What makes a medical provider "tactical?"

[unknown]

Another reply back from a Tatical Medic out of the Great State of IL...........

Wow I would think that would be more of a operational role. When we speak of a tactical medic we look at that as one that is assigned to a active tactical Law Enforcement unit that works alongside of them in hazardous situations such as shootings drug raids or hostage situations.They have been trained in some law enforcement duties also. We are actually sworn auxillary deputies for the county.

Thats just my .02 cents

JM

[brentoli]

I don't understand the role of the tactical medic. Put your operators thru EMT or CFR classes, give them a gunshot trauma kit, and put the medics back out at the command post waiting with the ambulance.

With that said, I wouldn't consider you a tactical medic with out a gun and armor and training.

We have a "tactical dispatch team" I am a part of. I love the concept, but wish we had a diffrent name. Incident Dispatch Team would suit me better. We go out with SWAT, but we are a mile away in the big command post. No guns or armor or any of that sort. We can also be called for basicly any large scale incident. Tactictal just makes it sound cooler I guess...

[NREMT-Basic]

I think there is sort of a contradiction coming out of Missouri:

You and your medic friend seem to say tactical involves SWAT type medicine. DMATs dont perform this kind of work, but you seem to consider them tactical. I tend to agree with the idea that they (and IMERT...which is essentially after all, a DMAT) are operational, not tactical. By the dictionary defintion, DMATs would be tactical, but by those who operate with LE, etc they would not be.

This also brings up another question: Im not deminishing what SWAT does at all, but how often do they need on scene medical care, I mean statistically. If its often, then it would seem to make sense to uptrain a member or two of the team as medics and not put doctors with sidearms out there to get tripped over. After all, a doctor isnt going to do much more out there on the lawn or behind the APC than a paramedic can do.

[unknown]

I think there is sort of a contradiction coming out of Missouri:

You and your medic friend seem to say tactical involves SWAT type medicine. DMATs dont perform this kind of work, but you seem to consider them tactical. I tend to agree with the idea that they (and IMERT...which is essentially after all, a DMAT) are operational, not tactical. By the dictionary defintion, DMATs would be tactical, but by those who operate with LE, etc they would not be.

This also brings up another question: Im not deminishing what SWAT does at all, but how often do they need on scene medical care, I mean statistically. If its often, then it would seem to make sense to uptrain a member or two of the team as medics and not put doctors with sidearms out there to get tripped over. After all, a doctor isnt going to do much more out there on the lawn or behind the APC than a paramedic can do.

Hhmm contridicting?

I only asked some medics that do Tatical work for a little educated input..one from Missouri one from Illinois and one from Kentucky..... I'm sorry did we all miss read what you where saying? Because I copied your post and sent it to them as you presented it.................

[NREMT-Basic]

Nope. Sorry. I misread what you said. My bad.

Its just my thinking that tactical EMS does not necessarily involve being armed. I would certainly think military medics of days gone by would be considered tactical, but there was also a period where, under the Geneva Conventions, medics/corpsmen could not be armed. Of course this isnt the case now. I have known some combat medics and hospital corpsmen that are some of the most heavily armed individuals in their squad, but again...I dont think simply carrying a firearm AND being an EMS provider makes you a tactical medical provider. Under some of the information and definitions that have been given, a doctor who goes along for the ride with a SWAT team and carries a sidearm for defensive purposed is not tactical, whereas as SWAT officer trained as a paramedic is. Hmmm..is it really all just about the cult of the gun? Dont get me wrong, I have firearms and enjoy using them and appreciate the fact that I am allowed to own them. But if it is just the fact that the provider is armed, then DMATs certainly are not tactical. When I think tactical, I think intended to provide a specific purpose and the case of medicine I think pre-hospital, austere, field medicine, guns or not. Under that definition, DMATs would be tactical. I also tend to think of tactical more as equipment and gear than I do a person or group. Standard medical equipment that has been modified or invented for use in the field: drag stretchers, VorTran ventilators, etc.

Im sorry I misunderstood what was said up there, its just something I am trying to sort through as I look at different types of pre-hospital providers during my Masters work.

[Doczilla]

I'll paste something from a previous post I made on tactical medical providers, because I'm too tired to type it all out again. Understand this: there is far more to being a SWAT medic than stopping bleeding.

...The vast majority of what I do as a SWAT medic is not trauma care, but symptomatic management, injury and disease prevention, and evaluating and treating injuries and illnesses other than those sustained in the stack. The medic is the "medical conscience" of the team, and I frequently provide input on work/rest cycles, hydration, nutrition, etc. I help them figure out work or training restrictions for the SWAT members who have injuries and illnesses. I often review medical care provided by another physician, particularly when relevant to injuries that impact mission readiness. I'm more approachable than their doc in a white coat, and can advise them about specialists to see and make relevant phone calls to arrange follow-up visits. I have never had to provide trauma care in the zone, but have had to listen to lung sounds of plenty of chuckleheads complaining of asthma after the flash-bang goes off and cuffs go on. I do "sick call" kind of stuff, and provide medical evaluation and management on minor illnesses, rashes, and injuries. And I'm the one that remembers to bring the big cooler full of ice and water bottles.

This is the uncommon image of the tactical medic, but is far more accurate. Paramedic school did absolutely nothing to prepare me for it. And no amount of training for the officers would prepare them for it...

If you are wondering how often I need to provide on scene medical care, it is just about every call out and training. And I can do a hell of a lot more than the paramedic behind the APC.

NREMT, the thing that is missing from your assertion that DMATs are tactical is the hostile nature of the tactical environment.

'zilla

[Dustdevil]

NREMT, the thing that is missing from your assertion that DMATs are tactical is the hostile nature of the tactical environment.

Agreed. Although, many will continue to try and make that leap, just as they try to assert that all nursing home transfers are EMS because the patient could possibly crash.

[NREMT-Basic]

Agreed. Although, many will continue to try and make that leap, just as they try to assert that all nursing home transfers are EMS because the patient could possibly crash.

Dust...arent you a little old to be caving to peer pressure, brother. You and I have gotten along quite well and I value you for your analytical thinking. I was not the first to assert that DMATs are tactical. I was extrapolating on our friend from Missouri whose paramedic friend says they are. I said in certain cases they might be, and in certain cases not. But what I said about the cult of the gun stands true. If hostile environment is what we are talking about, lets talk about Katrina where the literal environment itself was hostile. Lets talk about medical personnel with no defensive resources getting shot at. Lets talk about the fact that street EMS doesnt usually pack in their rations, water and supplies to be self sufficient for AT LEAST 72 hours. I dont see many paramedics from AMR or Acadian doing that. When IMERT was in the Gulf Coast in 2005, they lived off what they could carry in for more than 72 hours because the response of the Red Cross, FEMA and the National Guard was slowed. What you and that others are doing is equating "hostile environment" with getting shot at and slinging and MP-5 over your shoulder along with, what was it...ah yes "my bad ass combat medical pack. For the TacMed folks with the limited scope of vision dictated to them by the cult of the gun, its all about performing medical interventions while trying not to get shot. For DMATs (in which group I classify IMERT) its about working in situations where we are given drugs to counteract nerve gas, among other things. I dont particularly care if I am ever called a tacmed operator. I know what my job is, train on it regularly and may soon be coming to a disaster near you (well not you, but near someone).

It seems to me that tactical doesnt need to involve bullets and tactical black stethscopes. To me, tactical can also include a group that can be wheels up four hours after being requested and within 10-12 hours have a field hospital set up and be complete sufficient up and including providing their own drinking water, electricity, mass producing medical O2 from ambient air (now thats cool, I dont care who y'are) and bringing along a few hundred respirators that need no electricity and nothing but an O2 tank to function. Its not just about the weapons kids. If it were, would the $200 Benchmade I carry make me a tactical medical operator?

What interests me most is that I havent heard Dust ever do anything other than bash tacmed as a foolish and dangerous folly and now you seem to be defending it.

[NREMT-Basic]

redacted because it somehow posted twice.

[Dustdevil]

I have made no statement in this thread whatsoever, positive or negative, about the value of tactical EMS.

There is one thing I care more about than EMS, and that is semantics.

I care about the English language being used clearly and unambiguously to define our field and our profession. Yes, Websters says DMAT is tactical. But according to the dictionaries, a "paramedic" is also anybody trained to provide first aid or assist a physician. Obviously, professional usage and even legislation are the final authority on these terms, not Websters. Consequently, lifeguards are not paramedics, and DMATs are not tactical medics.

The popular professional usage of Tactical Medicine is, as Doczilla says, limited to that practice which is expected to take place within a hostile environment. And yes, you can call a snowstorm "hostile" if you want to, but it's still not tactical medicine.

If you, through the stupidity of your team leaders, end up in a hostile environment, that does not make you a tactical medic. It just makes you a DMAT EMT getting shot at. If I fall out of the bleachers, and onto the playing field at a Red Sox game, that does not suddenly make me a major league ballplayer. It just makes me an idiot holding up the game. Just because your mission objectives are fluid does not mean your title is fluid.