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

[strambo]

My experience is all military so I certainly understand the issues of "care under fire." I guess my opinion is that this makes sense for what Bleudreaux above calls the "warm zone" where the active shooter has been neutralized (or offed themselves) and you are 90% sure it is over. At this time we are just a few minutes to a half hour in or so, it makes sense to me for escorted civilian EMTs with armor to come in and not wait another hour for it to be declared 100% safe. Especially if there aren't any LE TAC medics on scene or it is a mass cal and the TAC medics are overwhelmed.

[TacMedic556]

My experience is all military so I certainly understand the issues of "care under fire." I guess my opinion is that this makes sense for what Bleudreaux above calls the "warm zone" where the active shooter has been neutralized (or offed themselves) and you are 90% sure it is over. At this time we are just a few minutes to a half hour in or so, it makes sense to me for escorted civilian EMTs with armor to come in and not wait another hour for it to be declared 100% safe. Especially if there aren't any LE TAC medics on scene or it is a mass cal and the TAC medics are overwhelmed.

Very logical and clear statement. I agree with your view in 90% of possible scenarios. In situations where it is less clear or could potentially move from field care to a care under fire situation, I would propose we have armed and trained medics. It is not at all difficult to arm and train medical personnel.

I am convinced that the main reason society and municipalities are hesitating to train medical personnel in the use of lethal force is because of what it means we have to admit has happened to our society if we do. It is a line in the sand essentially. Once we begin arming medics and training medical first responders how to integrate into the dynamic, tactical , unconventional medicine environment, we have admitted that certain incidents have become more common place that once were less common, that society has changed for the worse. Most cities wish to ignore, deny, that many of these threats exist at the level they may. History and our way of life is not static - and staying the same from generation to generation - our posterity will face threats we never did.

[Hmac]

I am convinced that the main reason society and municipalities are hesitating to train medical personnel in the use of lethal force is because of what it means we have to admit has happened to our society if we do.

I suppose every government unit is different, but the ones around here couldn't care less about admitting anything happening to our society. They're concerned only about their little corner of the world, and in that corner there has never ever been a need for a policy that allows for armed medics, even it their liability carriers and the state Attorney General allowed it. More to the point, there are virtually NO municipal EMS services around here...they're all private companies. Likewise, those companies don't give a crap about what "armed medics says about society..." they care about the liability and optics of having non-LEO and untrained employees toting guns on calls for which that company is responsible. Like the vast majority of corporate America, employees carrying guns on the job just ain't gonna happen, in Middle America anyway.

[TacMedic556]

...they're all private companies. Likewise, those companies don't give a crap about what "armed medics says about society..." they care about the liability and optics of having non-LEO and untrained employees toting guns on calls for which that company is responsible. Like the vast majority of corporate America, employees carrying guns on the job just ain't gonna happen, in Middle America anyway.

I should have clarified. I was referring to municipal/fire based or government provided EMS where the Paramedics are perhaps employed by the same City government or County government as the Law Enforcement agency. I completely agree and see your point with private entities being less keen on arming employees - such as agencies like Rural Metro or AMR.

The integration of Paramedics finding positions on tactical teams is happening with great success where they are employed by a municipality or jurisdiction that also provides law enforcement - such us in my case going on a decade now. As long as all POST training is up to standard, requirements are met, and policies and procedures in place the implementation can be incredibly beneficial for the team and public safety, by providing care when it would otherwise be delayed.

True Story: I was doing a grant presentation for a large corporation last year, in order to obtain several dozen active shooter trauma kits for two large High Schools in the area. A woman at the board stated and I will paraphrase, "I think we have to admit that we need to evaluate our societies desire to have guns in and protect that right to have them if we are at the point where now we need to place items like this in our schools". She went on and I cannot recall her statements as it was months ago. However she made it clear that she was troubled by the fact, we have guns in society and because of that (in her mind) we have gotten to a point to where we need trauma kits in schools (even though these can be used for shop accidents as well).

My point above is that some members of our society have an aversion to anything firearm, as well as having to discuss or entertain thoughts of bad things happening in their community. They are fragile. It is traumatizing for them to even begin to think about or plan for trauma that has yet to even happen. I have personally seen and witnessed a similar aversion to tactical medic positions on multiple occasions. For some reason, they see a magical line that separates someone who is medically proficient and trained from also being able to operate a firearm in a hostile situation.

I attended fire academy in 1999 - getting my FFI, FFII and EMT-B. I graduated with a degree as a Paramedic in 2002 and was hired as a professional firefighter paramedic. I have trained exhaustively in many skill sets for 16 years related to a myriad of hazards and emergencies. I qualified for SWAT in 2006, attended multiple TCCC and LETTC courses taught by US Special Forces (PJs, Delta, USAF Trauma Surgeon) as well as attending other courses related to terrorist bombing incidents. I understand my position is unique and foreign to some. In discussing trends, attending training out of state, and reading periodicals I cannot help but sense at times, from some individuals, a feeling that they are uneasy with the arming of those whose job it is to provide care - not harm. The idea of using force in order to provide care is foreign to some.

It is late, think I will hit the hay. Have a goodnight gentlemen.

[Hmac]

More than a decade.

I agree with arming tactical paramedics. My team grew up around the concepts that Rich Carmona espoused back to 2000 and before. We were early adopters and I'm completely on board. Have been for almost two decades.

Officially-sanctioned armed EMTs outside of the tactical arena? Hard to imagine that that would even begin to fly. I don't see that happening on a meaningful scale at all.

[Fly8791]

I'm a firefighter/emt in central Texas and the idea going around is:

Groups of 3-4 Law Enforcement officers form up strike teams and go hunting for the shooter(s).

As they move through the scene, casualty collection points are set up. Next in officers escort and provide security for Fire and EMS to get to the victims/patients.

Here is the kicker, the casualty collection points are pretty much anywhere there is a bunch of wounded. So this can be IN or around the scene.


Getting shot is honestly not my big concern. The problem I have is our communication issues between Fire/EMS and Law. I predict that a bunch of cops are going show up and they are all going to do the "strike team" thing and we won't have an effective way to get in there and do our plug the holes/tourniquet business.

[Fly8791]

Officially-sanctioned armed EMTs outside of the tactical arena? Hard to imagine that that would even begin to fly. I don't see that happening on a meaningful scale at all.

You are 100% right. NO Fire or EMS department wants any of the Travon Martin/Michael Brown/BLM bullshit to come down on them. People don't hate Fire and EMS like they hate Police, and there isn't a Fire Chief anywhere that is going to throw that away by having one of his guys start pulling triggers.

And of the guys I know 99% of them (the exception being the loudmouth dumbasses) do NOT want to carry firearms or have to draw a bead on a living person. Frankly if we wanted to carry a gun we would be Cops. I know the guys on my crew only want 2 things in a mass shooting: First is for Law enforcement to put the shooter down... Hard. and Second for ANYONE on the medical side to be able and help the wounded.

Getting a tourniquet to someone that needs one is what "my area" is trying to focus on. I can honestly support that. But it seems like people are going to be expecting a lot co-operation from departments that can't even effectively communicate.
The way it is set up now is that I (as the LT for my crew) would have to: Radio my IC/Bat. Chief who then talks to a patched over channel to talk to Law Enforcement incident commander (who ever that is going to be), who talks to his officers, who then reply back to Law IC that talks back to my IC, that talks back to me.... See where I'm going with this?


If something goes down in my area I think it will be one disorganized cluster F. There is very little history of anything like this going on. This isn't a Paramedic being attached to a swat team. This is new ground for everyone. Our way of doing thing has always been we stage until Law Enforcement secures the scene.

[TacMedic556]

You are 100% right. NO Fire or EMS department wants any of the Travon Martin/Michael Brown/BLM bullshit to come down on them. People don't hate Fire and EMS like they hate Police, and there isn't a Fire Chief anywhere that is going to throw that away by having one of his guys start pulling triggers.

And of the guys I know 99% of them (the exception being the loudmouth dumbasses) do NOT want to carry firearms or have to draw a bead on a living person. Frankly if we wanted to carry a gun we would be Cops. I know the guys on my crew only want 2 things in a mass shooting: First is for Law enforcement to put the shooter down... Hard. and Second for ANYONE on the medical side to be able and help the wounded.

Getting a tourniquet to someone that needs one is what "my area" is trying to focus on. I can honestly support that. But it seems like people are going to be expecting a lot co-operation from departments that can't even effectively communicate.
The way it is set up now is that I (as the LT for my crew) would have to: Radio my IC/Bat. Chief who then talks to a patched over channel to talk to Law Enforcement incident commander (who ever that is going to be), who talks to his officers, who then reply back to Law IC that talks back to my IC, that talks back to me.... See where I'm going with this?


If something goes down in my area I think it will be one disorganized cluster F. There is very little history of anything like this going on. This isn't a Paramedic being attached to a swat team. This is new ground for everyone. Our way of doing thing has always been we stage until Law Enforcement secures the scene.

Typically it's idiots or the misinformed that hate cops. I can name 5 Fire Chiefs in 5 different departments that have seasoned firefighter paramedics that are officially trained, sanctioned, deputized, certified, POST whatever you would like to call it on SWAT / SRT / aka tactical teams. It works very well. As soon as a position is available (its rare because guys like to stay on the team. I have been on 10 years straight) - as soon as one is open 5-8 firefighters show up from our Dept. alone to try to get on. Every area is unique, distinct and has differing needs as far as level as service.