# Tactical Paramedics



## nsmedicman

W eare looking to develop a tactical paramedic capability here in Nova Scotia. Just wondering who would be a good resource to help us get the program off the ground.


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## HItorMiss

That is going to depend on what you mean by tactical Paramedic.

Do you mean Paramedics used as integral support to say HRM Police Tac unit or do you have your own definition in mind?


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## medicineman

NS - talk to Edmonton, Calgary or Toronto EMS - they all have active tactical EMS programs.

MM


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## mariomike

BulletMagnet said:
			
		

> That is going to depend on what you mean by tactical Paramedic.



Perhaps something like this?:
http://www.flickr.com/photos/dalmond/584379969/sizes/l/in/set-72157600178392946/

"In 1996, Toronto Emergency Medical Services formed the first team of Tactical Paramedics in Canada.":
http://www.torontoems.ca/main-site/service/etf.html

"This specialized group of level 2 and 3 Paramedics are specially selected and trained in conjunction with the Toronto Police Emergency Task Force. These medics deploy with the Police ETF teams in high risk situations involving hostage takings, warrant issuances, or barricaded psychiatric patient calls. They work closely with the ETF Tactical Gun Teams, and enter the "Hot Zone" along with these teams. Their primary function is Team Support, and patient stabilization and extraction.":
http://www.torontoparamedicassociation.com/levels_of_practice.aspx

"Tactical paramedics and officers run 'The Gauntlet' ":
http://wx.toronto.ca/inter/it/newsrel.nsf/11476e3d3711f56e85256616006b891f/c5dfab08c56eeed485256df60045f0c5?OpenDocument&Highlight=0,*station*

"Tactical paramedics from Toronto EMS finished 1-2 in the International Tactical Emergency Medical Services Association's 2nd  Annual 'Medic Up' Competition on October 9 at Exhibition Place.":
http://wx.toronto.ca/inter/it/newsrel.nsf/3257dc890938d23b85256dde005a446b/446509a580f1d13185256df60045f23c?OpenDocument

T-EMS fills their Tactical Paramedic vacancies internally through the "senior qualified process". The "relative ability process" is limited to CCTU Paramedics. They are not hired "off the street".


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## nsmedicman

As in developing a specially trained and equipped unit to provide close medical support to police tactical teams.


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## medaid

Good luck!


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## The_Falcon

The OPP also employ tactical paramedics.


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## mariomike

NSmedicman said:
			
		

> W eare looking to develop a tactical paramedic capability here in Nova Scotia. Just wondering who would be a good resource to help us get the program off the ground.



Due to the nature of our business, SOPs and special units are often created as a result of a Coroner's jury recommendation.
You need a request from your local police to provide them Paramedics. The police, if they have an ETF unit, will provide their training. Your local government will have to approve the funding.
Under the Collective Agreement, "Paramedics of the Public Safety Unit (PSU), EMS Tactical Paramedics (ETF),  Heavy Urban Search and Rescue ( HUSAR ) and Chemical Biological Radiological Nuclear Response Team (CBRN) shall, in addition to their regular salary, be paid a $1,000.00 annual premium, which shall be part of their pensionable earnings."
In addition to that, they require special ambulances, uniforms and equipment. Loaning them for ETF operations and training will remove them from the 9-1-1 car count. The department will be required to call replacement crews in on overtime to ensure that the car count will be maintained at required levels. 

you would also have to receive endorsement from your Base Hospital. If unionized, from the union as well.

If you already have a program in place with your local police, such as Marine Paramedics, it will make things easier.


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## medicineman

Hatchet Man said:
			
		

> The OPP also employ tactical paramedics.



I was actually being scouted for that before I left Kingston...but the TRU team at the time didn't have a dedicated TEMS section, just a dude that worked for the Belleville ambulance service that took a tactical paramedic course and trained/deployed with the team on call outs.  Toronto, Calgary and Edmonton have dedicated sections within their respective ambulance services that respond with the ERT's to incidents requiring tactical intervention.  They train with the teams, have to pass their physical fitness tests, etc.  It's also not unusual to hear of a paramedic or two from local EMS that moonlight with the police tactical units as their dedicated support (usually under an MOU with the local ambualnce service) if they have infrequent callouts.

MM


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## Civvymedic

Most EMS services in Ontario have Tactical medics. I would contact Toronto, York and Ottawa EMS.

  I used to work in NS. Great system. Good luck.


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## mariomike

Hatchet Man said:
			
		

> The OPP also employ tactical paramedics.



For anyone interested in the job, here is the OPP Tactical Paramedic Job Call from 2009. 
Note:  "Must be currently employed and continue to be employed as a full-time advanced care paramedic with an ambulance service in Ontario." 
Position Title:  Advanced Care Paramedic (On-Call)		
Job Location:  Kingston, Orillia, London, Bolton and Thunder Bay
Salary:  $34.91 per hour
Classification:  Scientist 3 (A-typical)
Posting Date:  02 July 2009				Closing Date:  24 July 2009   __________________________________________________________________________

The Ministry of Public Safety & Security, Ontario Provincial Police, Field Support Bureau, is interested in developing a pool of on-call advance care paramedics, at key locations, to staff a new tactical medical program (TEMS). Paramedics will be required to provide medical support to a variety of police tactical incidents. 


Qualifications:	

Currently licensed as a Paramedic according to the Ambulance Act of Ontario.    Ability to maintain certification as an advanced care paramedic with a local base hospital and with the OPP Medical Program.  Must be currently employed and continue to be employed as a full-time advanced care paramedic with an ambulance service in Ontario.   
Ability to pass physical fitness testing.    Must be available and able to respond to calls for service within 30 minutes (average 2 per month).  Must be able to pass OPP background security investigation.



Resumes/applications are to be forwarded to: Inspector Chris Sharpe, Field Support Bureau, Ontario Provincial Police, 777 Memorial Avenue, Orillia  L3V 7V3 showing how your qualifications, training and experience relate to the position and must be received by 4:30 p.m. on 24 July 2009. 

Telephone: (705) 329-7590   Fax: (705) 329-7593

THE ONTARIO PUBLIC SERVICE IS AN EQUAL OPPORTUNITY EMPLOYER

OPP: Tactical Emergency Medical Services:
"The paramedics will continue to be employed as full-time paramedics with their own municipal ambulance services, and will be available to the OPP on an on-call basis, when off duty."
http://www.opp.ca/ecms/index.php?id=63

Topic: "Tactical Paramedics": ( by NSmedicman ) 
http://forums.army.ca/forums/threads/40106.0


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## mariomike

Civvymedic said:
			
		

> Most EMS services in Ontario have Tactical medics. I would contact Toronto, York and Ottawa EMS.



York sounds like "Super-Medics". I hope they get a nice bonus at Christmas:
"The York Region EMS SRU is the only unit in Ontario to offer an all-hazards approach to specialized
responses. The unit offers logistical and medical support to police tactical incidents and high-risk fire calls,
plus multiple casualty incidents, the care and transport of bariatric patients (those weighing greater than
150 kg/350 pounds), hazardous material emergencies, search and rescue operations and public order
incidents.":
http://www.york.ca/NR/rdonlyres/hey4vlctbr2jdlezjx5od7jhkh4yqvwyz6mznn7jttyrfop4rniuqubiauzysm6ygcf2ppmdyijxvjzfp5bubqtgvh/08-Nov11EMSSRU.pdf

"the care and transport of bariatric patients (those weighing greater than 150 kg/350 pounds)"
They must love < sarcasm> being specially selected for those calls at 4 in morning!  
The Dispatchers I know liked to save the back-breakers for their not-so-favorite crews.


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## Civvymedic

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.


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## mariomike

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.



"A car is car, and a call is a call."  But, that changed.
I decided to go on the Multi-Patient Unit MPU Program:
http://www.youtube.com/watch?v=gKEjyughXEE

We handled all the back-breakers bariatric patients. ( The buses had electro-hydraulic ramps. I have some ramp failure stories. I personally sustained a "Critical Injury" one time at Northwestern G.H. )  I have ( literally ) tons of heavy-lifting stories. Especially with so many old style homes and walk-ups built over ravines. 


The first ambulance-bus I drove was a 1961 GMC "fishbowl" ( model of the original ):
http://www.flickr.com/photos/emergencyvehicles/3592597898/

There were nine of us on the program. Split into three, three-man crews. ( 0700-1900 Monday to Friday only. Two crews on-duty, one crew off. You worked 20 days, every six-weeks. 5-3-2-5-3-2 ) Each crew worked an Orion bus:
http://www.flickr.com/photos/e2kmaster/4572195975/in/photostream/

We moved an average of 25 patients, per crew, per ( 12-hour ) day. They used to run us hot from one end of Metro to the other. The buses covered Metro-wide. ( And the GTA ) Once we pulled out of station, that's the last we saw of it until it was time to wash-up and book-off. There was a lot of overtime. We used to carry SCBA, but not anymore.

Incidentally, on MPUs, the stretcher patients all face forward. They liked that, and the big tinted windows to look out of. MPUs were very comfortable to work on. You could stand up straight and walk along the deck. Bus suspension is much smoother than the regular truck ambulances.

( There is also an ESU Eldorado bus:
http://www.flickr.com/photos/knl-17/4329989980/in/pool-1066497@N25
http://www.flickr.com/photos/gopherit2/4651461206/in/pool-1066497@N25

and various trucks:
http://www.flickr.com/photos/gopherit2/4650851227/in/pool-1066497@N25


 that are available 24/7/365. Also a three-axle MCI highway coach in reserve ( model of original ):
http://www.flickr.com/photos/emergencyvehicles/3592635310/in/photostream/

That is a good job too. Only downside is the shift-work.  )

If I was a young guy, this is the Special Ops unit I would put in for:
http://www.torontoems.ca/main-site/service/marine.html

"The Marine Unit covers an area of 460 square miles (that's twice the size of the City of Toronto) and operates year round, 24 hours a day. The Unit's patrol area extends to the United Sates border. The Unit is also responsible for all river systems within the City of Toronto." 

Topic: "Tactical Paramedics": ( by NSmedicman ) 
http://forums.army.ca/forums/threads/40106.0


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## Sheerin

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.



Durham's not alone, Hamilton doesn't have a tactical team either.  We do have several bariatric trucks, lol


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## mariomike

Sheerin said:
			
		

> Durham's not alone, Hamilton doesn't have a tactical team either.  We do have several bariatric trucks, lol



I read that the Paramedics in Ottawa are trained to treat police dogs. Two weeks at veterinary school.

"Ottawa paramedics learning to treat police dogs: Paramedics are often the first people on the scene when a police officer is injured in the line of duty, but if a new program in Ottawa is successful, a group of paramedics will be using their skills to treat injured police dogs as well.":
http://www.cbc.ca/canada/ottawa/story/2010/01/27/ott-ontario-paramedics-dogs.html

Coroner's Inquest. London, Ontario:

"Cocaine induced excited delirium:
Reasoning: In light of the successful training of tactical paramedics who administer chemical
restraint in other Ontario cities (E.g. Toronto) this technique should be explored in London as a
method of ensuring that the subject is brought under control and can be given medical
assistance as quickly as possible.":
http://www.ppao.gov.on.ca/pdfs/sys-tas-lam.pdf


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## acooper

As far as I know, Windsor-Essex EMS does not have a tactical team. At least I've never seen the job description posted, and I'm in the same union, and our group does their technical support. I have no idea about bariatric equipment, though...


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## mariomike

acooper said:
			
		

> As far as I know, Windsor-Essex EMS does not have a tactical team. At least I've never seen the job description posted, and I'm in the same union, and our group does their technical support. I have no idea about bariatric equipment, though...



Tactical ( We call them Emergency Task Force ETF ) are part of the regular fleet, until required. So are PSU, HUSAR, CBRN and Bike. Most of the time, they do regular 9-1-1 calls.

The most in-demand Ops are MPU/ESU, PCTU, ERU, CCTU and Marine. Marine would be my first choice. 
As far as bariatric units go, we have various, but this is the latest:
http://www.flickr.com/photos/gopherit2/4858576021/


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## acooper

I talked to one of the EMS Supervisors on my way in today, and yes - Windsor-Essex EMS DOES have a tactical team. Apparently, they are associated with the hazmat team here, and don't get a special position or anything. At least I can say I learned something today


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## mariomike

Video:
Peel EMS ( Ontario ) tactical paramedics:
http://www.peelregion.ca/paramedics/about-para/video/tactical-response.htm

Hastings-Quinte EMS ( Ontario ) Tactical Paramedics:
http://www.hastingscounty.com/index.php?option=com_content&view=article&id=70&Itemid=78


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## mariomike

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

See attachment, if interested.


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## mariomike

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


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## mariomike

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.


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## medaid

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?


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## mariomike

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.


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## Thompson_JM

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!


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## Cyrius007

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.


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## mariomike

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


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## mariomike

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/


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## mariomike

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.


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## MedCorps

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


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## mariomike

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.


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## MedCorps

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


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## mariomike

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


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## mariomike

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."


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## mariomike

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. )


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## mariomike

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.


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## Ludoc

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?


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## brihard

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.


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## mariomike

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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## mariomike

For anyone interested in ETF and RTF Paramedics,

This is from the US Department of Homeland Security, July 2016.

Although American, I believe our departmental chiefs will be giving it a serious read,

Active Shooter / Hostile Event ( ASHE ) Guide. July, 2016.
http://www.interagencyboard.org/sites/default/files/publications/IAB%20Active%20Shooter%20%26%20Hostile%20Event%20Guide.pdf

Although Toronto has had ETF Paramedics since 1996, any non-tactical Paramedic can be assigned to a Rescue Task Force at any time,
"Where Tactical Paramedics are not available, non-tactical Paramedics may be assigned to ETF police incidents."

Anyone familiar with targeted response times knows what that means.  

Regarding Ballistic PPE for Paramedics,
"BPPE for non-law enforcement responders is a contentious topic, and must be a local decision."


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## mariomike

Saw this on, "The official Instagram of the New York City Fire Department: Responding to and mitigating an active shooter event will challenge first responders."
https://www.instagram.com/p/BIlXPT0jk-_/?hl=en

( The Paramedic wears an orange helmet, the Firefighter wears a black helmet. ) 

A comment reads, "Sadly what you see in this nice calm photo of FDNY active shooter training will not mirror real life."

Also,

Tactical Paramedics in Ontario,

"As one of 24 advanced care paramedics with Ontario Provincial Police’s (OPP) Tactical Emergency Medical Service (TEMS), Shawn Pranger knows exactly what it means to have someone’s back.

It’s his job to go into a hot zone and treat injuries at the scene of high-risk and emergency situations, like an active shooter, alongside the OPP’s tactical troops.

“If we’re responding to an active shooter in an apartment building, we’re right behind the stack with the guys going through the door,” says Pranger. “If anyone gets hurt or injured, we’re right there ready to respond immediately.”

The TEMS team are true experts in pre-hospital care. Each member is a full-time paramedic with an Ontario Emergency Medical Service (EMS), practising their skills five days a week. They work for the OPP on their days off."
http://www.rcmp-grc.gc.ca/en/gazette/paramedic-advantage

That's 24 Paramedics in Ontario working full-time for their municipalities, who are part-time Tactical Paramedics with the OPP on their days off.

The story discusses Active Shooter. I would be interested in what their targeted response times are for those calls.


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