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Tactical Paramedics

mariomike

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OPP is now recruiting Tactical Paramedics.
Posting Date: 07 January 2011 Closing Date: 28 January 2011

See attachment, if interested.
 

mariomike

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FYI, if interested:

The O.P.P. is once again hiring Tactical Paramedics.

Posted on: Monday, May 28, 2012

Deadline to apply: Monday, June 18, 2012.

http://www.gojobs.gov.on.ca/Preview.aspx?JobID=44591



 

mariomike

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Young people considering tactical paramedicine as a specialty may find this of interest.
http://www.attorneygeneral.jus.gov.on.ca/inquiries/ipperwash/policy_part/research/pdf/Feldman_Tactical_EMS_Review.pdf

It is authored by the Medical Director of Toronto Emergency Medical Services Emergency Task Force Tactical Paramedics.


 

medaid

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What I find more interesting is that paper is written by a bunch of MDs... no offence to doctors but many of them have no clue about Pre-Hospital Care in general and TEMS operations to be specific. So, I am really curious as to how come no one from the TEMS community actually chimed in on this?
 

mariomike

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Breacher41 said:
What I find more interesting is that paper is written by a bunch of MDs... no offence to doctors but many of them have no clue about Pre-Hospital Care in general and TEMS operations to be specific. So, I am really curious as to how come no one from the TEMS community actually chimed in on this?

Paramedics may have "chimed in", but their authority to operate comes from the Medical Director of Toronto Emergency Medical Services Emergency Task Force ( ETF ) Tactical Paramedics.
So he gets to write the reviews. Not saying it's right or wrong, just the way it always has been.

Toronto Emergency Medical Services formed the first team of Tactical Paramedics in Canada, and that is the way it has been since it was created.

Unlike some provinces, Paramedics in Ontario do not have self-regulation. That may change in the future, but not yet.

 

Thompson_JM

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Civvymedic said:
  We have a bariatric unit where I work as well. We Durham Region EMS are the only urban service in Ontario to not have TAC Medics. We actually have no special teams... :crybaby: We do have a Bariatric unit that we can all access though.

Nope.... as of 2013 on the date of this post, Hamilton EMS Still does not have a TEMS team.  ???

But they sure do have a Bariatric unit... They may actually have two....... GO FREQUENT FLIERS!
 

Cyrius007

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Closer to you, we have many tac EMS services in Quebec. Sherbrooke, Montreal, Quebec city, Trois-Rivière...

In fact, they all were trained by their own unit, they have the EMS capability already and the police tac unit trained them to follow in operation. It's more than just the med tech in the action, it's the position of the ambulances, the moment they allow paramed to enter a scene, the coordination with police and firefighter if an evacuation is needed, etc. It's much more a local setup than a national training technique.
 

mariomike

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For young people interested in Tactical Paramedicine, this ( from a Job Call four weeks ago ) shows the primary responsibilities and physical fitness assessment of candidates.

As a Tactical Paramedic, your primary responsibilities will include but are not limited to:

• Provide immediate medical support to members of the Toronto Police Emergency Task Force (ETF) during their
deployments. This may also include medical coverage for other police agencies.
• Be willing to operate as a fully integrated member of an ETF Tactical Team under the command of the Special
Weapons Team Sergeant and/or senior police staff.
• Be comfortable working in a policing environment in all weather and under demanding conditions
• Be willing to operate as a single paramedic in demanding emergency situations where EMS back-up may be
delayed. This requires a high level of self-confidence and practiced EMS skills.
• Be a liaison on behalf of Toronto Emergency Medical Services. The highest level of diplomacy, tact, teamwork and
adaptability will be required
• Operate in a CBRNE environment as needed. CBRNE Awareness level training is currently provided as the ETF
Police are utilized as a back-up resource to the Toronto Police CBRNE Team.
• Operate with a minimum of EMS equipment that they must carry on their own person throughout tactical calls. The
potential for entering high risk situations will be high.
• EMS personnel will not be expected to perform any direct law enforcement duties and will not be armed.
• Maintain a high level of fitness as paramedics are required to re-test and re-qualify for the tactical team as per the
collective agreement Article 45.18

Physical fitness assessment consisting of:

- 2.4 kilometer run in a maximum time of 11:18 minutes.
- Complete 7 overhand chin ups (uninterrupted)
- Complete 7 vertical dips (start in up position, lower no farther than arms parallel to the ground.
- 35 push ups (< 60 seconds)
- Complete 40 sit ups in 60 seconds.
- Core test (Static Plank Test) 45 sec front plank, 45 sec left plank, 45 sec right plank, 30 sec front plank left
leg elevated, 30 sec front plank right leg elevated.
- Timed (<2.00 minutes) course wearing ballistic vest (approx 11 kg), C50 gas mask and work footwear,
carrying one man ram (approx 18 kg) up and down 5 sets of stairs, 25 m body drag (approx 90 kg), and
shield carry (approx 8 kg) back to the starting point. The candidate will then remove their gasmask and
have 1 minute to cannulate an IV arm.
http://www.temseducation.com/scheduling/downloads/etf_jobcall_2013.pdf
 

mariomike

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Global News January 30, 2014

"Winnipeg paramedics to get tactical unit

A new tactical paramedic unit is in the works to help Winnipeg Police Service officers respond to high-risk calls.

The city would not discuss the new initiative, but an internal memo obtained by Global News describes a rigorous selection process with physical and scenario training that might include psychological testing and phobia testing for heights and claustrophobia. 

Nearly two decades ago, Toronto created the first tactical paramedics unit in Canada, known as TEMS.

Other Canadian cities followed suit, including Edmonton, Ottawa, Regina and Calgary. Winnipeg will be next with a one-year pilot project."
http://globalnews.ca/news/1119530/winnipeg-paramedics-to-get-tactical-unit/
 

mariomike

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Regarding the recent massacre in Paris. This has to do with the emergency response, rather than the politics. So I am posting it here.

I am not an expert, but from discussions I have read elsewhere, this seems to be the way things are evolving,

Our service introduced ETF Paramedics 1996. The SOP for non-ETF Paramedics is to wait in the cold zone for a declaration of scene safety.

In recent years, the trend seems to be towards a Rescue Task Force (RTF) model. Regular Paramedics, with a police escort, rapidly move into the warm zone to begin the treatment of patients with life threatening hemorrhage or airway compromise.

Paris represents a different and increasingly violent type of threat described as a “Hybrid Targeted Violence” (HTV) attack. It will likely cause a long-term disruption to Paramedic system design, training, and budgeting.

eg: Paris sends a ExtraCorporeal Membrane Oxygenation ( ECMO ) team 24/7 to every cardiac arrest. That sounds like a very high expenditure of resources for a relatively small number of patients.

Unless there is a significant increase in funding, like there was after 9/11, I suspect special programs such as ECMO may be cut back or even sacrificed to better prepare for HTV attacks.

Increasing ETF and RTF capability, as well as increasing the fleet with Multi-Patient Units, might be a step in that direction.








 

MedCorps

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I just lectured on this topic about two weeks ago to a group of paramedics (some tactical, some wanting to be tactical, some not).  It is the second time I gave the lecture, the first time about two years ago. 

The thesis of my lecture is that in tactical medicine / tactical medical situations (or CBRN medical situations) you need to risk a lot to save a lot.

1. If you put yourself (or your subordinates) out in harms way (risk a lot) you will reap the benefit in casualties saved (save a lot). This comes at a potential cost of medics of course.

2. If you wait for a secure scene and then go in (risk a little) you are not going to save casualties that died from preventable causes in the vulnerable period (save a little). 

Like all good thesis it caused debate, which is always more interesting then hearing yourself lecture for two-hours.  It is especially interesting because the concept of "unlimited liability", a core-concept of the profession of arms, is not universally accepted by the para-medicine community, even within the tactical paramedic community. There is also the union lobby types which add an interesting dimension to the discussion with the "right to refuse unsafe work" angle. 

Cheers,

MC
 

mariomike

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MedCorps said:
I just lectured on this topic about two weeks ago to a group of paramedics (some tactical, some wanting to be tactical, some not).

I was never lectured by anyone from the military. I know a lot has changed at the department since I retired, but I doubt that has. They like to do their own lecturing.
 

MedCorps

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This time I was not lecturing while on duty as a military officer.  I was hired as a contractor to give some lectures whilst on annual leave as part of a professional development / training update. There were some Toronto medics present, although not hosted by TPS.   

That being said, I have lectured (without renunciation) a number of times to various paramedic services on a number of topics as part of my duties. These have generally been well received by the civilian audience(s) and have been supported by the Canadian Forces Health Services Group wholeheartedly. 

Likewise I have invited local paramedics to see / attend lectures we have given as part of military training. Again, well received and some interesting conversations between the military and civilian medics during breaks.

The occasional cross pollination between uniformed services is healthy I think. 

Another facilitator in this area is that the Chief of the Ottawa Paramedic Service and the Chief of Hamilton EMS is an Honorary Colonel / LCol in the Royal Canadian Medical Service (RCMS). There may be more, but these are the two that jump out. Members of the RCMS are also regular attenders and contributors to the Paramedic Association of Canada.

MC
 

mariomike

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I am only familiar with TPS operations. I asked a friend still on the job if he could recall being lectured by the military.  He said the only Med Techs he could recall were those doing their ride-outs ( ride-alongs? ) with our crews.

Our ETF Paramedics are lectured by Toronto Police:
http://torontoparamedicservices.ca/special-units-teams/emergency-task-force/

The SOP we all operated under when I was on the job:

"Paramedics are reminded of their responsibility under the Occupational Health and Safety Act, Section 43, (1) and (2).2 These sections exclude paramedics from the right to refuse work where the circumstances are inherent in their work and/or if the work refusal would directly endanger the health and safety of another person."

Our "rank and file" Paramedics are not issued protective vests,

"Prior to the initial submission of the Capital Works Program protective vests for paramedics had been considered for inclusion, however, following discussion with the Ambulance Services' Joint Occupational Health & Safety Committee, the decision was made to defer this item to allow for further research to be conducted. The preliminary cost for outfitting all paramedics was approximately $500,000.00 not including replacement costs due to attrition. Initial research indicated that the protective vests have a functional life span of approximately 5 years and, based on developments occurring in other jurisdictions the Joint Health & Safety Committee felt it appropriate to defer this item in order to gather additional information. In the interim, the Ambulance Division has reissued on-scene safety protocols for its paramedics and should the Health & Safety Committee recommend that paramedics receive this equipment appropriate adjustments will be incorporated in the 2001-2005 Capital Works Program."
http://www.toronto.ca/legdocs/1999/agendas/committees/bud/bud991209/cap/it022a.htm













 

mariomike

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Regarding Rescue Task Force ( RTF ),

New York City issued this Departmental Order on 15 Dec., 2015. It applies to all Paramedics, EMTs and Firefighters,

The optimal Rescue Task Force, with NYPD protection, to active shooter incidents is one EMS Supervisor, 2 EMT's and 4 Firefighters.
http://www.nyc.gov/html/fdny/insider/resources/do/2015/093_2015.pdf
2.2

I believe all NYC Paramedics and EMT's are issued "Level II ballistic and Level II Spike ballistic protection."
 

mariomike

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A couple examples of Rescue Task Force ( RTF ) Paramedics. They are not trained or equipped ( body armour or helmets ) as Tactical Paramedics ( Emergency Task Force - ETF ).
RTF Paramedics just happen to be first on scene. ETF Paramedics will likely have a much longer response time.

Eaton Centre:
"On June 2, 2012, the Toronto Eaton Centre food court suddenly turned deadly when shots rang out and panicked diners went running for cover. Within a few minutes of the first 911 call, two superintendents and four paramedics were at the scene. These first responders immediately approached the basement-level food court, despite the risk to themselves. As they tended to the wounded - some of whom had life-threatening injuries - the paramedics had to duck for cover to avoid being caught in the continued gunfire."

Scarborough:
"On July 16, 2012, repeated gunfire erupted at a community celebration in east-end Toronto, resulting in multiple casualties. The four paramedics and two superintendents who arrived on the scene met a surge of panicked people running down the street. While police searched for the shooters - still at large - the paramedics set up triage and treatment areas, putting their personal safety at risk. When they later learned that a shooter was hiding in their midst, the paramedics discreetly alerted the police, who were able to make an arrest without further injury."

( Ref: "Two dead, 22 injured in Toronto shooting" 4 pages. )



 

mariomike

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This product is on the market for citizens waiting inside the Hot Zone for arrival of Emergency Task Force ( ETF ) / Rescue Task Force ( RTF ) paramedics,
http://iactresponderbag.com/Concept.aspx

"The iACT Responder Bag is a wall mounted trauma case that resembles a Fire Extinguisher and AED in largely populated areas. It remains in standard locations where people can see it, access it and deploy when needed. The iACT Responder Bag provides the simplicity of a Fire Extinguisher and the functionality of an AED to apply life saving interventions until First Responders arrive."

The company envisions them in soft target environments such as government buildings, schools, malls, places of worship, airports, stadiums etc...

Even has its own acronym: BRAVE ( Bleeding, Respirations, Airway, Vessels and Environment ).

This is their sales pitch, "The average person who suffers from a life threatening arterial bleeding wound could bleed out and die in 2-4 minutes. On average, site studies show it takes 40-60 minutes for First Responders to arrive, be granted access and initiate life saving interventions. This 40 min difference is critical on how many people live or die."

I do not own shares in the company!  :)  Just something I saw in the news,

ROSWELL, Ga. - The city of Roswell has installed new safety equipment that will help save lives in the case of an active shooter or other similar critical incident at Roswell City Hall.





 

Ludoc

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mariomike said:
This product is on the market for citizens waiting inside the Hot Zone for arrival of Emergency Task Force ( ETF ) / Rescue Task Force ( RTF ) paramedics,
http://iactresponderbag.com/Concept.aspx

"The iACT Responder Bag is a wall mounted trauma case that resembles a Fire Extinguisher and AED in largely populated areas. It remains in standard locations where people can see it, access it and deploy when needed. The iACT Responder Bag provides the simplicity of a Fire Extinguisher and the functionality of an AED to apply life saving interventions until First Responders arrive."

The company envisions them in soft target environments such as government buildings, schools, malls, places of worship, airports, stadiums etc...

Even has its own acronym: BRAVE ( Bleeding, Respirations, Airway, Vessels and Environment ).

This is their sales pitch, "The average person who suffers from a life threatening arterial bleeding wound could bleed out and die in 2-4 minutes. On average, site studies show it takes 40-60 minutes for First Responders to arrive, be granted access and initiate life saving interventions. This 40 min difference is critical on how many people live or die."

I do not own shares in the company!  :)  Just something I saw in the news,

ROSWELL, Ga. - The city of Roswell has installed new safety equipment that will help save lives in the case of an active shooter or other similar critical incident at Roswell City Hall.

I don't get it. Is it just a well stocked first aid kit?
 

brihard

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First aid kits tend more to be boo-boo bags, lots of band aids, gauze and tape, maybe a folding splint for that unexpected broken arm in the accounting department coffee room. Looking at this bag it seems like they've revisited the notion of what a first aid kit should be to take mass trauma events into account. Unfortunately they claim that a half hour's training will suffice for stuff like tourniquets, quick clot, nasal airways, etc. My TCCC course was eight days long... I don't see how it could be watered down that much and still be useful. It DOES look like they have a well stocked and well laid out tactical first aid kit. I could see one of these being placed in police cars and such. I carry a smaller version of more or less the same that I've put together in my duty bag, and I carry a tourniquet, quickclot, gauze, shears, and OALES dressing on my person while on duty.
 

mariomike

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Ludoc said:
I don't get it. Is it just a well stocked first aid kit?

For only US$550!  :)

But, even with ETF paramedics, and now RTF paramedics, because of recent scenes like this,

"Delayed medical response
PD remained outside during 3-hour standoff
Emergency medical attention to gunshot victims was delayed when police units withdrew from the building.
Threat of secondary explosive devices led to withdrawal of responders.
Paramedics were denied entry to the building.
Needed PD force protection to make entry
Remained at staging area out of blast range
No triage and rapid treatment was attempted
Critically wounded victims received no treatment for 3 hours
Of 66 people found inside, only 17 survived"
FDNY Center for Terrorism & Disaster Preparedness Presentation on the Orlando Terror Attack

my guess  is that sales to government buildings, schools, malls, nightclubs, places of worship, airports, stadiums etc. will likely increase.






 
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