Nearly 10,000 Wisconsinites marched on the state capitol in Madison in February to fend off an attempt by Republican Gov. Scott Walker to eliminate state workers’ collective-bargaining rights. As a result, the Madison Fire Department deployed additional fire-based medics into the field to ensure protesters and law enforcement were served without comprising service to the rest of the city, said Jim Keiken, an assistant fire chief who managed the EMS/paramedic response.

Keiken said command staff determined early on that when protest crowds increased as the week continued, off-duty, overtime paramedics would be brought in to staff the event. In addition, fire medics were stationed at the capitol for rapid response, while third-party ambulance companies provided transport to local hospitals.

Part of operations was to determine paramedic staging. Keiken decided to station them at the foot of the capitol, because crowds prevented vehicles from being used for a rapid response. While medics were staged in safe areas amongst the crowd with law-enforcement support, equipment was staged in the capitol police dispatch area, he said.

“It was important they could maneuver in and out of those crowds to get to someone who needed critical care,” Keiken said. “So we worked with police officers to make sure a paramedic could get to an individual right away and then be escorted to into the ambulance to send them to the hospital.”

Medics deployed in the field carried basic first-responder kits with two-way radios assigned to a special events channel and ear-plug microphones to stave off background noise. The radios and microphones worked as expected, Keiken said.

“Sometimes it is hard to hear [medics], though, when you have a couple thousand people shouting, ‘What does democracy look like; this is what democracy looks like,’” he said.

Once paramedics reached the injured, they radioed back requesting equipment, such as an EKG monitor, and it would be delivered to their location, Keiken said.

“That way, paramedics weren’t burdened with carrying all of the normal equipment through thousands of people,” he said.

Slips and falls made up the majority of EMS calls during the protests, Keiken said. Chest pain also was treated.

“It was a good crowd that was helpful to the first responders. They didn’t interfere with the care provided by the fire department,” he added. “It was a respectful, easy-to-work-with crowd for us.”

Instead, fire medics found themselves monitoring first responders and law enforcement who worked up to 20 hours straight, Keiken said. Noticing the fatigue of officers, the fire department set up wellness checks that included paramedics testing law-enforcement officer’s vital signs.

“Out-of-town law enforcement worked extremely long hours,” he said. “We were more concerned about the police officers and their well being, than we were with the protestors — who were very well organized.”

It also meant bringing in outside help treat officers, Keiken said. For long-term rehab, including managing the stress of the event, the department hired a third-party medical group with the resources and equipment to treat officers, which was paid for by the state of Wisconsin and not billed to the department, he said. The move also freed up fire paramedics for other calls.

“We ended up learning this was a much bigger task than just putting paramedics in charge of taking blood pressures,” Keiken said. “So, we hired outside people to come in and truly evaluate the police officers as they were working. In addition, the police officers’ emotional stress was evaluated by professionals after we realized the [event] would last more than a few days.”

Keiken credited the fire department’s strong relationship with law enforcement agencies as the crucial element for delivering a well-organized response to the protest events. In fact, he said it was essential to work with the state management teams on operations and to cash-in on mutual-aid pacts with regional law enforcement.

“We’ve built a relationship with law enforcement over the past 10 years, dealing with other mass-gathering events, and that gave us the opportunity to have open lines of communications,” he said.