Helpful advice

Clearwater Fire & Rescue invites its EMTs and paramedics to try out for the tactical team. Mental and physical stress are part of the process. For example, potential tactical team medics do push-ups, run obstacle courses and immediately perform a medical procedure — all under high stress and in compliance with commands. Fire administrators and tactical medics also conduct interviews of hopefuls. Those who pass these tests are sought after as SWAT medics.

The chiefs offer these suggestions for other fire administrators when forming a tactical partnership with law enforcement.

• Both police and fire/rescue have resources and training that can benefit each other. For example, fire department rapid intervention teams perform forcible entries of burning buildings on a daily basis. These techniques have been adapted by swat on the tactical side. In addition, the police are using fire extraction techniques and tools such as carries and drags. They can now extract a downed officer without waiting for the paramedics, and because of this technology, still can have their hands free to fire their weapons. Another area of information exchange is in the use of thermal-imaging technology. Fire brought this to the attention of the police, and while the fire department uses it to locate victims, the police use it to find bad guys.
• Establish a good working relationship with the police department. This leads to trust, which evolves into success; the influences of this relationship are felt in other areas.
• Evaluate each incident. Adhering to this practice builds professionalism.
• Reinforce the basics. Before partnering with the police, the fire department must be doing its own basics well. This expanding role shouldn’t take resources away from fundamental fire and rescue missions.
• Share expense when possible. In Clearwater, the police department provided fire and rescue’s SWAT medics with ballistic vests, helmets and goggles. Investments in training are looked upon as benefits to the agency.

Supplies & skills

The tactical rescue technician course prepares medics for typical scenarios. Simply transferring civilian medical care methods to the “battlefield” won’t work.

Tactical situations call for different medical protocols than those expected by a conventional paramedic. For example, controlling direct pressure and IV fluid applications may not be as relevant while under fire. Popular thinking also has it that if a tourniquet is used, the patient will lose the limb. In reality, the most common cause of preventable combat or battlefield death has been the failure to use a tourniquet to control severe extremity bleeding. The loss of 2.5 liters of blood is likely to be associated with death from hemorrhagic shock. Indicators of shock during tactical care are the patient’s state of consciousness and quality of radial pulse. Also, in combat casualty situations with open wounds, the sooner antibiotics are on board, the better.