TRAINING Tactical Medics

     In military environments, fast evacuation of casualties is imperative. Ninety percent of combat deaths occur before patients reach medical treatment facilities; some 15%-20% of these are probably preventable, coming from causes like bleeding extremities, collapsing lungs and airway obstructions.

     Many of the wounding patterns seen in recent military conflicts are also seen in the civilian tactical arena. Medical providers supporting tactical law enforcement operations are now developing, implementing and utilizing casualty-response tactics, techniques and procedures based on concepts of tactical combat casualty care (TCCC)-utilizing the appropriate equipment at the appropriate time.

Casualty Response Training Course
     In the world of policing, the goal of tactical (SWAT) teams is to contain, control, communicate and try to bring about a peaceful resolution. Yet sometimes police actions do not end peacefully. Trying to fit conventional civilian medical methodologies into a police tactical environment can feel like trying to provide care at arm's length: Time, blood and hope are lost as ambulance crews wait in a safe place until the situation, the bad guys and their weapons are under control and the scene is safe.

     Learning from the military's experiences, enlightened tactical teams increasingly operate accompanied by unconventional tactical medics. These medics work up front, in close proximity to entry teams, where they might be urgently needed to deal with injuries.

     Recently, 90 participants and instructors took part in a new casualty response training course sponsored by the National Tactical Officers Association (NTOA), Greenville County (SC) Sheriff's Office SWAT Team and North American Rescue Products, Inc. The driving force behind it was North American Rescue Products CEO Robert Castellani, a former Air Force tactical medic and pararescuer. Castellani wanted to combine the knowledge and resources of leading academic institutions, culturally like-minded companies and experts in asymmetric warfare to generate innovative combat casualty care solutions. Accordingly, course organizers brought in a broad cadre of instructors to provide solid and well-referenced training.

     Participants similarly brought their day-to-day experiences to the program. While most were fire and rescue medics, they also included doctors with special-operations backgrounds and tactical operators including medics, SWAT operators, military special-ops personnel, federal agents, state troopers, sheriffs' deputies and police officers.

     Course objectives were to enhance mission successes and reduce legal liabilities by conducting practical exercises for students.

Lectures, Hands-On and Scenarios
     The conference began with lectures, then progressed to task-orientated hands-on training, and finally to show-what-you-now-know scenarios.

Lectures
     Lecture topics covered such areas as the evolution and future of TCCC, lessons learned from special forces, TCCC for civilian applications, perimeter tactics and movements, high-threat extraction and the physiology of self-preservation.

     One lecture, on medical threat assessment, imparted basic wisdom such as the need to know the type of mission being conducted, if there are any animals or hazardous-material concerns, and how to evaluate a targeted structure. Medics should also have extraction and treatment plans, know the medical and health issues of fellow team members, be aware of local medical resources and have transportation and evacuation available, both ground and air.

     Class members were provided with combat casualty response kits that included tourniquets, nasopharyngeal airways and other mission-critical products needed to address the three most preventable causes of death in the tactical environment. These kits were utilized for the scenarios and hands-on training.