Page 123 - Journal of Special Operations Medicine - Summer 2016

What is the selection process, work up, and Diego FD, and the Los Angeles County Sheriff’s Depart-
ongoing training like for your team? ment SEB-ESD [Special Enforcement Bureau-Emergency
We train a lot! On average, we are training about 253 Services Detail] were not given their due credit. Because
hours a year, not including initial workups or specialty of this, TEMS was not clearly understood in our state.
schools, such as SWAT, TEMS, CBRNE [Chemical, Biologi- Today, it is a much healthier and collaborative. We had
cal, Radiological, Nuclear, and high-yield Explosives], or several summits where we had SMEs present snippets of
other operator courses. I am on a great team and have factual, historical information. We had Dr Butler, Mike Me-
great paramedic partners. Ronny, Mark, and Keita are oli (retired SEAL), Phil Carmona, Dana Vilander from LASD
consummate professionals. We work our regular fire de- SEB-ESD, Ron McCarthy (retired LAPD D-Platoon [SWAT
partment assignment in addition to being on the team. It team]), and EMSA [EMS Authority] Chief Deputy Dan Smi-
keeps for a very busy schedule. We attend SWAT school, ley share information specific to their lanes. The California
PC 832 [Penal Code 832, a series of arrest and firearms TEMS Council, now a nonprofit, has written a curriculum
courses], TEMS School (now based on the NTEMSC predicated on the NTEMSC’s learning domains.
[National TEMS Council]) and other specialty courses as
needed. We have a FD-PD [Police Department] policy for How did you come to SWAT-TEMS?
TEMS. When with the team, we abide by the California When I received my paramedic certification, I was told by
AG [Attorney General] Blue Ribbon Commission standard a long-time family friend that I should work for the Los
on SWAT. Along with that, we have to maintain fitness Angeles County Sheriff’s Department in their Special En-
levels. forcement Bureau. I boldly explained that I wanted to be
a “fireman, not a cop.” Today, I am often told I should
You have worked on several notable TEMS projects. have been a cop or went into the military. I was at a meet-
Please elaborate on these. ing for the California State Firefighters’ Association and
I have been blessed with awesome opportunities and a discussion ensued about putting fire department para-
have met real heroes. My Lieutenant at the time, Brian medics on SWAT teams. I pitched the idea to my adminis-
Tidrick, was making a push through the Urban Area Work- tration and they bit. Coincidently, our police department
ing Group (UAWG), [a] local focus group for UA Security was looking for paramedics to work with the team. Work-
Initiative. The UAWG charged me with developing a law ing closely with Lt. John Cottriel, the program took off.
enforcement first aid course. After I realized I probably Our assignment to JHAT was a natural fit. Since the incep-
opened my pie hole a bit too far, I figured I couldn’t make tion of JHAT, we have taught all of the team’s elements
my team look bad. I made a life commitment to this proj- of TC3, nerve agent antidote administration, and how to
ect. I quit my formal education and made this my way of operate basic firefighting hose lines and appliances for
life. I scoured high and low for information on TC3 and cases of combating fire as a weapon. We can easily inter-
for information on who Dr [Frank] Butler is. Somehow, operate with other JHAT teams as a TEMS unit or indi-
I was put in contact with Jeff Mott, PA-C (retired Army) vidual medic.
out of Fort Sam [Houston]. He was a godsend. He helped
me to ensure the course was developed in a solid man- What was your first call out like?
ner. I was [also] put in contact with Dr Butler. One of the I was sitting behind cover with Gabe, a former Ranger. I can
benefits of attending this course is that every officer at- hear him now, with chew in his mouth while we’re wear-
tending receives their own IFAK (individual first aid kit]. It ing gas masks: “RANGERS LEAD THE WAY, SUUUUN!”
is awesome to look into your teammate’s face and know Just then, he rolls over and rips off a few rounds of cold
that this stuff works or to hear a LEO [law enforcement gas into the apartment where the suspect was barricaded.
officer] that you have never met rave about the course. At the same time, I was starstruck at the snipers doing
Thanks Jeff Mott, Dr Butler, and all of our Warriors who over-watch for us. It happened all so fast, it scared me to
have made the ultimate sacrifice. death. I thought to myself, “This is stupid! What am I do-
ing here?” Gabe had a bad seal; [he] vomited in his mask
For a period it seemed like Phil Carmona; Dr Andy Pen- and swallowed it. That’s Gabe, “RANGERS LEAD THE
nardt, formerly of the COM [Center for Operational Medi- WAY, SUUUUN!” I drank the Kool-Aid, ate the cup and
cine] out of Georgia Regents [University]; and myself were pitcher, and asked for more. I was hooked!
stationed together in California. With Phil’s dedication and
guidance, we brought together a grassroots consortium Your thoughts on personal development
of SMEs [subject matter experts] throughout the state in TEMS medicine?
to recognize and implicitly adopt the NTEMSC learning There is a lot of information readily available on TEMS on
domains. Prior to the recent convening of TEMS folks by the Web and in our own communities. One has to be careful
the state, we were spreading the word as to the histori- of what they read, who is feeding them information, why
cal facts with respect to TEMS under the consortium, the are they being fed certain information, etc. The key is
California TEMS Initiative and Council. I know they try to to be wise when researching TEMS in hopes of broad-
deflect accolades, but guys like Dr [Richard] Carmona, Dr ening our knowledge base. TEMS touches on many dis-
Butler, Dr [Craig] Llewelyn, Chief Chris Heiser of the San ciplines from operational, academic, and administrative

Interview: Ray Casillas 109