Because tactical medics work out of their medical bags, vests and backpacks, they do not carry oxygen cylinders. They need to stay light and be prepared to go through confined spaces. They must be comfortable carrying their medicine bag for six hours. Medics operating in rural environments most likely would carry more equipment than those operating in urban settings. Tactical-medic supplies include emergency bandages and products that promote coagulation, control moderate to severe bleeding, and can temporarily treat wounds. These might include a hemostatic powder such as Quick Clot and a hemostatic dressing such as a chitosan bandage by HemCon. Other items might be Asherman chest seals, a bag valve mask, blind insertion airway devices like the Combitube, an endotracheal tube and endotracheal tube holder, a nasotracheal tube, Vaseline gauze pads, adhesive pads that stick through blood, sterile moisture burn sheets, oropharyneal airways, a preset for impaled objects, prefilled flushes, suture tweezers, scalpel, aspirin, and iv solutions. Items with dual purposes are especially welcome. Minimal equipment is taken on call-outs, yet medics must be prepared for the type of mission the team is responding to, whether it be a high-risk warrant, active shooter, barricaded suspect, hostage or dignitary protection.

Emergency care for a SWAT team is not just for the human members. Medics also are responsible for the health and welfare of police dogs that become injured or ill, keeping them stabilized until they can be evacuated to a veterinarian. This responsibility includes being aware of a canine’s anatomy, protecting its airway, stopping any bleeding and knowing the signs of injury. Because police dogs are extremely protective of their handlers, it is important to include the handler in the care if a dog is injured.

Scenario training

It was daylight. Active shooters were in a building and people were wounded. The swat team’s mission was lie: locate, isolate and eliminate the threat. Medics moved with the tactical team as it worked its way to make contact. Because their primary duty is to act as medical support for the police department, the medics made mental note of patient locations, injury severity and alertness while continuing on with the tactical team. In all, the medics had to deal with 17 role-players, including the bad guys. Some of the wounded were patched and extracted, some could walk to evacuation points on their own, and another was “dead.”

One medic, as the designated team leader, saw to it that a counter-sniper element was deployed and that information was obtained from the walking wounded coming out of the building. As the medics advanced from cover to cover, movement was acknowledged using hand signals or verbal commands. As the tactical element opened up with suppressive gunfire against the bad guys, medics found a wounded person who was badly hemorrhaging from a wounded right leg. They dragged him to cover and applied a tourniquet.

Earlier, the medics had been taught drags and carries, including the fact that the ground can be a perfect dragging platform. Dragging by using a harness reduces the chance of spinal injury to the rescued person because there is better spinal motion restriction than when the body is carried. In a gunfire situation, sometimes the most efficient way to move a patient to cover is simply to grab an arm or leg and drag the victim to safety.