The five-day, 52-hour course involved classroom time as well as hands-on, practical exercises. Topics included the role of the tactical medic, legal and liability issues, tactical triage, and mission-specific equipment considerations. The course then moved on to the skills needed when dealing with hemorrhaging, chest injuries, intravenous/intraosseous, airway concerns and splinting in the tactical environment based on tactical combat casualty care guidelines. The students studied and practiced swat movements, explored maintaining team health during extended operations and severe weather conditions, and learned about giving medical care to the team’s k-9 member. They also tackled decontamination and fourth-generation warfare, the idea that the goal of the enemy would be to collapse a country internally rather than destroying it.

Clearwater Fire Department paramedics Sean McKay and Lt. Brent Bronson taught the tactical-rescue technician course. Both were the tactical-medic element of a SWAT/medic team formed by drawing lots in the 2005 International Tactical ems Association’s Medic Up competition. They placed first in 2003, second in 2004, and first again in 2005. Both adhere to the teachings of modern-day pioneers in tactical medicine, Vice Admiral Richard Carmona, M.D., the U.S. surgeon general, and Capt. Frank Butler, M.D., the present U.S. special operations command surgeon. Clearwater Police Department’s Officer Christian Zarra, a competitor in swat Round-Up 2005, taught tactics.

Course work also reflected earlier counter narcotics and terrorism operational medical support concepts, but with further evolvements that included the addition of Clearwater’s own life-saving courses.

According to Clearwater Fire Chief Jamie D. Geer and Special Operations Asst. Chief Jeff Patterson, the tactical-rescue technician course offers new techniques that are not taught elsewhere because when there is a swat call-out, fire and rescue personnel will be on the scene regardless.

If medics are on the swat team, they would be right there where they were needed, leading to a better survival rate for officers. This thinking evolved following a 1999 incident in Cobb County, Ga., where two officers were killed in a hostage situation and another officer was wounded, yet medics could only stand by and wait for the area to be cleared by the police.

Clearwater’s tactical team medics are clothed and equipped much like their police counterparts but with the word “medic” on their uniforms. They wear helmets and ballistic vests, and from a distance they appear just as intimating. This helps with compliance issues that may arise.

The medics do not carry firearms, but they are taught to use them in case they or the individual they are rescuing are caught in a situation where they need to defend themselves. Training medics in the use of firearms is touchy, and according to the two chiefs, takes the fire and rescue services away from where they want to be. In general, fire and rescue professionals want the public to know they’re unarmed. They are not law enforcement officers. For the most part, both the general public and the bad guys think of fire and rescue personnel differently from the police. This allows firefighters to work in high-crime areas without being threatened. If armed, they would be perceived differently.