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Smaller law enforcement agencies are often challenged by the responsibility
for resolving high-risk incidents. Such incidents frequently require the
commitment of tactical units with special training and resources, and pose an
elevated risk of injury to officers, innocent persons and suspects. Moreover,
the initial cost involved in establishing, equipping and training a tactical
unit can be high, and the subsequent expense required to maintain a high degree
of proficiency in such perishable skills compounds the financial strain on
smaller departments.
An incident involving the ambush and shooting of a Kannapolis police officer
in 1993 underscored the need for the department to be prepared not only to
provide a tactical response, but also to provide direct tactical medical care to
injured persons under high-risk conditions. We felt that it was not practical or
cost effective for us to train a police officer to a paramedic level and
purchase the necessary tactical medical equipment to support that role. Seeking
an alternative solution, we turned to our local county emergency medical service
(EMS) and explored with them the option of using volunteer civilian paramedics
in this tactical role. Local EMS paramedics were already trained to a high level
of proficiency in advanced life support skills, and were well equipped with
support vehicles and associated field medical equipment.
Implementation of an effective tactical medical support program was directed
at achieving the following goals:
• Provide for a safer environment in which the paramedic performs his/her
duties at the scene of a tactical operation.
• Enhance mission accomplishment.
• Reduce death, injury and illness, and related effects, among officers,
paramedics, innocent persons, and perpetrators.
• Reduce line of duty injury and disability costs.
• Reduce lost time for specially trained, hard to replace paramedics and
police officers.
• Maintain valuable team morale when true concern for member health is
realized.
 The focus of the project was to acquire a sustained tactical medic support
capability using non-sworn civilian personnel. The medics would operate as
integral team members of our tactical unit and perform medical related missions
both during deployments and training. The objectives were straightforward.
Identify qualified paramedics from local EMS providers, who were interested in
volunteering to perform in a tactical support role, develop and implement
operational guidelines, and ensure that they were provided with the necessary
tactical medical training and resources.
We subsequently recognized the need to execute an agreement with the EMS
agency employing the medics to establish a framework of understanding and
certain legal protections for the long-term continuation of this arrangement.
The Chief of Police and EMS Director worked jointly to draft an agreement that
set out the status of the paramedics, as well as the role and responsibilities
of each agency, training and qualification requirements, and the goals of the
program.
The tactical medic selected for this program was carefully screened by the
Chief of Police and EMS Director to ensure a high level of proficiency and
clinical experience in providing advanced life support in a field environment.
Subsequently, the police department provided the required sponsorship for the
civilian paramedic to attend the Counter Narcotics and Tactical Operations
Medical Support (CONTOMS) training program operated under the auspices of the
U.S. Department of Defense, through the United States Park Police, and Uniformed
Services University of the Health Sciences. This cost of the CONTOMS training
was paid for by the local EMS agency. The police department and the EMS agency
jointly provided tactical uniforms and equipment needed to complete this
training.
Following successful completion of the CONTOMS training, the paramedic worked
with our tactical team on a regular basis and was trained to understand mission
objectives, tactics and weapons used, pyrotechnics and other devices likely to
be employed, and communication policies and procedures. In order to function
effectively, the medic needed to have a working knowledge of the team, its
tools, and its tactics. Tactical medics are fully integrated as team members who
remain in an on-call status and are activated to respond to all operational
deployments. Since the medics are civilian volunteers and not law enforcement
officers, they are unarmed and rely on protection from tactical forces when
deployed near the inner perimeter. During deployments, medics are under the
direct command of the tactical team leader.
The mission of the tactical paramedic is diverse. They acquire and maintain
medical history, immunization status, and current health status on each team
member. They ensure the transfer of pertinent medical information to appropriate
medical personnel to save valuable time during the emergency treatment of
injuries or illness. They monitor the medical effects of environmental
conditions on individuals and team performance and make recommendations to the
team leader. They provide field medical treatment to team members injured or
taken ill while engaged in mission or tactical training activities. They also
conduct medical threat assessments and serve as medical intelligence officers.
These are but a few examples of their duties and responsibilities.
Tactical paramedics have the capability of providing advanced on-scene
medical care, greatly improving the efficacy and speed of medical response
during high-risk deployments. Moreover, these paramedics have the capability and
authority to request and coordinate the direct on-scene response of medical
evacuation helicopters for the air transport of critically injured patients from
the scene to a nearby regional trauma center. If transported by ground
ambulance, tactical paramedics can stay with the patient while enroute to a
medical facility in order to provide continuity of life support and emergency
treatment.
The cost of the tactical paramedic support program is shared between the
police department and the EMS agency that employs the paramedics. The police
department provides the medics with individual tactical equipment such as
uniforms, body armor, gas mask, and communications equipment. The EMS agency
provides an assigned EMS response vehicle, access to other medical support
vehicles and all field medical equipment and supplies used by the tactical
medics. Both agencies contribute directly to the cost of tactical related
training. This has proven to be a cost effective and mutually beneficial
arrangement.
The civilian tactical paramedic support program has been in effect since
1994. During the past five years, there have been no incidents requiring
significant medical intervention by the tactical paramedics during mission
deployments. During tactical training activities (itself a dangerous activity),
the paramedics have provided on-scene medical treatment for a number of training
related injuries to team members. Consequently, the lost work time from such
injuries was minimized and the health of the team member restored in an
expeditious manner. Team morale and confidence in the expertise of the tactical
paramedics has been exemplary.
The program has proven to be extremely beneficial and provides our agency
with a valuable tactical resource that would otherwise be unavailable. We have
been impressed with the level of commitment and support displayed by our local
EMS provider and the volunteer paramedics who place themselves in harms way
while performing this unique and dangerous role.
We are currently trying to expand the program to increase the number of
tactically trained paramedics who participate in the program. This will enable
our volunteers to rotate their "on-call" status for mission
deployments and training activities. In addition, an increased number of
qualified tactical paramedics would give greater capability for periodic relief
and replacement during protracted or prolonged incidents, or to effect response
to multiple locations.
For more information about this program contact Paul D. Brown, Chief of
Police, Kannapolis (NC) Police Department at (704) 933-2215.
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