PAs and (non-military) Tactical Medicine

[ICRob0351]

What's up guys and gals,

Just wondering if anyone out there has had experience or knows someone who has had experience working as a PA-C in a tactical setting. Given my tactical background, I would love to find an opportunity that combines the world of trauma surgery/EM and a tactical environment. For example, in CT, New Haven Sponsor Hospital has a unit called the SHARP team, which is a small team of docs and PAs that respond rapidly to complicated trauma in the field that the on scene EMS personnel cannot handle alone. Although they are not tactical in nature, that type of response unit is very attractive to me. I was wondering if there are opportunities for PAs out there that involve working alongside SWAT teams, government agencies, or as liaisons with law enforcement agencies for training and operations. If anyone has any info on this, or personal experience to share, I would really appreciate it. Thanks.

[LT_Oneal_PAC]

I think emedpa might have had a buddy who did that. Remember something being said about it years ago. Might ask him.

[flyingsquirrel]

I have friends (paramedics and MDs) who provide medical support to two different SWAT teams. I'm sure one of the teams would be happy to have PAs, the other one might only want paramedics. If you are interested and don't have any personal contacts on your local team, just call up the police agency that runs the team (state, county, etc), explain that you are interested, and ask where they draw their medical support from. I know that some agencies only draw medical support from within the agency (eg all the SWAT medics are state troopers first) and some have medics that are there in a pure medical role with formal no law enforecement background (and a full time job working in the medical field).

If you decide to go into this line of work, MAKE SURE that you get something in writing that you are covered by their workers comp policy for any injury sustained during training or activation.

 

You might also want to look at DMAT and/or USAR although neither one of those are "tactical".

[Acebecker]

Struggling through the red tape of getting this set up in my home town; I work as an EMT - we have a local LEO who volunteers with us. We've been working on this for about a year now and are struggling to get past the higher ups who are risk averse. Our idea is to cross train medics with local PD/SWAT teams to be second in - advance teams clear the area, we're buddied up with LEOs and we treat the critically ill/injured until we can clear them from the scene or bring in more personnel. The idea is not to have us trained in combat, but just to have us train with LEOs in movement, what's secure/what's not, and how they can cover us so we can do our job. I'll let you know how it goes.

 

Andrew

[EMEDPA]

Medic25 from the pa forum here is on the sharp team.

I have a buddy who is the the medical provider for the local swat team. basically involves him sitting around outside while the team goes in. essentially paramedic level skills + a few atls skills. don't think he has ever had to treat a swat officer. looks good on a CV but really doesn't amount to much more than a paramedic standby.

[CCEMPA]

Medic25 from the pa forum here is on the sharp team.

I have a buddy who is the the medical provider for the local swat team. basically involves him sitting around outside while the team goes in. essentially paramedic level skills + a few atls skills. don't think he has ever had to treat a swat officer. looks good on a CV but really doesn't amount to much more than a paramedic standby.

 

To mirror what EMEDPA said, I came from a system that utilized some of our medics on the SWAT team in conjunction with an ER Doc. They go do the training with the teams and get to dress in all the "cool" gear, but when it hits the fan, they are nowhere near the hotzone. Its too much of a liability for the police departments without you being actually employed by the department to let you anywhere near said zone. EMEDPA hit the nail on the head. However, if your name reflects your MOS, I would think you would be strongly considered for the team you mentioned.

[medic25]

As EMED said, I'm a member of the SHARP Team in New Haven, CT. We don't do a lot of tactical work, although we have done some work with local SWAT providing medical coverage (high risk warrants, etc). Most of our calls are things like MCI's, complicated traumas, hazmats, etc. We also periodically respond to more routine calls to perform "real-time" CQI and to expose some of our residents, PA students, etc. to prehospital medicine. Feel free to PM me if you have any questions about the system. We have also helped to develop training opportunities for the medics on some of the local tactical units by allowing them to work observation shifts with us in the ED. The guys who are strictly LEO's don't get many opportunities to assess patients and practice skills (e.g. IV's), so we give them a chance to keep sharp.

 

There are other PA's who have worked in the tactical medicine world. I knew of a PA a few years back who was both an EM PA and a member of NYPD's ESU; very cool combo!

[EMEDPA]

a few of the seal teams have pa's on them who are full fledged team members.

[Friction]

a few of the seal teams have pa's on them who are full fledged team members.

 

If you do the Navy EM residency you either go with Navy Spec Ops or the Marines, but I'm guessing you're neither based upon your comments. Being from Phoenix, I know Mesa Fire Department uses PA's on their rigs. Its basically a way for them to cut down on ER visits. Not exactly tactical, but its out in the field I guess.

[Friction]

I'm sure you already knew that though EMEDPA ;)

[EMEDPA]

the seal team folks I was referring to were profiled in one of the aapa mags a few years ago before the navy empa residency came into existence.

[Will352ns]

a few of the seal teams have pa's on them who are full fledged team members.

Ummm, I've never seen that. Most units have a PA and SO-IDC's, but they are not SEALs....it becomes an issue of assets. I have met a couple of NSW PA's that were also Navy divers...which is pretty bada$$. The example you speak of could have been one of a kind.

 

To the OP, the CIA hires PA's for field work.

[LT_Oneal_PAC]

If you do the Navy EM residency you either go with Navy Spec Ops or the Marines, but I'm guessing you're neither based upon your comments. Being from Phoenix, I know Mesa Fire Department uses PA's on their rigs. Its basically a way for them to cut down on ER visits. Not exactly tactical, but its out in the field I guess.

 

Since no one has graduated from the Navy EM residency yet, they all have to be before it. There are also many other utilization tours for the graduates than just FMF and SpecOps

[ICRob0351]

Thanks for the Data Dump guys, I appreciate all of the info. I'll focus on getting done with my first year of school, then start looking into it more next year. A lot of the above options sound great. Thanks.

[EMEDPA]

Ummm, I've never seen that. Most units have a PA and SO-IDC's, but they are not SEALs....it becomes an issue of assets. I have met a couple of NSW PA's that were also Navy divers...which is pretty bada$$. The example you speak of could have been one of a kind.

.

if interested look through the archives of aapa journals. it was a few years ago. might only be 1 guy as you said.

[Dan Barry]

This guy?

 

http://www.markldonald.com/?page_id=15

[RetNavyPAC]

Mark Donald was a SEAL Spec Ops Tech when he was enlisted. He was two classes ahead of me and several other SEAL corpsmen were in the classes just ahead of mine and after. Once they were commissioned, they were PAs and Medical Service Corps officers like the rest of us - who just happened to be former Team SOTs. They weren't SEAL PAs. There are no "SEAL PAs". There are some PA billets at Coronado at BUD/S, and there are some PA DMO billets (6 weeks of Diving Medical Officer school en route to the billet) with the Naval Special Warfare Groups on both East & West coasts but the billets are not coded for former Spec Ops techs. Anyone - who can pass DMO - can be assigned. They are support billets for the NSWG. They aren't assigned to operational platoons.

 

As far as the Navy's EM residency, when I heard of it and read the message I was deeply disappointed and spoke with a buddy, CDR Dave Holder, who at that time was the PA Specialty Advisor for the Navy Surgeon General. And unless BUMED has changed their plans for post-training utilization tours in the last year & a half, it's pretty much a waste of time. How can that be? Well imagine spending 18 months training to operate at a very high level in a modern ED and then being handed orders not to NMC San Diego, Portsmouth, Jax or any other place with a decent sized ED, but to a battalion aid station in Camp Lejeune or a clinic billet at the above-mentioned NSWGs. You're back to doing sick call - but you're not even doing that because you have highly-trained corpsmen (8404s and IDCs) who do almost all of it. But you just spent a year and a half learning how to manage critically ill and injured patients - and now you're not using all that very expensive training. As I said, a waste.

 

Now, if anyone on this thread is a current Navy PA or PA-select, or has recently left the Navy (more recently than the 20 months since I spoke to CDR Holder) and any of this has all changed, PLEASE disabuse me of this erroneous information. If BUMED has indeed come to it's senses I will be ecstatic.

 

LCDR out.

[Acebecker]

Update: I have an interview for the city Tactical Emergency Medical Support Team next week.  It is, as far as I know, exactly what I described above.  I'll let you know if there is anything else; my hope is that this is a "foot-in-the-door" opportunity for me.  We'll see if I even get past the interview.

[CorpsmanUP]

While BUMED may not have pulled their head out, the Marines are shifting their tune.  They have requested and been authorized an additional 75 PA billets to fill DMO and Flight Surgeon billets, and are looking at an expanded role with the MARSOC teams.  As the teams are Indirect Primary and Direct Action secondary they are looking at expanded medical care to flesh out the indirect action assignments.

[skyblu]

Someone from my class was a paramedic before PA school. After graduating, he has maintained his paramedic certification and works with SWAT-type team, but he does so as a paramedic, not a PA. Same with someone else I know who works for med flight (I third-rode with them, they work some REALLY cool scenes! And their flight jumpsuits are pretty awesome, too), where they employ paramedics and nurses but no PA's.