Expanded Duty for EMS Techs: Tactical Decisions

SWAT (Special Weapons and Tactics) teams are specialized police units that use weapons and tactics that typical line officers do not usually have at their disposal. They work primarily in high-risk situations where their additional resources may improve the chances for a successful resolution. The SWAT-team concept was first implemented in California by Los Angeles Police Department Chief Darryl F. Gates. In the years since then his concept of bringing military-style offensive tactics to police work has been expanded into using SWAT teams during “special” and non-routine missions – hostage negotiations, for example – and other less publicized but equally difficult situations.

Such assignments are frequently very dangerous, but also clearly the responsibility of law-enforcement agencies. However, anywhere there is high risk of injury to responders and/or other citizens – hostage “events” are the most prominent example – EMS (Emergency Medical Services) specialists are needed to support the operation. However, “Tactical EMS” means more than just being available on-scene – to provide care for injuries, for example. Today, the Tactical EMS member goes beyond the “safe zone” and travels with the SWAT team members, taking his or her special ER (Emergency Room) skills directly to the stricken.

Tactical EMS training typically starts with learning the basics of tactical operations. In order to support the tactical team effectively, EMTs (Emergency Medical Technicians) must now be able to move out, and with, the other members of the team. At the actual scene of an incident, though, Tactical EMS staff often operates as an island – i.e., in an advance position, but preferably in locations where they can stay in place and treat patients/victims while awaiting the opportunity to evacuate them to safety. At the risk of sounding overly dramatic, they are literally operating behind enemy lines.

Knowledge, Experience, and Deadly Force 

The medical component of the EMS training provided to SWAT team EMTs builds on the existing medical knowledge and experience of the individual members, while providing them both didactic training in advanced trauma care and practical experience during live scenarios. Because of the increased use of dogs in many law-enforcement situations, additional training in the treatment of canine injuries is now included in many tactical EMS training programs.

Many programs also provide training in threats such as those posed by IEDs (improvised explosive devices), chemical weapons, and other high-tech hazards becoming increasingly common in the modern environment. This component of the training syllabus is intended to: (a) give the SWAT team another set of experienced and well trained eyes to detect threats before they become reality; and (b) familiarize the Tactical EMS member with the potential damage that can result from these previously rare but now much more “routine” threats.

Training programs also include weapons training – which focuses on both the safe handling of firearms and the use of deadly force. With the increased presence of tactical EMS members on SWAT teams one of the more substantive issues to be decided is whether to train SWAT officers, who are first and primarily police officers, to be EMTs or to train EMS staff to be members of a SWAT team. California has answered that question by requiring that tactical EMS training be integrated into the training curriculum required for standard EMS units. That decision allows the state’s EMS structure to oversee the medical training and operational assignments of the tactical EMS team members.

In both Yuba City and Sacramento, to take but two examples, the city’s Police Department and the city’s principal EMS provider have partnered to add medical support directly to the tactical team. However a jurisdiction chooses to add them, the presence of tactical EMS members on SWAT teams today is often a matter of life-or-death importance – literally. 

Joseph Cahill
Joseph Cahill

Joseph Cahill is the director of medicolegal investigations for the Massachusetts Office of the Chief Medical Examiner. He previously served as exercise and training coordinator for the Massachusetts Department of Public Health and as emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as citywide advanced life support (ALS) coordinator for the FDNY – Bureau of EMS. Before that, he was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. He also served on the faculty of the Westchester County Community College’s paramedic program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montefiore Hospital.



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