SPECIAL OPERATIONS SWAT MEDICS

Recognizing the dangerous conditions, and the conduciveness for injury during a tactical police deployment, MedStar provides certified tactical paramedics to the Savannah Police Department's (SPD) Emergency Response Team, or ERT (SWAT). The MedStar Special Operations SWAT Medics are a team of eight paramedics selected by the SPD to serve a paramedics that respond to situations with their ERT. These paramedics train with the ERT and therefor must meet all physical agility requirements. SPD provides tactical training and safety equipment to assigned paramedics such as ballistic vests and other necessary equipment.

The paramedics involved in the program are all full-time employees of MedStar that have been selected by SPD officials. Only paramedics completing the federal Counter Narcotics Tactical Operations Medical Support (CONTOMS) program sponsored by the Department of Defense and the US Park Police, are allowed to participate. Participation in the program is voluntary and the paramedic remains an employee of MedStar and is compensated by MedStar during actual call-outs. The CONTOMS training program is a one week course that provides students with a 58 hour block of instruction that is considered by many in the tactical medical field to be some of the, if not the best, course of its type.

SPD selects and incorporates the paramedics as full team members, notifying the MedStar dispatch on all ERT call-outs. SPD requires that the paramedics continuously train with the ERT and maintain active practice and training in the paramedic profession.

The paramedics role on the team is one solely of medical support, therefore the paramedics will be unarmed and positioned at the discretion of the ERT commander as the situation dictates. However, as a rule the paramedics will be positioned somewhere just outside the inner perimeter of the objective.

Responsibility of the MedStar Paramedic
The Tactical Medic serves as the "team medical officer" and refers to the MedStar paramedic assigned to the team. His functions include:

• Acquiring and maintaining important medical history, immunization status and current health status on each team member. The confidentiality of this information is ensured by the medical officer. He also ensures the transfer of information to appropriate medical personnel to save valuable time during the treatment of injury or illness.
• Monitors the medical effects of environmental conditions on individuals and team performance. The tactical medic immediately brings any problems to the commander's attention.
• Providing field medical treatment to team members injured or taken ill while engaged in mission activity. He ensures that team members are afforded the best possible treatment and are transferred in a timely manner to an appropriate level of care. He provides humanitarian medical assistance to non-law enforcement personnel injured or taken ill during an operation until appropriate transfer to the EMS system can be safely effected. He elects when and where ambulances should be located in a standby mode during operations.
• Serving as the patient advocate for officers who are treated by other medical providers. He establishes good working relationships with local EMS systems and with receiving medical institutions and assures appropriate integration of the teams medical program with local health care delivery system. He also keeps commanding officers apprised of his findings and recommends actions which should be taken to insure optimum outcomes for the officer and the team following injury or illness.
• Conducting Medical Threat Assessments to determine the potential impact of medical/health factors on a mission and serving as the Medical Intelligence Officer. He serves as a health information resource for team members. The team medical officer is the commanders conscience and advisor on matters relating to the health of the team.
• Providing medical care under the direction of the MedStar Medical Director, using medical protocols and standing orders as established by the medical director. Provides medical and operational documentation to the medical director for review.
• Making himself available several times per month on an on-call basis to respond to ERT call-outs, responding within 20 minutes to all calls. The on-call paramedic shall carry a pager/beeper at all times while on-call. He will also carry a UHF radio during responses to assure communications with the MedStar dispatcher.

The tactical medic serves as an advisor to the unit commander, but the health and safety of the team is ultimately a command responsibility which can not be abrogated. The commander's functions include:

• Providing command level support to the team medical officer for matters relating to health and safety. The commander should demonstrate through intent and action a true interest and concern in the physical and psychological welfare of team members.
• Ensuring appropriate safety measures for and by the paramedic are maintained during an operation. Such as:

1. Positioning the paramedic at the scene of operation in a safe zone, but near the inner parameter of the operation.
2. Ensuring that the scene is safe and secure, as so far as is practical, prior to calling the tactical medic into the inner parameter of an operation.
3. Ensuring that victims needing medical care are brought out of an unsafe or unsecured location and taken to a safe zone for treatment by the paramedic.

• Ensuring appropriate medical coverage for all team activities.
• Ensuring that the tactical medic maintains his medical skills at a level higher than the average paramedic through continuing education and clinical work.
• Ensuring that adequate safety equipment, supplies and other resources are provided for the tactical medic to carry out his mission.
• Facilitating implementation of the medical officer's recommendations when determined to be in the best interest of the team.

Goals of Tactical Medical Support Activity.

Implementation of an effective tactical medical support program is directed at achieving these important goals:

• Provide for a safer environment in which the paramedic performs his duties at the scene of a tactical operation.
• Enhance mission accomplishment.
• Reduce death, injury and illness, and related effects, among officers, paramedics, innocents, and perpetrators.
• Reduce line of duty injury and disability cost to both agencies.
• Reduce lost work time for specially trained, hard-to-replace paramedics and officers.
• Maintain good team morale when true concern for the members' good health is realized.

• Team medical officers will be trained to at least the PARAMEDIC level and will be required to maintained current certification through the National Registry of Emergency Medical Technicians. Team medical officers will also maintain certification in Basic Trauma Life Support (BTLS).
• Team medical officers must be familiar with, and able to effectively coordinate with the entire Emergency Medical System, from the area of operation to the receiving medical facility.
• Tactical medics must work with the tactical team on a regular basis and must be trained to understand mission objectives, tactics used, weapons, pyrotechnics and other devices likely to be employed, and communication policies and procedures. In order to function effectively in support of a tactical team, the medic must have a working knowledge of the team, its tools and tactics.
• All paramedics assigned as tactical medics must maintain their clinical skills by actively participating in patient care activities on a regular basis.
• Team medical officers shall complete specialized training which teaches the skills necessary to operate in the austere environment and receive federal certification as "Emergency Medical Technician - Tactical".