Page 136 - Journal of Special Operations Medicine - Winter 2016

Special Operations medics receive significantly more What would you recommend to others
training to manage trauma and operate relatively inde- who are or will be making the same transition?
pendently in very austere environments, often for ex- How should they prepare for the transition? Any
tended periods. Military Special Operations medics, as specific training or education you would recommend?
a whole, generally also enjoy a broader scope of prac- I highly recommend to anyone making the transition to
tice than their civilian counterparts, who, depending on seek out whatever law enforcement-specific training may
jurisdiction, are often limited by state laws, agency poli- be available to them, whether it is a full academy, reserve
cies, and medical direction protocols. Civilian medics, on or auxiliary program, SWAT training, tactical medical pro-
the other hand, are likely more experienced in handling vider, or similar. Obtaining experience in law enforcement
medical emergencies (e.g., cardiac, respiratory), manag- will increase both one’s credibility and ability to provide
ing special populations (e.g., elderly, children, pregnant support for tactical operations. Don’t assume that your
women) that may require care during a tactical operation, military Special Operations background automatically
and handling unique aspects such as evidence preserva- makes you an expert in law enforcement tactical opera-
tion. There is also a major difference between military tions. There are a lot of organizations whose members
and civilian Special Operations medics from a standard- provide tactical medicine support for law enforcement,
ization perspective. The military benefits from a process such as the tactical medicine section of the American Col-
that readily allows standardization of training and casualty lege of Emergency Physicians, the physician section of
care guidelines, which are directed from the top down. the International Association of Police Chiefs, the TEMS
Civilian medics vary widely in how they are trained and section of the National Tactical Officers Association, the
allowed to function due to the complex system of authori- operational medicine section of the National Association
ties placed over them, including state, regional, and local of EMS Physicians, and the Special Operations Medical
EMS [emergency medical services] offices, laws and regu- Association, as well as other organizations seeking to
lations, and medical directors. further professionalize the specialty of tactical medicine,
such as the Committee for Tactical Emergency Casualty
Can you address the utilization differences between Care and the National TEMS Initiative and Council. Seek
being “operators” as opposed to being medical out the advice of others who are already involved, net-
support only? Are there any obstacles or significant work, contribute, and collaborate. And always remain the
considerations when arming tactical medics in the Quiet Professional. Law enforcement deserves the same
civilian (law enforcement) role? caliber people as military SOF.
Due to the inherent nature of their combat mission, mili-
tary Special Operations medics are generally qualified as
operators in the sense of your question. They are consid-
ered to be combatants and there is no question about COL (Ret) Pennardt is board certified in both emergency
them being armed and capable of engaging the enemy medicine and emergency medical services. He served in nu-
within the ROE [rules of engagement]. There is far greater merous Special Operations assignments, including multiple
variability among civilian Special Operations medics due combat deployments to Afghanistan and Iraq, during his 23
to a number of factors. For example, are the medics sworn years of active duty Army service. Dr Pennardt is the cur-
law enforcement officers [LEOs]? Sworn LEOs, as a rule, rent chairman of the USSOCOM Curriculum and Examina-
are armed. Nonsworn medics may sometimes carry for tion Board, the director of the National TEMS Initiative and
defensive purposes, if allowed by state law and agency Council, and the medical director for tactical medicine on the
policy. There are many considerations, such as liability Board for Critical Care Transport Paramedic Certification, as
protection, use of force restrictions, weapons qualifica- well as serving on the Board of Advisors of the Committee for
tion, and public scrutiny. Some states do not allow open Tactical Emergency Casualty Care. He additionally works as
carry except for sworn officers, and concealed carry may a TEMS medical director and certified law enforcement and
not be practical during a tactical operation. If not directly SWAT officer.
employed by the supported law enforcement agency, the
tactical medic may be prohibited from being armed by
the parent EMS/fire agency or hospital, usually due to The opinions or assertions contained herein are the private
liability concerns. Some medics may actually perceive a views of the author and are not to be construed as official or
conflict between their role of saving lives versus being as reflecting the views of the Department of the Army or the
armed and possibly shooting someone. A consideration Department of Defense.
for agencies is also the necessity of providing security
for unarmed medics, which can be a significant drain on
available manpower during a tactical incident.

120 Journal of Special Operations Medicine Volume 16, Edition 4/Winter 2016