By Andrew Haffner
Grand Forks Herald
GRAND FORKS, N.D. — Art Culver, manager of Altru Health System’s ambulance services, reflected last Friday on some of the various titles used for emergency medical services personnel.
Some of the nuances that differentiate EMS roles can be lost on the public, which in turn can lead to mix-ups. But while EMT is not synonymous with paramedic, there was one name that stood above the others as a true misnomer.
“Just don’t call us ambulance drivers,” Culver said with a smile.
Given the setting, that’d be an unlikely slip — he was making the distinction while standing alongside a fully equipped Grand Forks Regional SWAT Team truck.
Part of Culver’s management role involves overseeing the health system’s tactical medics, a crew with two Altru paramedics who work directly alongside SWAT to provide law enforcement with medical support services.
The program is the result of a memorandum of understanding forged between Altru and the Grand Forks Police Department.
Culver’s oversight is based in personal experience. He became one of the very first members of the team at its inception in 2003 and remained in the program until 2014.
Culver, who made a career in the U.S. Air Force before returning to civilian life, said medics are trained with all of the weapons used by SWAT but carry none of their own when called into action. What they do get is a bulletproof vest loaded up with a variety of medical gear suited for use in combat situations.
Culver said part of the reason he “jumped on board” at the program’s start was the prospect of excitement.
“I wanted maybe the adrenaline rush, of being part of the specialized team,” he said.
Later, Culver said his favorite aspect of the job was being ready to lend a hand at a moment’s notice.
“I was there to be able to help the team members focus on their jobs,” he said. “In the case that they got hurt or someone else got hurt, I was immediately available.”
Grand Forks Police Sgt. Travis Benson, SWAT team leader, said the medics are “100 percent part of our team.”
“They train with us, they go on activations with us,” Benson said. “Anytime that we’re on anything, we typically have our medics involved as well.”
The presence of the medical team doesn’t change the way SWAT does its job, Benson said; in an ideal situation, a tactical medic wouldn’t have to step in at all.
Still, Benson said, there’s some relief knowing medical services are there if injuries do happen.
Emergency medical treatment is fortunately not a frequent part of SWAT dealings, he said, adding the subjects of SWAT action are usually looked over by medics when the scene is secure.
For the officers themselves, Culver said most injuries occur during training exercises.
Front-line treatment
After spending more than a decade on the team, Culver described the service as enjoyable and said the additional training and experience had made him a better paramedic.
“I learned a lot,” he said of his time on the team. “I needed to stay highly skilled to be able to provide the front-line treatment.”
Culver estimated about 20 different Altru employees have been on the team over the course of its existence.
Applicants to the program must first meet the more basic job criteria of having relevant certifications and work history and interviewing for the position. The more intense side of the job screening includes a physical agility portion in which candidates must hit their marks in tasks, such as running more than a mile in a certain amount of time, dragging a 200-pound dummy at least 50 yards, and completing timed fence and stair climbs.
Once they make it onto the team, new tactical medics go through SWAT basic training and medics courses. Last summer, Culver said one of the medics attended a specialized course known as Tactical Emergency Medical Support, or TEMS.
Mark Gibbons, a TEMS instructor with the National Tactical Officers Association—a group which represents and supports SWAT units across the country—said he’d been involved in tactical medicine since the late 1980s.
“A lot of the focus, just the scope of what a tactical medic does, continues to evolve with the changing times,” Gibbons said.
Modern tactical medics “follow a lot of the military tenets” of medicine, he added, applying some of those standards to the civilian realm. In cases like mass shootings or other events with multiple casualties, Gibbons said tactical medics can be a valuable asset both in initial responses to dangerous scenes and in supporting cases where events are pulled into extended police operations.
Gibbons said a SWAT survey conducted by the association indicated more than half of 254 responding law enforcement agencies with tactical squads included paramedics as part of the team, as of 2013. TEMS training, he added, is a good way to link medical practices with police action in such a way as to reconcile was can sometimes be “two competing missions.”
“There needs to be a good match between the law enforcement tactical thing and the medicine,” Gibbons said. “Otherwise, you’re pulling the same rope in opposite directions. The synergy between the two allows for the tactical mission to be successful and to save more lives.”
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