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Tactical rescue class teaches emergency personnel how to work together in a crisis

Wednesday, July 16, 2003

By Alisha Hipwell

Quick -- could you determine from 150 yards, in the rain, whether a sniper victim was alive?

What if the decision to risk the lives of team members in a rescue mission rested on your assessment?

What if the sniper were still at large?

Trainees in a tactical rescue class offered last week by Butler County Community College struggled with such questions.

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Taught by instructors from the Florida-based company Tactical Element, the class is designed to teach emergency medical service personnel and police officers to work together in crisis situations.

"What we are basically trying to do is bring emergency medical services into unconventional environments," instructor Don Heath said. "We're bringing them into a high-risk tactical setting where, if special operations teams were to encounter casualties on their team or to bystanders, then you've got medical care up close and personal, without delay."

Primarily used to prepare military units for rescue and recovery operations, this kind of training is now offered to police and emergency medical service personnel. Heath cited the 1999 Columbine school shootings as the incident that made the need clear.

The training is applicable to a variety of crisis situations. For example, instead of waiting for police to apprehend an armed suspect, a tactical emergency medical services operator might go in to deliver care to a victim while the gunman is still in the next room.

"They know what the police are going to do and the police know what the medics are going to do, so they actually are delivering care much, much earlier," said Vern Smith, director of emergency medical service and police training for Butler County Community College.

Smith said the school offered the hands-on course as part of a push to provide more specialized police training.

The course, taught at the school's fire safety training center, attracted 23 participants, including EMS personnel, police officers, firefighters and a family physician.

Trainees didn't get any breaks because of the rain and storms that plagued the region last week.

"How you train is how you perform. People don't take people hostage only on bright, sunny days," Heath said.

Because there is no time limit on a real-life crisis, the weeklong course started with three days of sleep deprivation. Trainees got eight hours of instruction, followed by a short dinner break, another block of instruction and then just a few hours of sleep.

Much of the week was spent drilling trainees in how to care for the wounded in combat conditions.

"Medicine is delivered differently in a high-risk situation," Heath said.

A simple example involves a cut on the arm. Normally a tourniquet would be a last resort to stop the bleeding. But in a tactical situation, a tourniquet would be applied first so the victim could be quickly moved to a secure location.

Lori Bell, an emergency medical technician from Brockton, Clearfield County, and the only woman in the course, was there on her vacation because she hopes to persuade superiors to place a paramedic on a tactical team being formed in her county.

"I figure if I have the training I can better approach [the tactical team organizers], and the instructors have given a lot of ideas for how to approach your police departments, your high-risk teams," she said.

Butler family physician Mark Carlson has worked on Butler Memorial Hospital's anti-terrorism task force and took the course to be prepared for crisis scenarios.

That's just what the course offered.

In one simulation, trainees were taught to assess the scene of a sniper attack from a distance.

They were divided into teams of six, given binoculars, pen and paper, and taken to the facility's three-story fire training building.

Working in the rain, with twilight closing in, team members were given two minutes at each level of the building to assess the crime scene at a second structure about 150 yards distant. Trainees scanned two "victims" for tell-tale clues like respiration, movement, pallor and amount of blood loss.

It's important practice for the trainees, because the harsh reality is that it doesn't make sense to risk the lives of tactical team members trying to recover a victim who is already dead. Nor does it make sense to risk those same lives in ill-conceived rescue attempts of wounded victims.

A week of rain, mud, and mosquitoes culminated last Friday with a nighttime simulation designed to test the trainees' new skills.

Course instructors devised a scenario: A reporter had infiltrated a high school gang planning a school attack, but a meeting in the woods went awry. Guns and bombs went off. There were six casualties.

The trainees' task was to locate the camp, identify threats, secure the scene, pack the patients and get them to a medical facility.

The crisis scene, deep in campus woods, was made to look as realistic as possible, complete with fake blood and a variety of wounds on each victim to test trainees' medical knowledge. Trainees were outfitted with all the tactical gear they would wear in a real-life crisis, including bulletproof vests.

Trainees were expected to follow procedures precisely. Heath and fellow instructors Mike Drummond and Paul Bagley let them know when they made a mistake.

When one team stopped on a muddy path to confer, an instructor fired a "bear banger," a flare that pops like a firework, to let them know they had compromised their safety.

Another instructor fell in step with a team carrying a victim back to base to make sure they reassessed the victim's condition frequently.

That kind of rigor impressed even veterans like Bob Green, of the Ontario County Sheriff's Department in New York, who has more than 18 years experience as a SWAT team commander and another five years as a tactical emergency services provider.

"It's everything I hoped for. It's a no-nonsense program," Green said.

Though the training was specific to high-risk situations, trainees said it taught skills important in any situation.

Jim Kuemmerle, a Beaver County emergency medical technician who lives in Shaler, acted as a team leader during the simulation.

"It gives you greater focus. It teaches you things you can use every day -- to collect your thoughts, take your time and be focused," Kuemmerle said.

Alisha Hipwell is a freelance writer.