Here's a recent example. The report goes out that allegedly a pair of gunmen attempts a bank robbery and as they make their escape they encounter local police trying to block the road. The officers come under fire from high-power semi-automatic rifle fire, injuring one officer, and the pair continues to flee. Radio notification goes out to all area police agencies, and officers from local, county, state and federal agencies begin to converge on the area where the suspects have abandoned their vehicle and fled in to the woods on foot.


The local ambulance company places a crew at a safe staging location, just like most agencies around the state would do. But let's look at the situation from a medical perspective if you are one of the officers whose family is expecting you home for dinner, or just saw you race out the door when you heard the call, "officer has been shot". Those of us in EMS don't often think about the medical care we may need ourselves on any call, because we practice "scene safety". But ask yourself, if you suffered a life threatening injury such as a bullet wound, how long do you want to wait for the "scene to be safe" before the EMTs are at your side? Tactical situations exist when there is a strong potential for lethal violence, doesn't it make sense to help insure the safety of those officers by having medical help close at hand?

Part of our medical assessment means knowing what kind of weapons or hazards are involved to forecast possible injuries and come up with mitigation strategies or response plans. In this case scenario above, we have two heavily armed suspects, reported to be in body armor with high-powered rifles in the woods. We are responsible for medical support for up to 60 police officers including two tactical teams, two canine officers and numerous support personnel. Not only do we have to worry about injuries due to firearms, but the associated hazards of walking, crawling through the woods and streams. We have to consider hydration of the officers, heat and cold stress and what kind of medical assets the community can provide once the "scene is safe" or the injured parties are extracted.

In my numerous years of working with EMTs, fire and police officers, I have come to the conclusion that we have much more in common than differences in our jobs. We are all in public safety and we all want to work our shifts and go home at the end of it. Many of us have children waiting to see mom or dad walk in the door, and many of us rely on the other discipline to "make the scene safe" so that the rest of us can apply our expertise to the situation. Tactical medics are EMTs who have made the commitment to provide the officers that literally risk their lives to make the scene safe for us, with rapid and efficient medical support.

What kinds of EMTs make the best tactical medics? In my limited experience of 6-7 years helping OSP SWAT and coordinating the EMS-Special Operations course at Camp Rilea, I've formed some opinions. You can take a police officer and train them to be an EMT, this produces a very safe team member because they are well trained in officer safety and tactics. On the medical side however, some of these officers may not get to practice the medical trade sufficiently to feel confident in handling the more challenging traumatic conditions that could arise during a tactical event.


You can take medical personnel and train them to be a police officer, however the same drawbacks occur if you expect that person to function as a police officer, when most of their time they act in the role of medical provider. In my case, I am a paramedic/firefighter, I have great respect for the police profession but don't want to be one. If something goes wrong, I need to think and act like a medic or else I've let the team down in my primary role. I need to have enough tactical training so that I am not a liability to the team or stupidly become a casualty myself, but my sole purpose is to make sure these officers go home after each callout or training session to see their families.

Tactical EMS does add to the risk factors for the EMTs involved, but this kind of training goes a long way in keeping me and my fellow firefighters safe on the "normal" runs with the fire department. The terrible trend of school shootings is not likely to go away. What plans and training has your agency done to address the unique medical consequences of this kind of event. If your child is in the school, and local officers enter the building to neutralize the threat, how close will medical support be able to safely operate? Will you want to help your child or officer who becomes injured, or will you wait until the entire scene is declared "safe"? Life is full of risks, training and education is one of the best ways to minimize them.

Tactical medics working with police teams train constantly with a tactical team to know the procedures, weapons, personalities and medical history of team members. We don't make tactical decisions but we support the commander in their overall mission planning by being the medical conscience.

Operating as a medic within the inner perimeter of a SWAT team is not something taught in any normal EMT class. Several courses are available for EMTs interested in providing this kind of medical care around the nation. In Oregon, a weeklong course is offered two times a year at Camp Rilea on the northern Oregon coast. Sixty hours of training time is spent practicing medical skills in a tactical environment, culminating in an all-night field exercise that tests the physical and mental toughness of the participants. Sponsored cooperatively between the Oregon Department of Public Safety, Standards and Training, the Clatsop County Sheriff's Office, Oregon State Police, Warrenton Fire Department, the FBI and numerous other subject matter experts.