Page 124 - Journal of Special Operations Medicine - Summer 2016

responsibilities. That said, most legitimate folks can talk shooter response. The difference now is that you have pa-
on all aspects of this topic at length and depth. Not just trol officers mitigating the problem, not SWAT. And, fire
“this or that” or “I am a so and so, I must know what I am and EMS are learning and applying elements of TC3 in
talking about.” If you are being strong armed or told only the warm zone. It takes more than a handful of hours to
certain things apply in certain environments, caveat emp- be proficient at this. The challenge is to make sure patrol
tor [Latin, let the buyer beware]! officers understand small-unit tactics and TC3. And be
able to work with fire and EMS in the “hot” and “warm”
Those who can translate between communities, environments. Additionally, fire and EMS needs to under-
LEO and medical, are important to the work of both? stand small-unit tactics. Real-life training and preparation
We [the city and county] work extremely well together are key!
and can bring to bear a lot of resources that can interop-
erate well with one another. Sadly, if we are only focusing Any guidance for the operational medicine
on law and medical interoperability, we are excluding vast community on life-work balance? Work longevity?
resources and skill sets that can complement a tactical I believe being on SWAT as well as providing TEMS is one
operation. It is important for law to understand applicable of the most benevolent undertakings. I was involved [in
small unit tactics, TC3 according to their scope of prac- the community] before I had kids, and I seemed to only
tice, and have a basic understanding of unified command. get busier as they got older. For me, I am aware of my
minimal sacrifice compared to those who have given their
Any thoughts on the LEO community’s view lives for our country. I can sit in the comfort of my home
of operational medicine? and answer these questions; those who made the ulti-
Without going into all of the details, one of our guys was mate sacrifice cannot. The least I can do to honor them
shot. The entire team pulled together darn near flaw- is to drive on and share the best practices all of us are
lessly. Things went so well during our interventions for a learning from their shed blood. Make sure your family is
period of time, I thought we were just training. Today we aware of the commitment. You will miss out on birthdays,
can laugh, but at the time, it sucked! I know in the region, holidays, anniversaries, and more. “SWAT is a lifestyle; it’s
the story got out, it was on the local news, and caused a a way of life.” When it causes you conflict, loses its luster,
lot of other teams to pay closer attention to TC3 and a or you are physically unable to perform, it is probably time
few other factors. This is exciting to see. I believe most to tap out.
LEOs have and are continuing to embrace it. The entire
Committee on Tactical Combat Casualty Care has done a Closing thoughts for the operational medicine
great job with sharing information. It is not uncommon for community?
me to receive pictures of cops performing medical tasks The roots of operational medicine are planted in the mili-
on calls or sharing what they have done on calls. tary. From my family to you all, thank you for your service
and dedication.
Active shooter response is new? What are some
of the challenges? A special thank you to Hondo—Jim Harrel of LASD SEB-
Somewhere along the way, we changed the term “drive ESD. Sometime before his passing, he schooled me and
by shooting” to “going postal” to “active shooter.” Even told me “SWAT is a lifestyle; it’s a way of life.” He was
before that, didn’t we have the Saint Valentine’s Day Mas- right. His words were so profound, they continue to in-
sacre, where six folks were killed? I am aware of the con- spire me.
cerns for all of us to effectively respond to and mitigate as
best as possible the variances to this type of incident. We
need to be ready! We are now collectively doing some- Disclosures
thing about this. It is awesome that we have law talking to Ray Casillas is the Interim President of the California TEMS
fire and EMS, and fire is willing to hang it out there a bit Initiative and Council, is on the board of directors of the
more, albeit, it has to be very calculated and coordinated. NTEMSC, and is co-chair of the California State Firefight-
There are several sides to the response. Sadly, some folks ers Association EMS Committee; all three are nonprofit
are not receiving the entire message during training. I am organizations.
not sure that a few hours of training is enough to cover
everything that should be taught. As a matter of fact, I just
heard a firefighter say that “we will never work in the hot The opinions or assertions contained herein are the private
zone, so why do I need to learn that?” Uh-oh, baloney- views of the author and are not to be construed as official or
o-meter is going off. What we have to recognize is that as reflecting the views of the Department of the Army or the
the response for a hostage rescue is analogous to active Department of Defense.

110 Journal of Special Operations Medicine Volume 16, Edition 2/Summer 2016