Accidents involving Emergency Vehicles

[mariomike]

Once I explained the fentanyl risk, and that there was a very good chance he would have died too if there was any fentanyl in the drugs she took & then he proceeded to place his lips on hers, all of a sudden 'it clicked'

This topic is about urban and rural Defensive Driving for emergency vehicles, of various licence classifications.

I've been retired for a long time. I've heard anecdotes from guys still on the job, and read a few things,

What's going on with Fentanyl these days? What are the facts?

Police ODing on fentanyl?
https://nbcboston.com/news/local/billerica-officer-hospitalized-after-fentanyl-exposure-but-experts-say-it-probably-wasnt-an-overdose/3028125/…

“In many of these events that have transpired beforehand a lot of times the symptoms are really consistent more with a panic attack which is fed by misinformation about fentanyl.” - Leo Beletsky, professor of Law & Health Sciences

Five suspected fentanyl ODs in Hackensack, NJ. Maybe, maybe not. Revived w/Narcan and CPR (??!!). Maybe, maybe not. The other good news: Not a single cop collapsed.

5 employees OD on fentanyl in N.J. mall parking garage, police say

All 5 were revived using Narcan and CPR, police said.

www.nj.com

11 police officers had to be treated by paramedics for exposure to fentanyl following a drug bust on Thursday in Camden County, New Jersey. https://6abc.com/collingswood-nj-hazmat-situation-ems-workers-injured-creswood-apartments-camden-county/12696632/… The five suspects in the house with the police were fine.

Police officers saw what appeared to be powdered fentanyl in her possession ...well you know what happens next.

Ventura police officer exposed to fentanyl during arrest

Ventura police officials say an officer suffered minor exposure to the powerful drug during an arrest Saturday.

www.vcstar.com

EMS and police carry a OD patient down the stairs.
Who needs to be treated for fentanyl exposure with Narcan and were taken to the hospital? The police. The EMS crew was fine.

https://wktv.com/news/four-oneida-county-deputies-exposed-to-fentanyl-during-investigation/article_edecbd68-5be1-11ed-9da8-3b7a69e390e5.html…

It’s nearly impossible for an overdose to be caused by brief contact with fentanyl. - Zachary Siegel

What’s Really Going on in Those Police Fentanyl Exposure Videos? (Published 2022)

It’s nearly impossible for an overdose to be caused by brief contact with the drug. It is possible these videos will worsen the danger for those truly at risk.

www.nytimes.com

EDUCATION/TRAINING

Fentanyl Fear and Facts​

https://www.hmpgloballearningnetwork.com/site/emsworld/original-contribution/fentanyl-fear-and-facts

Police officers say they’re overdosing from fentanyl exposure. Are they? Probably not.

Police officers say they’re overdosing from fentanyl exposure. What’s really going on?

Law enforcement agencies have repeatedly warned of first responders absorbing fentanyl...

www.sfchronicle.com

 

[CBH99]

This topic is about Defensive Emergency Vehicle Driving of various licence classifications.

But, I've been retired for a long time. What's going on with Fentanyl these days? What are the facts?

I've heard some anecdotes from guys still on the job, and read a few things,

Police ODing on fentanyl?
https://nbcboston.com/news/local/billerica-officer-hospitalized-after-fentanyl-exposure-but-experts-say-it-probably-wasnt-an-overdose/3028125/…

5 employees OD on fentanyl in N.J. mall parking garage, police say

All 5 were revived using Narcan and CPR, police said.

www.nj.com

Ventura police officer exposed to fentanyl during arrest

Ventura police officials say an officer suffered minor exposure to the powerful drug during an arrest Saturday.

www.vcstar.com

https://wktv.com/news/four-oneida-county-deputies-exposed-to-fentanyl-during-investigation/article_edecbd68-5be1-11ed-9da8-3b7a69e390e5.html…

What’s Really Going on in Those Police Fentanyl Exposure Videos? (Published 2022)

It’s nearly impossible for an overdose to be caused by brief contact with the drug. It is possible these videos will worsen the danger for those truly at risk.

www.nytimes.com

We had a paramedic in Calgary about 2 years ago almost die because he was in the back of the ambulance with a patient who was OD'ing on it

So I have absolutely no idea


Maybe it's an individual thing? Maybe there is a measure of built up tolerance?

 

[mariomike]

So I have absolutely no idea

Neither do I. Just know what I read on here, and from guys still on the job.

 

[KevinB]

CAD, Computer Aided Dispatch is a catch all at this point for most systems.
It’s also used a lot to describe the computer in the cars.

I have never worked in a 911 Dispatch center, but from what I have viewed of them, it’s only really effective when tied to GPS. (In car CAD will let you see everyone’s status, well in your region, district etc of your entity and tied in entities)

1) You can see a list of car crews and there status as well as how long they have been in that status and location, if either tied to GPS or reported by the vehicles occupant(s) manually - so if you need one car for a task you can assign the task by who’s been sitting longer for lower priority tasks, or who’s closest for higher priority ones.

2) That really doesn’t help reliability assigning the closest available unit unless it’s also tied to vehicle GPS, or the officer(s) in the vehicle has been accurately reporting their location if not tied in to GPS.


I don’t know of any entity these days that doesn’t have a GPS enabled system - outside of some very small rural Departments down here. All the GSA (Federal) vehicles (outside of non GSA low vis vehicles) are also low jacked (so they report your speed too and you get a nasty gram if your speeding- usually sent to your boss).

The downside is most systems won’t assign a vehicle booked out of service (eating, getting gas etc) even if they are next door - so unless something like an ‘all available units’ comes out, one could be out of service next door and not get tagged to respond.

For LE lower priority calls also usually just get listed, so it’s not uncommon for the least enjoyable ones to sit for sometime, as no one wants to take them on.
*Not being familiar with EMS and Fire I suspect they don’t have the same problem as they generally only roll for significant incidents that involve injuries or significant issues. When I did the Violent Fugitive Task Force with the USMS, we would sometimes take an ambulance with us for a raid, as pretty much 9/10 times someone was going to get hurt, and many services will dispatch EMS to events that require ERT/TAC units as well.

Edit I have no idea how the 911 Dispatch assigned the Ambulance’s for that. We’d just get on the local net and request an ambulance for support at our staging area.


So sorry for my wall of text, but it can explain how an ambulance literally next door wasn’t assigned to the task.

I’ve been out of that before Fentanyl became a thing, so no idea on what it can cause.

 

[CBH99]

CAD, Computer Aided Dispatch is a catch all at this point for most systems.
It’s also used a lot to describe the computer in the cars.

I have never worked in a 911 Dispatch center, but from what I have viewed of them, it’s only really effective when tied to GPS. (In car CAD will let you see everyone’s status, well in your region, district etc of your entity and tied in entities)

1) You can see a list of car crews and there status as well as how long they have been in that status and location, if either tied to GPS or reported by the vehicles occupant(s) manually - so if you need one car for a task you can assign the task by who’s been sitting longer for lower priority tasks, or who’s closest for higher priority ones.

2) That really doesn’t help reliability assigning the closest available unit unless it’s also tied to vehicle GPS, or the officer(s) in the vehicle has been accurately reporting their location if not tied in to GPS.


I don’t know of any entity these days that doesn’t have a GPS enabled system - outside of some very small rural Departments down here. All the GSA (Federal) vehicles (outside of non GSA low vis vehicles) are also low jacked (so they report your speed too and you get a nasty gram if your speeding- usually sent to your boss).

The downside is most systems won’t assign a vehicle booked out of service (eating, getting gas etc) even if they are next door - so unless something like an ‘all available units’ comes out, one could be out of service next door and not get tagged to respond.

For LE lower priority calls also usually just get listed, so it’s not uncommon for the least enjoyable ones to sit for sometime, as no one wants to take them on.
*Not being familiar with EMS and Fire I suspect they don’t have the same problem as they generally only roll for significant incidents that involve injuries or significant issues. When I did the Violent Fugitive Task Force with the USMS, we would sometimes take an ambulance with us for a raid, as pretty much 9/10 times someone was going to get hurt, and many services will dispatch EMS to events that require ERT/TAC units as well.

Edit I have no idea how the 911 Dispatch assigned the Ambulance’s for that. We’d just get on the local net and request an ambulance for support at our staging area.


So sorry for my wall of text, but it can explain how an ambulance literally next door wasn’t assigned to the task.

I’ve been out of that before Fentanyl became a thing, so no idea on what it can cause.

So when I worked EMS here in Alberta, we called our dispatching system CADS. I hadn’t realized it was a common term for most modern dispatch networks (learned a few new things from your post!)

In Edmonton ‘metro region’ we could see the direction other units were facing, and what their status was. This was for EMS & police, but Fire wouldn’t show. I know the police could see their units & ours also.

We would chuckle because our CADS system would have ambulances going all over the place rather than dispatching the nearest available unit.

It was supposed to, Ofcourse. But it didn’t work properly, and everybody would end up taking calls all over the plane sometimes.

(I kid you not, an ambulance from a small town about 10 minutes south of the city was dispatched to a call that was basically around the corner from us, and we were tagged as available/online)

If we were ever in a ‘Code Red’ situation (no available ambulances to respond to 911 calls) the screens would fill up with pending calls pretty quickly - so crews would take the ones they wanted, those would get taken off the screen, and just the sucky ones would still be there for whoever had to take them

(Thankfully we use the SUV’s up here a lot, we call them Primary Response Units, and you could mop up those non-urgent calls pretty quickly)



(Fentanyl - just stay away from. We had that one paramedic almost die just from sitting in the back with a patient who had OD’d, we’ve had ER nurses almost code (one did) while being in close contact. I think a few medics have coded also in other areas. Dangerous stuff. Maybe the druggies have a bit of a tolerance built up that we don’t, but it’s pretty deadly to them too most of the time…)

 

[mariomike]

I’ve been out of that before Fentanyl became a thing, so no idea on what it can cause.

Me too. Was interested to read what those still on the front-line have to say.

There is a good deal of discussion about Fentanyl exposure fact / fiction on our private server.

Why Do the Media Keep Uncritically Repeating Implausible Police Fentanyl Overdose Stories?

Last month, something beyond imagination happened in Southern California: A San Diego sheriff's deputy appeared to overdose simply by touching fentanyl,

reason.com

I have no idea how the 911 Dispatch assigned the Ambulance’s for that.

This explains how 9-1-1 works in our town if you call for police - fire - paramedics. It is from five years ago.

As a bus driver stationed at HQ, I got to hang out in Communications between runs.
Clean, inside work, no heavy lifting with a thermostat on the wall. Well paid, according to the 2023 Sunshine List.

When I did the Violent Fugitive Task Force with the USMS, we would sometimes take an ambulance with us for a raid, as pretty much 9/10 times someone was going to get hurt, and many services will dispatch EMS to events that require ERT/TAC units as well.

Our department has Emergency Task Force (ETF) paramedics.
They provide specialized medical care and support to operations of the Toronto Police ETF, and was the first such group in Canada.

When the ETF receives a call, the tactical paramedics, who are on regular duty, are taken out of ambulance operations and respond to the scene. Well-protected paramedics can then proceed into the situation under the direction of the Gun Team sergeant and under the cover of the Gun Team itself.

But, the hot topic in EMS these days is Rescue Task Force.

Response time too long, and too little, to wait around the corner for ETF Paramedics to arrive on scene.

 

[brihard]

Me too. Was interested to read what those still on the front-line have to say.

There is a good deal of discussion about Fentanyl exposure fact / fiction on our private server.

Why Do the Media Keep Uncritically Repeating Implausible Police Fentanyl Overdose Stories?

Last month, something beyond imagination happened in Southern California: A San Diego sheriff's deputy appeared to overdose simply by touching fentanyl,

reason.com

This explains how 9-1-1 works in our town if you call for police - fire - paramedics in our town. It is from five years ago.

As a bus driver stationed at HQ, I got to hang out in Communications between runs.
Clean, inside work, no heavy lifting with a thermostat on the wall. Well paid, according to the 2023 Sunshine List.



Our department has Emergency Task Force (ETF) paramedics.
They provide specialized medical care and support to operations of the Toronto Police ETF, and was the first such group in Canada.

When the ETF receives a call, the tactical paramedics, who are on regular duty, are taken out of ambulance operations and respond to the scene. Well-protected paramedics can then proceed into the situation under the direction of the Gun Team sergeant and under the cover of the Gun Team itself.

But, the hot topic in EMS these days is Rescue Task Force.

Yeah, not sure how well the RTF model is holding up in the face of actual unfolding situations. With active shooter stuff, odds are the situation is moving super quickly, before there's much time to really assemble and coordinate such teams. Cops with a suspect down and victims bleeding on the floor are likely going to just start CASEVAC back to the first medic they can find, and many police forces have members with some advanced member training who can and will do the tactical field care stuff. If we have the opportunity to pull a casualty back, we probably aren't going to wait for a properly assembled team while they bleed out.

 

[mariomike]

Yeah, not sure how well the RTF model is holding up in the face of actual unfolding situations.

Right. I think RTF is for the so-called "Warm Zone".

Definitely not the "Hot Zone".

But, not just the "Cold Zone" (eg: Columbine ) either.

Key components of a Rescue Task Force include the creation of three zones: Hot Zone - Known hazard - shooter possibly still at large. Warm Zone - Law enforcement has mitigated the threat - area clear but not secure. Cold Zone - Area is under control and secure - safe to operate.

Response time too long, and too little, to wait around the corner for ETF Paramedics to arrive on scene.

 

[brihard]

Right. I think RTF is for the so-called "Warm Zone".

Definitely not the "Hot Zone".

But, not the "Cold Zone" (eg: Columbine ) either.

I think the model relies on a degree of situational awareness and fluidity of communications that’s unlikely to exist in most situations. Police will (or should) be pushing to the threat, with probably a ton of cops flooding in behind and unsure what, precisely, to do. In the normal course of cops flowing in and then finding themselves bogged down, they’ll end up colocated with, and likely working on casualties.

Only trained teams will be deliberately stretching out with link men to have a physical line of communication through a building. Most cops who just flood in to the situation will be uncoordinated and underutilized save for those who by happenstance find themselves in a fight. Radio comms will be completely shot and should be reserved for the contact teams anyway. Officers finding casualties will be acting on their own initiative in grabbing first aid stretchers, chairs with wheels on them, cargo dollies, or plain hand carries to get casualties out once they slam tourniquets on and maybe do basic wound packing.

 

[mariomike]

I think the model relies on a degree of situational awareness and fluidity of communications that’s unlikely to exist in most situations.

That's the FEMA plan, anyway.

Federal Emergency Management Agency - FEMA

Center for Domestic Preparedness

Rescue Task Force During an Emergency Response to an Active Assailant Event

Rescue Task Force During an Emergency Response to an Active Assailant Event - Center for Domestic Preparedness

Never been on an RTF team, so never got to see how well, or how badly, it worked, or did not work.

I believe the worst in our town was Danzig. But, that was long after I retired.

Personally, I was ok with the pre-Columbine model of waiting in the "Cold Zone".

Unofficially, of course, I have heard some of our guys unenthusiasticly refer to RTF as the "sitting duck squad".

 

[KevinB]

Most ERT teams have a dedicated medic who’s a LEO with varied degrees of training, I’ve seen some of the more active teams use Reserve LEO’s who are full time trauma doctors, 18D’s or NP’s, to guy who took a ~3 day TCCC.

One issue I have with ERF/ERT Paramedics as unarmed support is that in an AS situation as @brihard pointed out the teams will be driving towards a threat - like a HR/PR mission and not stopping to deal with casualties on, often medics/paramedics will want to stop to treat injured.
Which can leave unarmed personnel alone until more bodies arrive.

Mostly it’s a moot point as formed tactical teams are rarely first responders (unless nearby by accident) so it most likely will be patrol officers, and any medical support will be able to advance with support and left with patrol officers to deal with casualties.


I have a number of concerns about MasCal incidents that require Fire as well, but won’t air them in open boards.

 

[mariomike]

Our ETF paramedics are unarmed. They are not police officers. Or, employed by the police.

They are not some sort of half-arsed cops.

They are part of 9-1-1 ambulance Operations. Members of the City of Toronto Dept. of Emergency Services.

When ETF calls come in, they taken out of Operations, and placed under the direction of the ETF police.

After that, they return to service in the regular ambulance Car Count.

In addition to their regular paramedic salary, they are paid an annual ETF premium of $1,000.

EMS Chiefs of Canada
The Canadian Tactical Paramedic
Training Competency Profile & Best Practices
May 2008

https://www.emscc.ca/docs/TacticalParamedicProfile-May2008.pdf

The Paramedics Chiefs of Canada have outlined 38 competencies that Tactical Paramedics should have.

 

[mariomike]

(Thankfully we use the SUV’s up here a lot, we call them Primary Response Units, and you could mop up those non-urgent calls pretty quickly)

That's interesting. Our town uses "Clock-stoppers" the opposite way.

Emergency Response Unit - Single paramedics in SUVs, tasked solely with response to high priority emergency calls.

 

[CBH99]

That's interesting. Our town uses "Clock-stoppers" the opposite way.

Oh we use them the same way as you do...why they got dubbed as Primary Response Units is a mystery

We use them as clock stoppers also, and handy for attending calls that don't necessarily require an ambulance so we can keep those available for the calls that do.

(Minor motor vehicle accidents, for example)



Our Public Safety Unit uses them, as does our Community Paramedic Program

 

[CBH99]

Our ETF paramedics are unarmed. They are not police officers. Or, employed by the police.

They are not some sort of half-arsed cops.

They are part of 9-1-1 ambulance Operations. Members of the City of Toronto Dept. of Emergency Services.

When ETF calls come in, they taken out of Operations, and placed under the direction of the ETF police.

After that, they return to service in the regular ambulance Car Count.

In addition to their regular paramedic salary, they are paid an annual ETF premium of $1,000.

EMS Chiefs of Canada
The Canadian Tactical Paramedic
Training Competency Profile & Best Practices
May 2008

https://www.emscc.ca/docs/TacticalParamedicProfile-May2008.pdf

The Paramedics Chiefs of Canada have outlined 38 competencies that Tactical Paramedics should have.

So out this way, EMS members that want to do the Tactical EMS gig are in our Public Safety Unit.

Usually they are the single paramedic driving the SUV that can get to some calls faster & start getting control of the situation, assist with traffic, or hit some non urgent calls while the ambulance crews are on scene or waiting in hospital. (Or supervisors)

If the police tacticsl unit gets a call, they can wrap up what they're doing & head to where they are needed.(Hard to do if your stuck in an ambulance & have a patient)

A big chunk of their time is spent training & operating with the police tactical boys.


Their uniforms are identical to that of the other tacticsl unit members, the only difference being their vest is clearly marked PARAMEDIC or EMS, just as the police are marked POLICE

(Tacticsl fashion being what it is, I know EPS tactical now goes with a green uniform, and our PSU guys are still rocking their gray)


Obviously they are unarmed out this way also, which sucks but also makes a lot of sense.

We can't expect them to be expert medics, maintain their con-ed, do their paramedic duties, do all their training with tactical, and then also ask them to be experts with service weapons also.

At that point they may as well go be cops, and it would directly violate the whole 'Do No Harm' thing.


(That being said, I do wish they'd be armed with a pistol & expected to maintain a high degree of proficiency with it. Say it can only be used for self defense or whatever -- but if the medics are in the stack thats breaching, being the only empty handed guy on the team kinda sucks)

 

[brihard]

So out this way, EMS members that want to do the Tactical EMS gig are in our Public Safety Unit.

Usually they are the single paramedic driving the SUV that can get to some calls faster & start getting control of the situation, assist with traffic, or hit some non urgent calls while the ambulance crews are on scene or waiting in hospital. (Or supervisors)

If the police tacticsl unit gets a call, they can wrap up what they're doing & head to where they are needed.(Hard to do if your stuck in an ambulance & have a patient)

A big chunk of their time is spent training & operating with the police tactical boys.


Their uniforms are identical to that of the other tacticsl unit members, the only difference being their vest is clearly marked PARAMEDIC or EMS, just as the police are marked POLICE

(Tacticsl fashion being what it is, I know EPS tactical now goes with a green uniform, and our PSU guys are still rocking their gray)


Obviously they are unarmed out this way also, which sucks but also makes a lot of sense.

We can't expect them to be expert medics, maintain their con-ed, do their paramedic duties, do all their training with tactical, and then also ask them to be experts with service weapons also.

At that point they may as well go be cops, and it would directly violate the whole 'Do No Harm' thing.


(That being said, I do wish they'd be armed with a pistol & expected to maintain a high degree of proficiency with it. Say it can only be used for self defense or whatever -- but if the medics are in the stack thats breaching, being the only empty handed guy on the team kinda sucks)

Very similar out here.

I'm on a part time team that fills a variety of different support roles in major operations; basically if you need a fairly organized platoon of guys and girls to throw at a problem, we're on hand, and fairly self sufficient for comms, logistics, command and control etc. One of our tasks is to be a follow on force for a tactical response unit- big threat happens, tactical has to go in and start clearing, we're intended to flow in behind, deal with casualties, prisoners, found-ins, and provide as much of a chain of link men as possible. We also hold the ground they've moved through so that 'green' doesn't go back to 'read'. In the event that a new threat emerges from an area they've bypassed, we're prepared to do an immediate 'active shooter' IARD push into it.

Anyway, with all that as context, I've done a decent amount of training with tactical and the attached tactical paramedics. What I've observed - and this also jives with my former CAF training as an urban ops instructor - is someone like your medic should NEVER be in the stack that's breaching; generally they're hanging one (short) tactical bound back, probably a room or two prior to whatever door or problem is being worked right now, generally co-located with my team's forward element because we're also following right behind tactical and have their members in eyesight.

So, there are a bunch of us, both on the tactical team, and in follow on forces, whose jobs it will be to keep the medics safe to do medic stuff. We'll escort them if they need to move, and will assist with moving casualties out. These are tactical medics, and are in short supply; non-tactical medics likely won't be anywhere close to us. They'll be well outside the objective, and we'll move casualties to them as long as there's still a risk of shooting.

 

[mariomike]

Obviously they are unarmed out this way also, which sucks but also makes a lot of sense.

Obviously.

Did you read any of these 22 pages? ETF paramedics, in our town at least, are not half-arsed cops.

EMS Chiefs of Canada
The Canadian Tactical Paramedic
Training Competency Profile & Best Practices
May 2008
https://www.emscc.ca/docs/TacticalParamedicProfile-May2008.pdf

The Toronto Paramedic Services Emergency Task Force ( ETF ) provides specialized medical care and support to operations of the Toronto Police ETF, and was the first such group in Canada.

CBH99:

We can't expect them to be expert medics, maintain their con-ed, do their paramedic duties, do all their training with tactical, and then also ask them to be experts with service weapons also.

I guess you could ask.
As a paramedic, I would ask, if a prosaic paramedic in our town can make up to $260,000 / yr., why take on ETF reponsibilty, AND IN ADDITION, that of a half-arsed cop, all for an extra $1,000 a year?

CBH99:

Our Public Safety Unit uses them, as does our Community Paramedic Program

Not sure how ours compare with yours,

• Tactical Unit - Cross-trained paramedics providing medical support to the Toronto Police Emergency Task Force.
• Marine Unit - Cross-trained paramedics staffing the patrol vessels of the Toronto Police Marine Unit in order to provide support for Toronto Police personnel, EMS services on the waters of Lake Ontario, and EMS service to the Toronto Islands.
• HUSAR - Specially-trained paramedics operate together with elements of the Toronto Fire Services, Toronto Police Service and Sunnybrook Health Sciences Centre Emergency Physicians to provide a joint-service Heavy Urban Search and Rescue team.
• CBRNE (Chemical, Biological, Radioactive, Nuclear & Explosive) - Specially-trained paramedics operate together with elements of the Toronto Police Service and Toronto Fire Services to provide a joint-service Terrorism/Hazardous Materials Response team.
• Public Safety Unit - Cross-trained paramedics providing medical support to the Toronto Police Public Order Unit
• Emergency Response Unit - Single paramedics in SUVs, tasked solely with response to high priority emergency calls.
• Bicycle Unit - Paramedics equipped with mountain bikes, capable of providing either BLS or ALS services in off-road areas, or at special events. Team also works in concert with the Toronto Police bike team to provide first response capabilities in the Entertainment District on weekend nights.
• Emergency Support Unit - Paramedics trained to operate the service's busses and equipment trucks. These respond to all potential Mass Casualty Incidents (fires, multi-patient car accidents etc...), support for large crowd situations such as festivals and parades as well as responding to all calls involving aircraft at Toronto Pearson International Airport

We have Community paramedics. But, they are not part of 9-1-1 Operations.

Seems to be some interest in the role of ( non-ETF ) paramedics at an ASHE.

https://www.nfpa.org/~/media/files/news-and-research/resources/external-links/first-responders/urban-fire-forum/uff-rescue-task-force-operations-2013.pdf?la=en.

Note: This is a U.S. "Fire-based EMS" source. Thankfully, we are independent. But, the concept is the same in our town, and possibly, or possibly not, elsewhere in Canada.

 

[CBH99]

Obviously.

Did you read any of these 22 pages? ETF paramedics, in our town at least, are not half-arsed cops.

EMS Chiefs of Canada
The Canadian Tactical Paramedic
Training Competency Profile & Best Practices
May 2008
https://www.emscc.ca/docs/TacticalParamedicProfile-May2008.pdf



CBH99:


I guess you could ask.
As a paramedic, I would ask, if a prosaic paramedic in our town can make up to $260,000 / yr., why take on ETF reponsibilty, AND IN ADDITION, that of a half-arsed cop, all for an extra $1,000 a year?

CBH99:


Not sure how ours compare with yours,

• Tactical Unit - Cross-trained paramedics providing medical support to the Toronto Police Emergency Task Force.
• Marine Unit - Cross-trained paramedics staffing the patrol vessels of the Toronto Police Marine Unit in order to provide support for Toronto Police personnel, EMS services on the waters of Lake Ontario, and EMS service to the Toronto Islands.
• HUSAR - Specially-trained paramedics operate together with elements of the Toronto Fire Services, Toronto Police Service and Sunnybrook Health Sciences Centre Emergency Physicians to provide a joint-service Heavy Urban Search and Rescue team.
• CBRNE (Chemical, Biological, Radioactive, Nuclear & Explosive) - Specially-trained paramedics operate together with elements of the Toronto Police Service and Toronto Fire Services to provide a joint-service Terrorism/Hazardous Materials Response team.
• Public Safety Unit - Cross-trained paramedics providing medical support to the Toronto Police Public Order Unit
• Emergency Response Unit - Single paramedics in SUVs, tasked solely with response to high priority emergency calls.
• Bicycle Unit - Paramedics equipped with mountain bikes, capable of providing either BLS or ALS services in off-road areas, or at special events. Team also works in concert with the Toronto Police bike team to provide first response capabilities in the Entertainment District on weekend nights.
• Emergency Support Unit - Paramedics trained to operate the service's busses and equipment trucks. These respond to all potential Mass Casualty Incidents (fires, multi-patient car accidents etc...), support for large crowd situations such as festivals and parades as well as responding to all calls involving aircraft at Toronto Pearson International Airport

We have Community paramedics. But, they are not part of 9-1-1 Operations.

Seems to be some interest in the role of ( non-ETF ) paramedics at an ASHE.

https://www.nfpa.org/~/media/files/news-and-research/resources/external-links/first-responders/urban-fire-forum/uff-rescue-task-force-operations-2013.pdf?la=en.

Note: This is a U.S. "Fire-based EMS" source. But, the concept is the same in our town, and possibly, or possibly not, elsewhere in Canada.

I did read most of it, you bet.

I apologize, I ended up combining my own wishes & bias in with our organization chart & how tactical medics operate within Edmonton metro area - I re-read it and it wasn't very clear.


Our medics are dedicated medics, and don't have firearms at all. AHS would literally have a metaphorical stroke at the very suggestion, and I genuinely don't know if they'd be okay after hearing such a suggestion.

While ours do respond to 911 calls and by all measures are regular EMS members outside of a tactical call-out, they do spend a fair chunk of time with the EPS tactical unit doing the constant refresher training for repelling, ASHE scenarios, etc.

And because those tactical callouts can come at any time, they are usually deployed for their shift with the SUV's.

Our Community Paramedic Program isn't linked with 911 either.

And we don't have any of those other units you mentioned, except for the Support Unit for the specialized vehicles.

(No Marine unit. Our Tactical Medics are with our Public Safety Unit, we don't actually have a separate Tactical Unit. No NBC type unit. No HUSAR.)


From what I've gathered from your training pipeline and application process, you guys do EMS far better than we do out here...

AHS is a bit of a mess, and has a corporate side that is a huge part of the problem.

Shortly after becoming Premier, Danielle Smith made some pretty sweeping changes in some areas of AHS & things genuinely became a lot better in noticeable ways, in short order.

Even with that stuff all aside, I suppose comparing Canada's biggest city with a real waterfront & sprawling geographical area to Canada's biggest small town with no waterfront to speak of & much more contained geographically is a bit silly.

I had no idea Toronto EMS had all those specialized units & capabilities!




Brihard, everything you've described is exactly how our tactical medics train & are employed also.

I totally agree they shouldn't be in a stack thats about to make entry, that spot should be filled by a shooter. Nothing wrong with letting the police go in & deal with those threats first, and coming in once cleared to do so.

That being said, I've seen it happen.

When we had our 'terror incident' a few years back, I was working that night. I stopped to assist various groups of pedestrians who had been ran over (who were all somehow surprisingly okay) once the suspected vehicle had been knocked on its side a few blocks ahead of where I was. (Saw it happen from 4 blocks away or so, and gotta admit it was pretty fricking cool to see even from that distance)

One of our tactical medics was riding in a EPS tactical vehicle that was on scene when they did the vehicle takedown...

Once the suspect vehicle was rocked to its side, all the tactical guys got out & spread out about 20ft infront of the windscreen - rifles up, and ready to fire.

Our tactical medic, not having a firearm, pulled out his flashlight & kept the suspect lit up so his movements would be all the easier to watch...but held the flashlight like it was a pistol


After it was all done & the scene cleared, I complimented him on a job well done & good thinking with the flashlight. His response just made me chuckle, even to this day, and I'm not sure why...

"Between you & me, bruh, one minute we're chatting about this & that...the next minute...like...what the fuck even happened!? I just got out & instinctively reached for a sidearm I've never once had, and felt stupid just standing there with absolutely nothing & everybody else has their C8's out, so I guess I pulled my flashlight so they could see what they were shooting at...didn't even notice I'd held it like that until a few minutes ago..." in like the calmest voice ever


I swear I must've slipped from one dimension to another during that incident, as my sense of time perception on that call makes absolutely zero sense even to this day

 

[mariomike]

I don't believe any paramedic department in any province of Canada is any better or worse than any other. Just different challenges and regulators.

Funding is a big part of it. You get what you pay for.

Prior to deploying an RTF team in this town, threat zones must be identified:

• Hot Zone - Area where there is known hazard or life threat that is direct and immediate. An example of this would be any uncontrolled area where the active shooter could directly engage an RTF team. RTF teams will not be deployed into a Hot Zone.

• Warm Zone - Areas that police have either cleared or isolated the threat where there is minimal or mitigated risk. This area can be considered clear but not secure. This is where the RTF will deploy, with security, to treat victims.

RTF Teams are not to deploy into the Warm Zone unless they have two police officers as security. RTF does not self deploy into the warm zone.

RTF teams will enter the Warm Zone and treat as many patients as possible until they run out of equipment to use, or all accessible victims have been treated. Once this point has been reached, these RTF teams start the evacuation of injured. Additional RTF teams that enter the Warm Zone should be primarily tasked with extrication of the victims treated by the initial teams.

When the RTF is operating in the Warm Zone, no triage will be conducted. All patients encountered by the RTF teams will be treated as they are accessed. Any patient who can ambulate without assistance will be directed by the team to self-evacuate down the cleared corridor under police direction, and any patient who is dead will be visibly marked to allow for easy identification and to avoid repeated evaluations by additional RTF teams.

• Cold Zone - Areas where there is little or no threat, either by geography to threat or after area has been secured by police (i.e. Casualty Collection Points). An area where paramedics will stage to triage, treat, and transport victims once removed from the warm zone.

At least one paramedic ambulance bus will respond to the Cold Zone.

 

[mariomike]

From what I've gathered from your training pipeline and application process, you guys do EMS far better than we do out here...

I had no idea Toronto EMS had all those specialized units & capabilities!

The special units and teams all have their various training programs. Competition is Internal. Some based on "Senior Qualified" others on "Relative Ability".

If you don't mind me asking, what is the "training pipeline" in Alberta?

Only thing I know for sure, is if you know one service, all you know is one service, and its provincial regulator.
Not that any one is better or worse than another. Just different.

To become a PCP, you first have to become an AEMCA - Advanced Emergency Medical Care Assistant.

To become an AEMCA, you must attend a recognized 2-year Primary Care Paramedic program in a community college.

Before you can apply to a college, you must provide proof of the prerequisites:

• Current Standard First Aid (or equivalent) certificate
• Current CPR (Level-C) - Basic Cardiac Life Support
• Senior math, biology, chemistry and English high school courses
• Ontario Secondary School Diploma or equivalent
• Class 'F' Drivers License - Ontario
• Current Immunizations (including Hepatitis A/B, Chicken Pox & Influenza vaccine)
• Be free of all Communicable Diseases
• Be physically fit & able to lift
• Possess good communication skills & be able to fluently read & write English
• Be at least 18 years of age upon completion of the program

Then come the Written Evaluation, Multiple-Mini Interviews ( MMI ), Driving Evaluation, and Sunnybrook Regional Base Hospital Evaluation.

After hiring, you go through the departmental new recruit training system and orientation, preceptorship with a Field Training Officer ( FTO ) and probation. It has changed beyond recognition since I hired on.

For the rest of your career, there will be Continuing Medical Education ( CME ) with the department, and Base Hospital.

To become an Advanced Care Paramedic, you must first successfully complete the 2-year Primary Care Paramedic program, and have a minimum of three years street experience as a PCP.

The Advanced Care Paramedic program is an additional year.

The Critical Care Transport Unit (CCTU) program transports critically ill patients between hospital intensive care units. These critically ill patients are characterized by specialized needs that include:

• A higher level of intensive care.
• Already on a number of medications via IV and infusions etc.
• A higher expectation for deterioration en-route.

There is a four-year Bachelor of Science (Honours) degree program from the University of Toronto.
But, at this time, it is not mandatory.