Medics with guns

Like army medics, SWAT paramedic teams combine fire, EMS and police training to provide tactical defense and first aid care in situations civilian teams can't touch

      Police work can be war — unpredictable and downright dangerous. Sometimes police lines more resemble enemy territory, with flying bullets, impenetrable standoffs and erratic players. When the stakes are high, the threat of serious injury to responders can be great. So why must law enforcement officers in high-risk situations depend so often on civilian medical care?

   Agencies who have designed their own Tactical Emergency Medical Service (TEMS) units within the last decade or so can't imagine not having these highly skilled, highly versatile men and woman onboard. SWAT paramedics not only protect officers in the hot zone, but they offer immediate aid to suspects, victims and hostages. Like military medics, TEMS units accompany teams on virtually all high-risk missions and training. When a situation heats up and SWAT is stacked, they're standing in line.

Officer in trouble

   Standard medical protocol does not allow medics near a scene until it is secured. So what becomes of those inside? Lt. David Wood, commander of the Columbus (Ohio) SWAT team, was forced to consider this one day as his team was called to perform a dynamic entry. While inside, an officer was shot in the flashlight mount of his machine gun. Not knowing the extent of injury, fellow officers promptly called for assistance.

   "Of course, when you give an officer in trouble call, all the cruisers come with their red lights and sirens on and try to help," recalls Wood. "What happened that particular day was they blocked all the streets so the medics couldn't get in. After that, we said we've got to have them closer."

   The system was re-worked and medics were now trained to come to the command post rather than stand by at the firehouse. Still, Wood decided this wasn't good enough.

   "I wanted them even closer. A lot of teams in the country were having their police officers actually trained as medics, SWAT officers, and going right in with the teams."

   The cross-training of Columbus' SWAT and paramedic units started around 1988, when medics from the fire department would standby to assist SWAT during dynamic entries, or "crack house raids." Now Columbus' tactical medics are trained above the level; they possess firearms and tactics training as well as the medical training and qualifications of the standard civilian EMS system. Of the 100 people who applied for the Columbus tactical emergency medical team, 27 are currently employed — and all are current fire department medics.

   Wood's unit spends 50 percent of its time serving felony warrants for robbery, rape, homicide and felonious assault. Team members spend 25 percent of their time in training, though most of it happens on the job.

Choosing teams

   Unlike civilian paramedics, tactical medics can defend themselves as well as provide faster life-saving support to officers. But how does an agency go about designing its team?

   "I Googled TEMS just to see how other people are doing it, and it's so varied … there's no set way," says Wood. In fact, forming a TEMS team can be more like a game of a pickup. Agencies must do some research and see what works best. That includes finding candidates with relevant training who are also willing to learn new skills.

   Sheriff D. Brad Riley of North Carolina's Cabarrus County Sheriff's Department helped start his county's SWAT team in the 1990s. Everybody he spoke to who already had teams established suggested getting a medic onboard. Cabarrus County used regular law enforcement medics for about six months before switching to paramedics from an EMS service. The department now assigns two medics to every team.

   "We kept thinking we needed somebody internal, somebody that could carry a gun [and] had some military experience doing medic stuff. [But] the more we got involved and we tried some of that, we realized it just didn't work. The best thing for us to do was get somebody that was a true paramedic professional," says Riley. He points out medics with military experience train differently than medics who are on the street and provide emergency care every day. Wood agrees: "That's who I want to have working on me; a guy who's had stabbings and shootings every day and is working on people. "

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