Many agencies may never prepare for a visit from a dignitary; for other agencies, though, such visits are considered routine events. As a result of their serving as homes for the United Nations and the U.S. capital, New York City and Washington, D.C., host daily visits from individuals who frequently go unnoticed but in any other city would be front-page news.
During the election season the chance of even a small town hosting an incumbent governor, U.S. senator or congressman, or president – or a candidate for any of those offices – increases significantly. Those towns, and even smaller communities, want such events to go as smoothly as possible, of course, and many of them form dedicated EMS (emergency medical services) units to help protect such dignitaries.
A presidential visit will almost always be preceded by contact from the U.S. Secret Service well in advance of the actual visit; the Secret Service also will be the lead agency coordinating event activities. Similarly, the U.S. Secret Service or the U.S. State Department will provide the leadership and guidelines for the visits of other world leaders.
There are, however, many well known and/or highly publicized persons who may not be provided similar support from these same agencies but whose visits may nonetheless pose special problems. To deal with those problems it is important to recognize that, generally speaking, there are two principal factors that make any person a “dignitary” per se: importance and risk.
Mandatory Adherence to a Basic Principle – Usually
An important EMS principle to keep in mind is not that one life is more valuable than another. This principle is embodied in: (a) the triage system, which mandates that the criterion for the prioritization of on-scene care is the medical condition of the individual patient; and (b) emergency medical dispatch (EMD) systems that call for the dispatch of EMD units first to the most life-threatening situations.
Both of these examples embody the same operational principle as well: prioritizing the use of scarce resources. In that context, the EMS dignitary-protection unit should be considered a dedicated resource that probably would not even exist in the absence of the same dignitary. Observing that distinction allows the dignitary-protection unit to be viewed outside the basic EMS principle referred to above.
The “individual risk profile” of the specific dignitary might well change the need for coverage and protection – in various ways. A lower-ranking official who has a known medical frailty, for example, might be offered coverage because he or she might be more likely to become seriously ill during his or her visit.
Similarly, an individual who is a more likely target of violence may require additional protection not only in the form of EMS services but also both law-enforcement and/or fire-suppression attention. Finally, the activity planned also may dictate additional attention. A short visit to a remote or well protected site such as the Tomb of the Unknown Soldier, for example, would be easier to prepare for than a motorcade through Miami to attend the Super Bowl.
Providing effective protection for a dignitary may require the assignment of a dedicated unit that can travel with the dignitary. This possibility is particularly critical when a protective parameter must be formed in the immediate area around the dignitary and/or if the event being attended requires bringing in an unscreened EMS resource from outside the parameter – either of those possibilities represents a potential loss of the protective integrity usually required.
The Price That Is Sometimes Paid
It is worth repeating: The primary and usually only duty of the protective unit is to provide for the dignitary’s care and survival. Adherence to that principle presents an obvious problem, of course, when someone else is ill or injured. A prime example of this happening is when a police officer assigned to the dignitary’s motorcade is injured. In such instances it should be kept in mind that, when a unit is dedicated to protection of the dignitary, that unit is turned over to the lead agency (the Secret Service or State Department, for example, as previously mentioned) and answers to that agency, at all times, during the event. It logically follows, therefore, that the lead agency must make the call on whether the dignitary protection unit stops to assist the fallen member (of a motorcade, for example) or continues with the dignitary, as originally planned. The second option just mentioned, continuing with the dignitary, is not because of a cold disregard for the fallen, but because the unit’s primary and only focus must be keeping the dignitary alive.
Terrorists and other lawbreakers know, obviously, that causing a motorcycle crash is a very easy way to slow or stop a motorcade, and/or possibly stripping away some of its resources as well as allowing vehicles from outside the parameter access to the motorcade route. That is why, whenever there is a dignitary protection unit assigned to a high-risk activity such as a motorcade, there also should be a screened “shadow” unit immediately available to step in and provide care to anyone in the protected area who may need medical or other emergency assistance.
Lest anyone think this concern is extreme, it should be remembered that, in the past four years, three police officers lost their lives in the motorcades of the president or presidential candidates: Police Officer Germaine F. Casey (Rio Rancho, N.M.), on 27 August 2007; Police Officer Steve Favela (Honolulu, Hawaii), on 26 November 2006; and Senior Corporal Victor Lozada (Dallas, Texas), on 22 February 2008.
For more information on motorcade deaths, click on either of the following sites:
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.