Tactical Medicine in EMS Today - Term Paper Example

Running Head: TACTICAL MEDICINE IN EMS TODAY Tactical Medicine in EMS Today Research reveals that around 90 percent of war deaths take place in the battle field, much before any kind of medical intervention. It was observed by Army colonel Bellamy that most of these deaths were potentially preventable. Deaths caused due to loss of blood from wounds, fatality caused due to tension pneumothorax or due to airway obstruction are avoidable. As a result of this research, U.S. military and American law enforcement agencies (LEAs) have employed medically trained members to the SWAT (Special Weapon And Tactics) teams (Heiskell, 2006). Tactical medicine is focused and highly discerning endeavor that necessitates intensive training, control, regulation and distinctive association with law enforcement. Tactical medicine encompasses the principal accountability of giving medical care to the SWAT team, although their duties extend far ahead of such undertakings. The present article observes the progression and current tactical medical beliefs and methods engaged by military and LEAs specifically SWAT teams (Morrissey, 2013). The concept of tactical medicine is in existence since the dawn of medicine and combats. In early battles the treatment was given only to the royal individuals like Kings and other important people. Although outcomes were not significantly promising and caused mortality at times or else the victim suffered with the serious infections which may cause death. Over the centuries, advances in tools, techniques and medical facilities drastically enhanced the understanding towards injury management (Morrissey, 2013). Conflicts witnessed in the last decade displayed controlling extremity hemorrhage as well as aggressive airway management, resulting in a significant decline or drop in casualty fatality rate (CFR), the percentage of individuals who got injured in the battle and expire. A closer examination of CFR highlights the fact that a remarkable reduction in fatality occurred after 2004. The CFR for World War II was recorded as 19.1 percent, in Vietnam War it was recorded to be 15.8 percent while in Iraq/ Afghanistan conflicts CFR was recorded to be 9.4 percent. However, earlier than 2004, a considerable percentage of deaths of American soldiers during the Global War of Terror (GWOT) involved numerous kinds of injuries such as hemorrhage from extremity injure; junctional hemorrhage involving high traumatic amputation; gunshot injury to the abdomen resulting in non-compressible hemorrhage; airway problems and tension pneumothorax (Morrissey, 2013). Introduction of tactical medics enabled LEAs to accept the challenging task of saving lives. The initial first five minutes are crucial for the critically wounded individual, time wasted in the transportation of the wounded individual to the safe/ secure areas for the treatment often resulted in tragedies. However, with tactical teams encompassing paramedics, EMTs, registered nurses, and physicians chances of fatal outcomes are reduced. Physicians potentially take the charge of the wounded individual at the right time because they are traditionally trained in advanced medical as well as surgical procedures. Today, police tactical teams have made additions of emergency medical personnel encompassing individuals trained as full-time SWAT or paramedics, or there may be trained medical workforce to provide faster relief to the wounded individuals and to aid tactical police operations (Heiskell, 2006). Considering the fact that medical care in a tactical environment could be exceedingly challenging, tactical medics professionals are preferred to be trained extremely well in order to take the desired action and appropriate decision at the time of casualty so as to save the life of the wounded. It must be taken into contemplation that there persists a difference between traditional EMS (Emergency Medical Services) and tactical EMS; the doctrine of traditional EMS highlights the sight safety and savior safety as the first priorities while the patient care comes next, on the contrary, in tactical EMS rendering immediate attention in the operational care is the priority. Thus, tactical medic when rendered to the victim provides care in a timely manner in contrast to the traditional EMS where the unit waits till the victim is taken to a secure place by LEAs. Besides the fact that tactical medics are not equipped well as compared to traditional EMS, they are required to work under intricate conditions where maintenance of light and sound discipline is essential (Heiskell, 2006). The primary objective of tactical medicine is to support tactical team to attain their aims. This is accomplished with the help of health management, keeping the members of tactical team healthy all the time prior to the operation, during operation and after operation. However, SWAT conditioning requires that all the members of tactical team maintain sound health; for this each member should train every part of the body. In certain cases, tactical operators train only some parts of their body and ignore others as a result they become prone to injuries (Heiskell, 2006). Tactical medicine is an exhilarating and growing field of emergency medicine. Initially, extremity hemorrhage was the most common basis of preventable battlefield fatalities. Introduction and emphasis on use of tourniquet and hemostatic agents in U.S. military provided remarkable success. Tactical medicine is becoming a specialty and discipline within LEAs. In the past decades two important shifts in doctrine related to SWAT and LEAs operations have been observed; one alteration was paying attention on violently going after active shooters with anything in hand instead of waiting for a SWAT team. Another alteration involves recognition of emergency medical contingency planning. However, inclusion of tactical medic is the primary concern and notification to local EMS. Dedication of tactical medical part is desired as a result, LEAs send officers to special tactical medical classes or to the EMT school (Morrissey, 2013). According to Young et al. (2014), presence of physician as a part of Tactical Emergency Medical Support (TEMS) is enhancing in number as well as popularity, therefore physicians in the team are more apparent. Physicians have in depth knowledge of medicine and therefore they provide their expertise as TEMS elements as compared to law enforcement personnel with medic training. Thus, TEMS program attains more success because of the presence of physician (Young et al., 2014). Besides physicians, paramedics, nurses, EMT others are also taking interest in tactical medical education. Organizations like NAEMT Tactical Combat Casualty Care (TCCC) and International School of Tactical Medicine (ISTM) provide intensive programs to train practitioners about law enforcement operations. Tactical medic supports law enforcement operations. It is important for EMS providers not to enter the shooter’s area. EMS providers work closely with tactical medics all through the event. In the present epoch where terrorism, wars and enmities between the nations take the form of war, tactical medics are gaining prevalence. It is not only an act of humane and kindness but also generates a feeling of respect for the people. Tactical medics require diverse steps and phases which could be planned before the hit. Mission objectives and target settings are reviewed in co-ordination with the EMS. However, local EMS is provided with the communications and instructions to prevent maximum casualties (Morrissey, 2013). Thus, war or any act of violence does not support humane behavior but tactile medics do ignite humane inside every human being. Tactical medics and EMS in present scenario are turning out to be biggest act of humanity as tactical medicine provides new life to those who put their lives in danger to prevent the lives of others. Tactical medicine enables one to look at the brighter prospects of humanity and sends a message that no war is important than life as war does not provide any good to the mankind. References Heiskell, L. E. (2006). First AID. Retrieved from http://www.tacticalmedicine.com/files/policemarch06.pdf. Morrissey, J. (2013). Tactical EMS: An overview. Retrieved from http://www.policeone.com/police-products/tactical/tactical-medical/articles/6352966-Tactical-EMS-An-overview/. Young, J.B., Sena, m.J., Galante, J.M. (2014). Physician roles in tactical emergency medical support: the first 20 years. J Emerg. Med, 46(1), 38-45. Annexure (Taken from Heiskell, 2006) Personal Supply Module Kit Trauma Dressings Bandages Minor Dressings Adhesive Bandages IV Start Kit 100cc IV fluid, an alcohol wipe, tourniquet, IV catheter, IV tubing, tape, flush and saline lock Saline Bullets foreign bodies in the eyes are very common on entries so a bottle of eye drops or saline bullets may save the day and allow an operator to continue on a mission Medications Pain- acetaminophen, ibuprofen, narcotic analgesics; antibiotics- ciprofloxacin, metronidazole, cephalexin Wound Closure Surgical staples or liquid tissue adhesive Basic Medical Module Splints Two sam splints Airway Pocket mask, BVMAD or BVM, oral nasal airway Litter Fold-up stretcher Wound Care Various trauma dressings Other ACE wraps and cravats Major Trauma Module Dressing May be self administered by the patient with one hand. Combines an ACE wrap, combine dressing and tourniquet in one device Combine Dressings To control heavy bleeding or cover eviscerated bowel and open fractures Gauze Pads Multiple uses Antibiotic Packs Predetermined medication packs for major trauma, containing pain medication and antibiotics Tourniquet Several excellent devices are available for tactical use Wound Closers Sutures, staples and wound adhesives Minor Surgical Tray For performing surgical procedures that cannot wait for extrication or transport Ace Wraps For strains, sprains and fractures which are common Splinting Sam splint or a short sealed roll of fiber-glass casting material. Bullet wounds frequently fracture long bones Iv Fluids For infusion of medication and management of shock as needed. Also used for wound irrigation and eye irrigation. Several IV start kits should also be on hand Supplies Gloves, tape, trauma shears, tweezers, adhesive bandages, roll gauze, cravats, nasal airways, 60 cc syringes, headlamp Other Duct tape, biohazard bags, medical record sheets and trauma tags for multiple casualties Read More