Vol. 76, No. 4Cover stories

The paramedic advantage

Bringing medical support inside a tactical environment

Ontario Provincial Police's Tactical Emergency Medical Service demonstrates how medical care is provided inside the perimeter of a high-risk incident. Credit: OPP


As one of 24 advanced care paramedics with Ontario Provincial Police's (OPP) Tactical Emergency Medical Service (TEMS), Shawn Pranger knows exactly what it means to have someone's back.

It's his job to go into a hot zone and treat injuries at the scene of high-risk and emergency situations, like an active shooter, alongside the OPP's tactical troops.

"If we're responding to an active shooter in an apartment building, we're right behind the stack with the guys going through the door," says Pranger. "If anyone gets hurt or injured, we're right there ready to respond immediately."

Tactical paramedics

The TEMS team are true experts in pre-hospital care. Each member is a full-time paramedic with an Ontario Emergency Medical Service (EMS), practising their skills five days a week. They work for the OPP on their days off.

Dr. Andrew Reed, who leads the TEMS program, says it's necessary for the OPP to have its own paramedics.

"It's potentially too dangerous for the local EMS to go into the perimeter of an emergency situation with us," says Reed. "Having TEMS means we can provide medical care where it can't be provided by regular EMS."

TEMS members have advanced tactical training to support any of the OPP's tactical teams like the Tactics and Rescue Unit (TRU), Emergency Response Team (ERT), Urban Search and Rescue, Chemical, Biological, Radiological, Nuclear and Explosives Response Team (UCRT) and the Public Order Units, when they attend high-risk calls.

But the safety of the TEMS member is paramount. "Any time they deploy into a hostile environment and they're still searching for a suspect, and the TEMS has to go and render assistance to somebody, they would be protected by tactical officers," says Reed.

Trained members

The RCMP has taken a slightly different approach with its Emergency Medical Response Team (EMRT). Where the OPP takes paramedics and gives them police training, the RCMP takes its police officers with medical experience and gives them further training in tactical and emergency medical response.

Just like the advanced care paramedics in the OPP, EMRT members are trained to treat life-threatening injuries like gunshot wounds. They're armed with tourniquets and hemostatic dressings to stop a major hemorrhage.

They're also trained to assist with medical emergencies like breathing emergencies, hyper/hypothermia, burns and anaphylactic shock, among other things, to get injured police officers to the next step of extended care.

Sgt. Wendy Smith, the national co-ordinator of EMRT, says there's a big benefit to having police with medical training.

"Our members regularly work in dangerous environments," says Smith. "They're used to thinking about their own safety and security and have the training and tools to protect themselves."

Both TEMS and the EMRT are called out for active shooters, hostage situations, high-risk warrants, search and rescue situations and protests. "Basically the teams are called out to support potential or known high-risk situations," says Smith.

Integral support

And for those police officers in the RCMP and OPP tactical troops, knowing there's medical support available reduces some of the stress of the situation.

"The peace of mind of having medical support, to know that there is a medic close by, it's just that extra comfort," says Reed. "Members are willing to put themselves at that level of risk — going through a door when they know there's a gun on the other side — because they know there is somebody there to help them if something goes wrong."

Sgt. John Welcher, a member of the New Brunswick ERT, says the EMRT is part of the whole package. "They're just as important as the ERT members doing the job. We've used them before, and when you use them on a call, then you realize how important they are."

No matter the approach taken, Smith and Reed agree that having medical support in the hot zone is vital.

"There's a huge difference with having EMS three or four blocks away, and having EMRT on scene, it permits members to remain focused and on the task while EMRT treats the injured," says Smith. "And depending on the type of injury that's sustained, if it's a major hemorrhage, two to four minutes can mean someone's life or death."

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