Dr. Barbara Bass, left, shows Harris County Sheriff Adrian Garcia and Dr. Aashish Shah how to practice airway management on a practice mannequin at Houston Methodist’s Institute for Technology, Innovation and Education. The hospital is helping the Sheriff’s Office conduct training in tactical medicine.
Tactical medicine is like combat medicine, but on the domestic front. Doctors or paramedics receive training that allows them to advance into unsecured locations, and work in conditions that could involve threats such as tear gas, darkness or gunfire.
The Harris County Sheriff’s Office has had a volunteer team since 2010. The tactical medical team often deploys during SWAT events such as stand-offs. The team helped out during the shooting and stabbing incidents last year at Lone Star College campuses.
Now the Sheriff’s Office wants to expand the team and standardize the training. It is creating a five-day compressed curriculum, in partnership with Houston Methodist’s Institute for Technology, Innovation and Education. The idea is to eventually offer the training module to law enforcement agencies around the country.
In a simulation laboratory at Methodist, doctors and paramedics gathered around mannequins to practicing intubation of the trachea. It’s a procedure that’s routine for an ER doctor, but it’s not easy to do in the dark or while hiding from an assailant.
One of the teachers, Dr. Michael Eby, encouraged the men to put aside their intubation scopes and blades and use their own fingers to guide the breathing tube into place. It’s a skill that could be useful in the dark.
“At the end of this they’re going to be doing this on the ground, in the dark, with noise, in a gas mask, wearing body armor,” Eby said.
Eby works in San Bernardino, California, with the police and the air rescue unit. He is also a trainer with the International School of Tactical Medicine.
“Now we’re taking them and asking them to apply their skills in a environment that is a hostile environment, conditions that are under low light, no light and potentially in very dangerous situations,” Eby added.
Dr. Aashish Shah leads the program for the Harris County Sheriff’s Office. He said just sending an ambulance to a scene isn’t always enough, especially in an era when active-shooter events can go on for many hours.
“There are always going to be ambulances and EMS and paramedics around, but their role is not to go into the heat of the battle,” Shah said. “Those folks typically provide care when everything is safe. That is the clock ticking away on somebody’s life.”
Like combat medics, tactical medical teams have the training to advance into unsecured areas and stabilize victims before the all-clear signal is given.
Tactical medical teams helped out last year during the shooting and stabbing incidents at Lone Star College campuses.
Dr. James Wrinkle was one of the men taking the five-day course. He is an emergency medicine physician with the Memorial Hermann Health System. He’s already worked as a tactical medical volunteer for a few years.
He says the conditions are vastly different from working in a well-lit, well-stocked trauma center.
“You’re wearing gloves, hats, helmets, (and) tactical vests which weigh about 75 pounds,” Wrinkle explained. “Your physical limitations are extremely restricted so you have to streamline what you do.”
Harris County will eventually offer the five-day training course to law enforcement agencies around the country, Dr. Shah said. He trained as an obstetrician-gynecologist, then went to law school, and eventually became a sheriff’s deputy as well. Now he works for a non-profit health insurer while also leading the tactical medical team for Harris County.
“The fellowship of medicine and law enforcement is intoxicating,” Shah said. “It’s a great pairing of people, we are to some degree both running on a little bit of adrenaline. We are not timid when it comes to stressful situations, and we both share the idealism of trying to help.”
Shah says the goal is to recruit enough medical volunteers to have a five-person tactical medical team on call at all times: three medical responders and two deputies to protect them.