I'm talking about hostage barricade situations, or high risk warrants, or raiding a meth lab. We're talking about EMTs being able to defend themselves in their high-risk jobs, just like they are legally allowed to do in their low-risk lives.

[ST911]

Excellent resources from Arlington County (VA) on the "rescue task force" concept and how they execute it. Complete with protocol.

https://www.vdh.virginia.gov/OEMS/Fi...s/OPE-4006.pdf
http://www.nfpa.org/~/media/files/re...cols.pdf?la=en

These are similar to those I've seen from a number of other jurisdictions.

Hostage-barricade, raids and planned ops, and medical support once you have SWAT engaged are different animal than RTF.

[T2C]

We're not talking about mass casualty fantasies. We're talking about hostage barricade situations, or high risk warrants, or raiding a meth lab. We're talking about EMTs being able to defend themselves in their high-risk jobs, just like they are legally allowed to do in their low-risk lives.

Any of those scenarios would apply in our area and rarely medical personnel would enter a hot zone due to the time involved in those situations. Any scenario could turn into a barricaded subject incident should things go south during the execution of a search or arrest warrant and it would be handled differently.

When we executed warrants or performed other high risk operations that were not long in duration, medical personnel were kept out of the area until it was secured.

With a barricaded subject as a rule no one is allowed inside the inner perimeter until sufficient tactical personnel are on scene. Medical personnel are escorted by trained tactical personnel if they need to enter one of the inner perimeters to stabilize and evacuate injured and wounded.

A mass casualty incident is not commonplace, but I would not refer to it as a fantasy. An active shooter in a school, church or workplace where there are multiple wounded would be good examples.

In two of the areas I worked, Paramedics needed to carry side arms on routine runs where there were not sufficient law enforcement personnel on scene and I strongly support arming qualified medical personnel.

[Fly8791]

I'm not talking about mass casualty fantasies. I'm talking about hostage barricade situations, or high risk warrants, or raiding a meth lab. We're talking about EMTs being able to defend themselves in their high-risk jobs, just like they are legally allowed to do in their low-risk lives.

Well.... I was talking about mass casualty incidents. My comments where about my area's planned response to things like Aurora Colorado, Virginia Tech, Columbine... Etc.

Like I said. My big concern was the communication difficulties. As the Lieutenant for my crew/unit it is my call if we go in. I don't like making that call with no information. Why? Because I'm going to hold my guys back unless we have a organized/capable escort. And as it stands, I don't see that being put together quickly. All I care about is getting to the people that are leaking tomato juice so we can help before its to late.

As for hostage rescue, stand offs and other incidents.
Our local SWAT has attached Paramedics that have training, a pistol, and a member of the SWAT team assigned to them as protection. The SWAT teams don't need us fire guys. The only way we would have any part in something is if it was a massive incident or ongoing scene.


Good input from everyone. It is always nice to get perspectives from people that have been doing this stuff.

[Hmac]

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Our local SWAT has an attached Paramedics that have training, a pistol, and a member of the SWAT team assigned to them as protection. The SWAT teams don't need us fire guys. The only way we would have any part in something is if it was a massive incident or ongoing scene.

Let's step back a sec, just to be clear. At no point do I, have I , or would I advocate everyday field paramedics going inside the inner perimeter of a SWAT operation. SWAT-trained, tactically trained, armed and armored, non-sworn Paramedics...yes. Fire or private ambulance paramedics who aren't part of a tactical team and don't' train with them...absolutely not. They park the rig at the edge of the operation and wait for the scene to be secure before going in.

If a team wants to or is able to find sworn officers, train them for SWAT, then train them as paramedics...that would be great. In most situations, I think that's an unlikely scenario since keeping up with the training, employment, and CME requirements of EMT-P make it largely impractical to be both a full time SWAT officer and a paramedic, so it's been my observation that it's more practical to take employed paramedics, municipal or private ambulance and train them for SWAT operations.

As to arming, private, non-sworn Tactical Medics, yes, for self-defense only. As to arming non-SWAT field paramedics, most cities/hospitals/private EMS companies are certainly going to ban ALL of their employees from carrying guns at work.

[Huldra128]

http://emsmn.org/wp-content/uploads/...14-current.pdf

The above is an outline of the 3Echo training course I went through about a year ago. Its a good concept but takes a lot of people to get it done.

In a nutshell how it works:

The first group of LE arrives to an active shooter situation. Their job, obviously, is to find the shooter(s). A second team arrives and secures an area where wounded/dead are. Once EMS and fire show up LE starts getting teams together which consists of 2 LE and 2-3 EMS/firefighters. These teams go in and get the wounded and bring them out. Once more LE and EMS/firefighters arrive they continue to secure more hallways/areas and continue to move the wounded out.

Its a good concept but like I said before it takes a lot of bodies to secure a perimeter and the hallways after the "hunting party(s)" initially goes in.

In the area that Hmac and I work and live in it would probably be an hour or more before this concept could be set up. I think once it is set up it will work.

I am a LEO but from an unarmed perspective I wouldn't want to go in unarmed either and totally understand that viewpoint.

[chuckman]

I for one appreciate the perspective, but military operations ≠civilian EMS or SWAT.

I generally agree, but there is increasing crossover whether we like it or not. Hell, TCCC was never meant to be a civilian course, but because of the generally practical guidelines and money-making venture that it is, there it is.