Question on Law Enforcement raids....

[chuckman]

H2H-
WHO THE F is "Monday Morning Quarterbacking"? I asked a simple question thats been on my mind for years, and the FBI story promted me to ask. And I CLEARLY did NOT say have the medics & ambulance in the the perps driveway for shits sake, I said "nearby"...like down the block. a half mile or so, whatever, just not 10-15 minutes or more away.
I dont know if it was a raid, "warrant service" or they had ****in doughnuts...I just asked a question. And to cite your one instance, out of the thousands per year that a nearby unit DID make a difference means exactly SHIT to me.
Next time you answer MY questions- DONT BE SUCH AN ASSHOLE.

I am not going to speak for H2H, I will say that tacmed remains a contentious issue, often political, and almost always financial. There are still a lot of old-time sheriffs and chiefs out there who think all EMS does is scoop-and-run anyway. A lot of PD-Fire-EMS turfism. The fact that there are so many models, protocols, systems, etc., doesn't help, either.

[dwhitehorne]

Poor planning

^^This^^

In a PD when officers get to be Detactives/Investigators they usually have years of street experience before going to investiations. The general FBI Agent I've dealt with knocking on the door usually is someone fairly junior in the organization. When a warrant service goes bad prior planning helps mitigate the confusion. An ambush is definitely one of the worst situations to be in. David

[FromMyColdDeadHand]

We have a SWAT medic on the team, that actually is in the "stack" to make entry. He is actually an MD, but also holds a Commission and is a Sworn Officer (usually a Reserve Officer). One I worked with at my previous PD was a Combat Medic/Trauma Surgeon. We also have EMT/Ambulance staging in the "outer perimeter". They will enter the inner perimeter only after there are no longer any threats, (Scene is code 4 as we put it).

That seems to be a bit of overkill on the other 'accessible' side? The last thing I'd want is the doc needing a doc. Having an MD sounds cool, but to me, the real advantage of docs is their ability to leverage tech and manage care in a clinical setting. A doc with out tools and nurses and infrastructure isn't that much more useful than a medic.

[ggammell]

Poor planning

Pretty much this. And the age old “we’ve always done it this way.”

[chuckman]

That seems to be a bit of overkill on the other 'accessible' side? The last thing I'd want is the doc needing a doc. Having an MD sounds cool, but to me, the real advantage of docs is their ability to leverage tech and manage care in a clinical setting. A doc with out tools and nurses and infrastructure isn't that much more useful than a medic.

There's not much data that show outcomes are better with a physician on the scene, especially for point-of-care treatment, for the very reasons you mentioned. The longer a scene goes on (i.e., 2-day, 3-day hostage situation or something like that) it's helpful to have a doc that can come or be on scene just to handle routine sick call kind of stuff.

In the early 90s the medical director for a local SWAT team was a neurosurgeon. He was a great guy, but he didn't know what he didn't know and I had to help manage his expectations.

[dwhitehorne]

That seems to be a bit of overkill on the other 'accessible' side? The last thing I'd want is the doc needing a doc. Having an MD sounds cool, but to me, the real advantage of docs is their ability to leverage tech and manage care in a clinical setting. A doc with out tools and nurses and infrastructure isn't that much more useful than a medic.

We have a MD on one team and a paramedic on the other also. On the scene the Doc is basically just another medic. The benefit of having a Doctor directly involved with your SWAT is the ability to have him establish your medical protocols and be the signing authority for the SWAT medic program. Other departments have to rely on a state appointed medical director or some ER doctor taking on the SWAT medical program as a collateral or voluntary assignment. David

[TomPenguin5145]

I am not sure but I am pretty darn sure SWAT was called in AFTER the agents got shot. Now they had an armed suspect with a tactical advantage and already refused to comply with "normal" agents.

Search warrants are executed all the time on homes without the use of SWAT. A simple, knock knock, "Its the Police come to the door please" and a convo at the front door stating they have a search warrant and they are let in. A DV investigation often leads to more violence.

I could be all wrong but I thought this was "just" a search warrant for the home related to child porn...so I assume things like digital evidence. This didn't appear to be a search warrant for a violent criminal (NOT downplaying child porn). I like the give the benefit of the doubt when it comes to this stuff but mistakes do get made.

[ST911]

TCCC/TECC guidelines contain great information about what level of care is provided, by whom, at what phase of care. These would give you an idea about what resources might be used for different types of ops and what reasonable expectations of personnel are.

TECC- http://c-tecc.org/images/4-2019_TECC...uty_to_act.pdf
TCCC- https://jts.amedd.army.mil/assets/do...1_Aug_2019.pdf

Skill sets by provider level: https://www.naemt.org/docs/default-s...rsn=f8c3e093_2

These are obviously quick looks, not deep dives.

[Straight Shooter]

TCCC/TECC guidelines contain great information about what level of care is provided, by whom, at what phase of care. These would give you an idea about what resources might be used for different types of ops and what reasonable expectations of personnel are.

TECC- http://c-tecc.org/images/4-2019_TECC...uty_to_act.pdf
TCCC- https://jts.amedd.army.mil/assets/do...1_Aug_2019.pdf

Skill sets by provider level: https://www.naemt.org/docs/default-s...rsn=f8c3e093_2

These are obviously quick looks, not deep dives.

Very interesting & informative- thank you sir.

[andre3k]

In 20 years I've never had an ambulance staged for a warrant. Why? Sometimes we'll have three or four squads running felony ARREST warrants in the same general area. If we had one staged for each warrant we would have every ambulance in the area tied up waiting on us, on the off chance that something might happen.