Page 71 - Journal of Special Operations Medicine - Summer 2014

Photo credit: Walter Sim, The Straits Times, 22 Feb 2014. Figure 1 Timeline.

Source: Walter Sim, The Straits Times, 22 Feb 2014.

Unfortunately, the riot left 54 uniformed personnel in- damaged vehicles had varying degrees of damage such as
jured. The majority of the casualties sustained lacerations smashed windshields and vehicle body damage.
to the extremities, face, and head. Those with fractures
were treated by SCDF paramedics in the cold zone.
Twelve SCDF members were injured, sustaining lacera- Current Situation
tions to the face and hands from the projectiles hurled When the original emergency medical services (EMS)
at them (Source: 9/12/13 the Straits Times). The rest of and paramedic system was developed, the world was a
the injured included 37 from the SPF and five from the much different and safer place. At that time, and con-
auxiliary police. tinuing to this day, paramedics are trained to manage
patients when the scene is safe. Although scene safety
Among the 25 emergency vehicles damaged, the release is of paramount importance, the principles of prehos-
mentioned that the nine SCDF vehicles that were badly pital care requiring that the scene be safe are no longer
damaged consisted of three ambulances, a “red rhino” applicable in the realities of today’s world. The operat-
(Figure 2), a fire engine, and four support vehicles. In ad- ing environment for EMS and paramedics is becoming
dition, two police cars and one of the ambulances were increasingly unpredictable and dangerous as the threat
completely burned at the incident site, while the remaining from civil unrest to terrorism is becoming more preva-
lent in many countries. This trend will only intensify
globally. Therefore, the EMTs and paramedics must be
Figure 2 Red rhino emergency response vehicle at the left.
able to understand the necessity of operating in high-
threat environments and how this environment must
change their approach to delivering prehospital medical
care.

One solution that has worked well and has a proven
track record is currently in practice in the United States
Photo credit: David Chew, MD. principles developed by the military for prehospital care
and other countries. It represents a modification of the

in a high-threat environment or austere environment.
Paramedics are selected and trained to operate with
tactical law enforcement units such as special weapons

medics function as tactical emergency medical support
(TEMS) medics who are able to operate specifically in
Source: David Chew, MD. and tactics (SWAT) teams. These tactically trained para-

Little India Riot and Tactical Medicine Among Medics 61