Crossing the Line

EDWARD R. MYERS

Mar 15, 2012

Interoperability is the glue that will bind effective and efficient pubic safety response operations in the future. One of the most apparent examples of this is the 700 MHz spectrum campaign that is intended to provide the tri-services (fire, law enforcement and paramedics) with modern broadband communications capability. Interopera-bility is also attained in other ways, such as cross training of firefighters to respond to minor medical injuries and safely transport patients to a hospital.

Tactical Emergency Medical Services (TEMS)
Effectively crossing operational lines, EMS and law enforcement personnel form team groups in Ontario to support operations where serious injuries may occur during a police operation. The model comes from the military, where medics are assigned to units and travel with them during military operations. Unlike the military model, which uses medics, the Ontario program, under the command of the Ontario Provincial Police (OPP), uses a fully qualified Medical Doctor to run the program.

This specialized program, the Tactical Emergency Medical Services (TEMS) Program is managed by Dr Andrew Reed, the OPP Physician. Dr Reed is an Emergency Specialist, Assistant Professor at Queen's University, and an Emergency Physician at Kingston General Hospital.

Tactical medical capability was realized in 1985 when the OPP allowed civilian medics to accompany tactical teams during high-risk incidents. Dr Reed joined the OPP in 2002 and took a position as an EMTT with the Eastern Tactics and Rescue Unit (TRU). Shortly after joining, he recognized the need for a more robust medical response within the OPP. In 2006, he was tasked with the creation and implementation of a tactical paramedic unit known as the TEMS program. These TEMS include Advanced Care Paramedics that currently work full-time with an Emergency Medical Service in the province of Ontario, and who is willing to provide 6 to 7 days of on-call availability to the OPP. The initial group of 16 TEMS were hired as part-time employees of the OPP in 2007 and received intensive training to prepare them for their new roles. They carry with them all of the advanced medical equipment and supplies required to provide advanced pre-hospital care in a high-risk incident.

The Mandate
The mandate of the OPP TEMS program is to provide emergency medical care to anyone within the perimeter of an OPP critical incident. These include: tactical, CBRNE (Chemical, Biological, Radiological, Nuclear, Explosive), and Urban Search and Rescue (USAR) incidents. They also train to provide close support to Public Order Units for crowd management. TEMS are also provided with protective equipment required to provide medical care safely at these incidents.

Since 2007
Since their inception, the TEMS team has grown to become a 24-member unit. They have provided care at hundreds of tactical incidents, several Presidential visits, the 2010 G8/G20 and, most recently, in the aftermath of the Goderich Tornadoes. Beyond providing advanced medical care at OPP incidents, TEMS also provide advanced medical training to specialized response units of the OPP.

An OPP Medical Response
In addition to supervising the TEMS program, Dr Reed has developed a more comprehensive medical program within the OPP's Field Support Bureau. Dr Reed has created training programs for Ballistic Injuries, Blast Injuries, OPP Countermeasures (Antidotes to Chemical Weapons), Excited Delirium, Heat Related Injuries, Less Lethal Weapons, and the Tourniquet and Pressure Dressing. He works closely with the OPP Academy, creating first aid content for all officers. Dr Reed is available to provide medical advice to any critical incident commander 24 hours a day.

One of the great successes of the OPP Medical Program was the implementation of the tourniquet program for all tactical response officers and In-Service trainers. One of the OPP's In-Service trainers who had been seconded to the Ontario Police College (OPC) was present when a recruit accidently discharged a weapon into his own leg. The recruit was experiencing life-threatening bleeding from the wound and without the tourniquet provided by the OPP member, could have undoubtedly bled to death prior to arrival at the hospital.

Upon hearing of the incident, the OPP sent Dr Reed to work with the OPC to institute a train-the-trainer program to teach their instructors how apply tourniquets and pressure dressings. For its own members, the OPP has committed to providing each of its 6000 plus officers with a tourniquet and pressure dressing. This investment will save additional lives.

Another recent investment, part of the OPP's commitment to improving medical care, has been the purchase of more than 200 Automated External Defibrillators (AEDs) for its detachments.

The OPP is also developing an ERT (Emergency Response Team) Medic program. This involves selecting former paramedics as ERT officers and providing advanced medical training and equipment to provide emergency medical care while performing their duties. The first cadre of ERT medics has already saved the life of a civilian during a tactical incident where the local Emergency Medical Services were unable to respond.

As our world grows more complex with new threats to public safety, the law enforcement community continues to search for new ways to provide safety and security to its ranks as well as to the general public. Dr. Reed and his TEMS Program provide an integrated and interoperable level of medical expertise that can be counted on to save lives in times of crisis. Thank You Dr. Reed!