SWAT officers’ injuries incurred during a showdown with criminals often involve excessive bleeding from gunshot or knife wounds. In the past, downed officers waited for an ambulance to be called and arrive at the incident — then for police officers to deem the area safe for paramedics to enter — increasing the risk that such officers may bleed to death.

“When I was a young firefighter, we’d have to stand by after a shoot out where officers were injured and wait for the scene to be completely safe and clear before we could enter,” said Alex Cohilas, fire chief of Clayton County (Ga.) Fire and Emergency Services Department, just south of Atlanta. “Those were precious moments lost.”

That’s where tactical medics come into play. Often, such medics are trained paramedics from area fire departments who — after rigorous training — are taken off their firefighting shift during a SWAT incident and sent to the scene to assist officers, Cohilas said. He currently oversees the county’s all-hazards department that protects about 144 square miles and more than 273,000 residents. Every firefighter in the department is cross-trained as an EMT–intermediate, which was a priority when he made chief in 2001 because he wanted to advance the department’s ALS capabilities. He then began to lobby for a tactical-medic program.

By 2008, Cohilas put into place the building blocks for a tactical-medic program. Now, the department has 22 tactical medics spread across three shifts who are on call to the SWAT teams for special response team operations overseen by the Clayton County Police and the Clayton County Sheriff’s departments. They also assist the U.S. Marshal’s Office and other Atlanta County public-safety agencies, he said.

“If a SWAT team is making an advance or entry, these medics are behind the officers,” Cohilas said. “If an officer gets shot, they don’t have to leave the officer behind or wait for medics to arrive on scene. Instead, the medics are imbedded inside the unit and work alongside officers.”

Tactical medic candidates must have at least three years of experience as a certified paramedic in order to be considered for the program, Cohilas said. In addition, the tactical medics must have seven years of service as firefighters. In fact, he said almost all of the current medics are sergeants or lieutenants, and several are chief officers with more than 25 years of service.

“The objective is to ensure that only seasoned and experienced paramedics are deployed to assist special response team operations,” he said. 

Tactical-medic candidates also must pass criminal background checks and drivers' history investigations. In addition, they must pass medical exams and aptitude tests. The fire department’s tactical-medic coordinator reviews the gathered data and approves the list of eligible candidates, Cohilas said. Then, candidates begin the process of gaining Georgia Peace Officers Standards and Training Council (POST) approval by attending and passing the Basic Law Enforcement (BLE) course, he added. 

During the peace-officer training, candidates are certified on a .40 caliber glock semi-automatic pistol and must pass sharpshooter tests. Cohilas said weapons are purchased out of the fire department’s budget and training is done on a reciprocal agreement under the Clayton County government’s regional training academy. Once certified as tactical medics, they then train on a regular basis with SWAT teams. There is no additional cost to taxpayers for the training, he noted.

In addition to firefighting gear, tactical medics have their law-enforcement uniforms, body armor, Kevlar helmets and duty belts. Their glock pistols are secured in a locked gun vault and only are accessed before they are deployed to an incident, Cohilas said. Tactical medics perform their regular firefighter-paramedic duties and handle fire suppression, EMS, hazard materials alarms and rescue alarms on their 24-hour shift. However, a special operations call out is their highest priority alarm, where they immediately don their medic gear and report to the SWAT briefing location or rally point, he said.

“If there is a deployment, such as a raid on a drug house, they go in as part of the special response team,” Cohilas said. “They will be out-of-service until the operation is complete.”

The fire service would benefit from an increase in the number of tactical medic programs, although Cohilas believes it may not be feasible in every jurisdiction. In fact, he said the program is cost prohibitive and works best in an urban department with a high population density and a high number of calls with a potential for violence.

However, firefighter medics bridge the gap between law enforcement and the fire service, Cohilas said.

“Ever since this program started, our departments have grown closer,” he said. “Now there is a true spirit of cooperation and respect and approved efficiency as well as shared ideas and experiences."