by Todd Spence

It was a typical day; I stopped by the Sheriff’s Department to turn in some certifications to my Captain, when I was stopped by the Sheriff in the hallway. “Spence,” he says in a inquisitive manner. “Spence, I know you’re a hell of a paramedic and we really need a SORT (Special Operations Response Team) Team paramedic. Are you interested?” Before I could even get out the words “Yes sir, the SORT Team Commanders walked in and the Sheriff looked at them. In a proud voice he said, “We now have a paramedic on the SORT Team.” Next thing I know, I was in the same situation a lot of you guys are in, trying to find training and information on becoming a Tactical Medic.

Well, after three years and a lot of classes, I have become a certified Tactical Medic through various institutions, and I’m willing to share my information with all you current and future Tactical Medics.

One of the hardest things to try to get in your head as an EMT-IV or Paramedic is to be limited in care. When I say limited, it is in regards to the situation. We all fall into a failsafe environment with our ambulance. We take our airway bag, trauma bag, and monitor into a house where the call originated. We may even take the gear, place it on the cot, and roll it into the house right off the bat. Either way, we have a lot of medical instruments and equipment to use to treat the patient. With Tactical Medicine you are very limited in the amount of medical gear that you can carry in, or have on you, and you have to add additional weight from your sidearm, magazines, and in many cases a long rifle or shotgun.

Let’s be honest with one another; we all carry a lot of gear in our everyday job whether it’s in a police car, ambulance, or fire truck. I have forever been called “Batman” because all of the equipment that I carry on me. We have all been there, showing our coworkers in the station or on the road the new gear or gadget we’ve just gotten.

In a general tactical medic setup you, may have a pack or two that you can put on the front of your vest, along with a leg bag with some gear. One of the most important things to carry is a tourniquet - my suggestion and what I carry is two of the cat tourniquets. For your leg bag and vest packs, it is really up to the person. I am a very big fan of North American Rescue, which has all the gear that you really need on scene. The kits usually come with tourniquets, a chest seal, SAM splints, combat gauze, saline lock/ INT kits, and chest decompression needles. A lot of your officers may carry an IFAK kit (Individual First Aid Kit); if they don’t, get them in the habit of having one on them at all times. The important thing is to know the limits of yourself and your gear, especially how much you can really carry.

All of the gear you will have on just for the mission will really limit the space you will have for your medical kit. I usually carry an ALS bag and leave it at the vehicle. Then, after the scene is registered safe, you can run back or have someone go and get your ALS bag.

Now let’s talk about training and what it takes to be a Tactical Medic. There are several great instructional institutes and companies. Start off on the right foot and go for your international certification. NAEMT.org has a TCCC (Tactical Combat Causality Care) Class available on its website that provides you with downloadable PowerPoints and information. Use those to see how the training is different from your everyday normal patient assessment and care. The website will also show you all of the classes going on in your area. You may also be able to find a local company that is certified to teach under NAEMT.org. Try these websites and contact information:

https://tacticalmedicleague.com/ ( They have remote classes, as well.)

http://myshootersedge.com/?ammoland ( Contact Mike Lewis or Ray .They have an exceptional training center in east Tennessee. )

http://www.naemt.org/ ( The international certification is the Military standard.)

http://www.tacticalmedicine.com/ ( Which is one of the best schools in the United States. They also have remote classes. I have taken one in Knoxville, and it was an exceptional class).

http://emtt.org/

These are just a few websites to check out for yourself.

The training shows you how the actual Military Medics render care in the field and some of the challenges they face. As I mentioned, one of the hardest things for me to get a hold of in real life situations is being comfortable with the gear I carry on me. It also requires you to have the confidence in your skill set and equipment that will allow you to keep the patient stable until an ALS Ambulance arrives, or the scene is rendered safe and you can properly treat the causality.

Another hard thing for me is knowing when to treat or when it’s safe to treat your patient. I have been in a situation where we were taking heavy gun fire; the scene was chaotic at best. The mentally unstable / conspiracy/ prepper was barricaded in his home, refusing to come out, and firing out toward the cruisers. All of our team had taken hard cover and returned fire when safely able. Luckily none of my team was seriously injured, but in dealing with the one injury we had, I found it very hard not to run to him and care for his wounds right then and there. It was very hard as I yelled to him to stay put until I got over to him. The team member only went a few minutes without care, but to me it truly felt like an eternity. When the subject started firing at the back of the house, my team was able to stack up and get the injured out of the scene. Back in a safe zone, the team member was taken care of, and his injuries were not life-threatening.

I will tell you be a full member of your team. Don’t just have the title and go to train with them here and there; it’s truly a brotherhood and a big family. Be there every time they train, meet, and just go hangout. Develop a friendship with the team and members. This in turn will develop a great trust in one another. After making it through this injury situation, the trust between the team and I went through the roof, which is something you cannot put a price tag on.

Other things you will learn in the Tactical Medic training include and are not limited to the following:

Quick IV access or IO/ Fast 1 applications for vascular access.
Airway Management with NPA/ OPA and application of King Airway
Splinting
Bleeding control
Chest decompression
Fluid volume replacement
Rescue operations
Team tactics and defense shooting

Another great thing about this class is that you continue to learn more and more. There are several new advancements in protection and care when it comes from the military down to your team. Literally, in this day and time, with the influx of doomsday preppers and conspiracy theorists out in the world, there is no telling what you will run into. So, be prepared, ready, and trained to encounter and overcome any situation that you get called on.

Always stay safe and be ready!

Todd Spence
Paramedic / TCCC