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Armored Vehicles Give Tactical Medics an Edge


With their ballistic protection, armored vehicles allow special weapons and tactics (SWAT) operators and tactical paramedics to be protected from gunfire while moving about a dangerous scene. These vehicles can be used to rescue people who are pinned down by gunfire, have been injured or wounded, or are victims of flooding and other disasters. Armored rescue vehicles (ARVs) can also navigate areas traditional response vehicles cannot, such as the sites of blizzards, tornadoes and hurricanes. When New Orleans was paralyzed during Hurricane Katrina, only ARVs were able to negotiate the flooded city streets

An even newer concept than ARVs is that of tactical medics -- medical care providers who support tactical law enforcement operations. Leaders in this field develop, perform and implement casualty responses -- tactics, techniques and procedures -- based on the military concept of tactical combat casualty care (TCCC). The basics of TCCC include treating casualties, preventing additional casualties and completing the mission„with the right equipment at the appropriate time.

Four ingredients are essential to conducting successful rescues under fire:

  1. Special weapons and tactics (SWAT),
  2. Armored rescue vehicles (ARVs),
  3. Tactical EMS (TEMS) and
  4. EMS.„

Such partnerships between law enforcement and fire/rescue are win-win situations and exist around the U.S. An example is Clearwater (Fla.) Fire and Rescue Department and the Clearwater Police Department. In this partnership, medics go through demanding, strict SWAT training as well as special TEMS training. In addition, they must meet the requirements of being rescue paramedics/firefighters.

The Pinellas County (Fla.) Sheriff_s Office SWAT team has an ARV that can clear bad air within three seconds. In addition, all the team's tactical medics' bags are set up exactly the same, which ensures no problems using someone else's bag. It also helps medics easily direct SWAT to give basic medical care from a distance in situations where medics are unable able to get to the patient.

Case Study: Cleveland

ARVs were first introduced in response to riots across the U.S. in the 1960s. In the aftermath of the 1968 Glenville Shootout, Cleveland Police Department's (CPD) ARV and rescue Medevac concepts were born. The police tactical unit evolved into a SWAT team, and a custom-made armored vehicle became a tactical ARV called "Mother." Cleveland now has a second ARV, Mother-2. At least one SWAT Medic is assigned to Mother-2 whenever it deploys.

The basic tactic for a rescue conducted against armed opponents is to place the ARV between the victim(s) and suspect(s) as a shield whenever possible. Cleveland Police SWAT uses two rescue elements for 360-degree coverage. One operates inside the ARV and the second operates alongside it, using the vehicle for coordinated protection. The victim is removed from danger, secured onto the backboard and placed in the ARV. Once inside, interim emergency medical care is provided while the victim is transported to waiting EMS personnel and ambulances.

Other casualty extraction methods are being taught nationwide. These include drags and carries, and the use of harness systems and drag Skeds, which are rollup plastic stretchers and half-stretchers that become rigid when holding a patient and slide easily across the ground). Another efficient way to move a patient to protective cover is to simply grab an arm or leg and drag them. Dragging a victim on the ground is effective because there's better spinal motion restriction than when the body is carried. This means there's less chance of spinal injury to the rescued person.

As far back as the early 1980s, CPD SWAT developed an in-house "Tac Med" program. By the late 80s, it had a number of law enforcement SWAT officers trained and certified as EMTs. In the early 90s, CPD SWAT began intense efforts to upgrade its TEMS to include Cleveland EMS and Cleveland Fire Department paramedics. But political obstructions delayed TEMS until 2007, when Cleveland finally approved SWAT Medics. CPD SWAT persisted because they knew TEMS was a necessary lifesaver.

In January 2008, 35 CFD and CEMS paramedics tried out for four Cleveland SWAT medic positions. After an initial testing phase, including SWAT's rigorous physical fitness test, 15 candidates remained. Additional screening followed until four full-time SWAT medics were selected. All four had field experience, and two had military combat experience. Once selected, they attended intense TEMS training at the internationally recognized International School of Tactical Medicine (ISTM) in Palm Springs, Calif.

Cleveland SWAT is a full-time team, with one medic assigned to each SWAT shift on an on-call basis and a second added for raids/searches. All four attend hostage situations, barricades and training. This system allows the SWAT medics to continue to perform their fire/EMS paramedic duties when not assigned to SWAT, which helps keep their paramedic skills honed.

As a new part of the SWAT team, CPD medics have been busy developing Tac Med protocols and obtaining the proper medical equipment and gear for SWAT missions, as well as obtaining formal approval from the city's medical director.

The SWAT medics have dedicated use of one of CPD's unmarked SWAT vans. They are in the process of outfitting the van for their TEMS missions, and it will be equipped almost the same as a regular EMS emergency vehicle. Each medic carries small, personal medic packs featuring QuikClot. For every deployment, at least one medic carries a backpack filled with supplies for any trauma treatment.

SWAT battle dress uniforms (BDUs) are currently on order for the medics, and all wear issued ballistic body armor, helmets, and chemical agent masks. They're issued a ballistic shield on missions and have been familiarized with SWAT weaponry. For now, Cleveland SWAT medics won't be armed, because they're accompanied on missions by armed SWAT personnel.

The process of incorporating SWAT medics into Cleveland SWAT's tactical operations is ongoing. Both SWAT team members and medics continue to revise how and where to best deploy the medics. Interaction, discussion, briefings and debriefings continue on a daily basis.

Case Study: Orange County, Fla.

The Orange(Fla.) Sheriff's Office (OCSO) has four full-time SWAT deputies and 43 part-time SWAT deputies,who also perform other law enforcement duties. Department officials say their goal is to eventually have 53 SWAT deputies and six tactical medics. Presently the OCSO SWAT team has a single tactical medic, Orange County Fire Department Lieutenant Elaine Fisher.

Unlike many tactical medics, the OCSO SWAT paramedics will carry weapons. Because of this, they also need to be sworn deputies, and the agency will be looking first at deputies who are already EMTs or paramedics. Fisher has been through SWAT school and trains with the team, familiarizing herself with their operations. But future OCSO tactical medics will only need to meet the EMT/paramedic and regular law enforcement requirements.

Although Fisher has gone through all of the SWAT requirements and trains with the team, she isn't used in a SWAT capacity. Rather, she responds and stages with them so she's on the scene. And although she doesn't accompany the members when they enter buildings, she does stay near the command post vehicle ready to render aid if the situation calls for it. She is also more involved with the team when there are hostage and barricade situations.

According to SWAT team Commander Tom Stroup, the OCSO at first used unarmored vans for their SWAT team. They then changed to a modified prototype Hummer. Currently, they use a custom Lenco Bearcat armored vehicle with Hazmat detector, FLIR infrared system, Level IV armor, run-flat tires, eight shooting ports and a turret. The vehicle can seat up to 12, including the driver and front-seat passenger.

Five-man shield rescue tactics are generally used to retrieve injured victims and bring them to the vehicle. It's preferable to use the ARV as a shield between the medic and patient and the shooter, or to have the medic inside. This allows the victim to be extracted as quickly as possible and taken to the staging area. Fisher says, "If it's bad enough for an ARV, it's bad enough to get out of there."

The only problem Fisher has faced when using an ARV for rescue is the height of the rear doorway threshold; the back of an ARV is usually high off the ground. Because of this, it takes at least four people to lift a victim into an ARV.

In addition, medics must realize that very little treatment can be done in an ARV because of the tactical environment and limited space. Treatments common to ARVs include airway, breathing and controlling bleeding.

Building Support

To get the funding to equip an agency with an armored vehicle, much depends on the community's perceived needs and how the concept is marketed to that community. For example, armored police vehicles are often called armored "rescue"vehicles (ARVs), a term that carries a more positive connotation and expands the scope of the vehicles' usage.

It helps to make it clear to the community/funding agency that the vehicle has many other uses, such as community aid in times of disaster. In addition, depending on the population and needs of the department, costs and usage can be shared by several agencies, which creates a multi-agency task force. Many armored vehicle manufacturers will provide grant-writing assistance, and the chances of receiving a grant are often improved if the vehicle will have multi-jurisdictional use. Many ARV manufacturers will also provide training assistance for purchased armored rescue vehicles and are very helpful in providing repair assistance or repair courses at the factory for agency mechanics.

Jim Weissis a former army military policeman, former state of Florida investigator, and retired Broookpark, Ohio, police lieutenant who is a frequent contributor to safety forces magazines.

Mickey Davisis a Florida-based freelance writer and author whose novel, Evangeline Brown and the Cadillac Motel, has won national and international awards.

Bob O'Brienis a retired Cleveland Police SWAT sergeant who was the co-founder of the Cleveland Police SWAT team and assistant SWAT team leader. He can be reached atRjogrp1@aol.com.

For another system profile, click here to read "At Home on the Forefront.


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