Urban Shield has grown into a comprehensive, full-scale regional preparedness exercise.
A synopsis of the Urban Shield Medical and EMS Branch
Urban Shield has expanded and for the last several years we have had a separate EMS Branch and Medical Branch. Medical professionals need to be clear on what each branch does so that we can best meet your needs and interests. Some EMS and medical practitioners work in both branches, but clearly not at the same time. This introduction explains the two branches so that you have more information about your involvement in Urban Shield.
The Urban Shield Medical Branch has two main functions:
1. To assess, monitor and respond to “real world” medical problems that occur during the event. While primarily focused on the competing SWAT teams, the medical practitioners and EMS personnel who are geographically spread out throughout the course are often the first on scene to assess and decide the best course of action pertaining to any medical problems. These people coordinate with Urban Shield Command and local EMS to transport patients if need be. The competing SWAT teams are medically evaluated before, during and after the event and are often times “patched up” by Medical Branch personnel if need be to keep them “in the game”. Medical Branch staff work under the Urban Shield medical director. There are fixed and roving medical teams throughout the event.
2. To train and expose the competing SWAT team members in some aspect of trauma care pertinent to law enforcement operations. We have found that during the first 12 hours of Urban Shield, teams are in good shape physically, and need little medical care. This “window” has been found to be a great opportunity to train the teams and share tools, techniques and technologies especially focused on trauma, ballistic injuries and other related topics. This training block is then incorporated into several of the scenarios that the teams will participate in over the next 48 hours. Topics in the past have included tourniquet use, wound packing, chest injury assessment and treatment, medical packs, triage, etc.
Positions available in the Medical Branch include:
Command Staff Support: Supervisory Medical staff for positions in the medical departmental operation center at the EOC. Responsible for medical oversight for all Area commands and participants.
Communication: Medical practitioners who can coordinate medical information with Medical check points/ supervisor and stationary medical providers. Oversee surveillance of all 280 SWAT team participants continuously. Remote telemedicine systems are tested to allow for video remote assessment and communication with Physicians/Medical decision makers.
Tactical Medical Trainers: Educators who are proficient in the Tactical Medical topic areas to be covered. Responsible for providing a tactical medical training block during the first operational period to each SWAT team.
Tactical Medical Evaluators: This position evaluates SWAT team’s competence in addressing medical emergencies in high risk environment under stress. Assignments are at a scenario where teams are presented with a medical situation that needs to be addressed. Data is collected, so attention to detail and high level of competence are needed. Evaluators in Training are welcome.
Supervisor medics/Law Enforcement: Medical/paramedics and Law Enforcement officers are paired up to provide logistic/assessment and treatment in the field. This is a roving position.
Stationary medics/Medical Staff: Medical Check points are strategically placed in four locations. This is an excellent opportunity to challenge medical practitioners in alternate care site placement, set up, logistics and collaboration with many disaster/emergency medical assets.
Logistics: Facilitate all equipment, communication and sustainment needs for the all medical locations and medical command sites.
Shifts are typically 12 hours and all aspects of the Medical Branch
The Urban Shield EMS Branch integrates EMS and other medical practitioners into some of the tactical scenarios that the competing SWAT teams go through. We staff about 150 EMS/medical personnel by scheduling 36 EMS teams of 4-6 “medics” that kick off every hour or so for the 48 hour event. EMS participants rotate through a training block, 3 SWAT scenarios and debrief- all taking about 6 hours in total. Each team has a roving proctor/evaluator who escorts, educates and mentors the group throughout the event. This experience is not a test, but rather an opportunity to work in hyper-realistic, high action and dynamic scenarios with law enforcement; and be able to actually perform infrequently used skills such as mass casualty triage and treatment including needle decompression, wound packing with hemostatic dressings, tourniquet application, chest seal application and advanced airway procedures. Working under law enforcement protection in a warm zone environment is becoming more of an accepted practice for EMS in responding to IED and active shooter events. Urban Shield embraces this concept.
EMS teams (4-6 members) are staged outside of the “hot zone” while the SWAT teams engage the criminals, terrorists and other threats such as an active shooter incident. Once the threat is neutralized, the competing teams then escort and protect the EMS team while they begin triage and life threatening interventions on the casualties. The casualties are either volunteer role players who are moulaged or are high fidelity mannequins where advanced life support procedures such as needle decompression, wound packing and tourniquets can be fully implemented. The EMS teams start by getting a one hour training block then move directly into SWAT scenarios. EMS teams will rotate through 3 separate scenarios (each lasting about an hour) and then come back to the EMS base of operations for a debrief, evaluations and procuring EMS or RN continuing education certificates. The experience of the EMS participants has been outstanding, with feedback being universally positive.
Available positions in the EMS Branch include:
EMS Participants- are EMTs, Paramedics, RN, physicians and any other medical practitioners who rotate through the SWAT scenarios after the training block. This is about a 6 hour time frame. Some people actually go through twice if slots are available. No prior MCI, tactical or any other training is required. EMS CEU and RN BRN are provided. Some agencies send an entire team for a block, but most teams are mixed and have variable medical levels. Trauma focused medical kits are provided for every scenario.
Note: EMS teams are responsible for their own transportation between scenarios. Car pooling is recommended.
EMS evaluator- are either stationed at one of the EMS integration scenarios or are roving evaluator/proctors who accompany each EMS team through all of the scenarios and facilitate the final debrief upon returning to the EMS base of operations. EMS evaluators should have a high level of expertise in trauma care and be comfortable with the law enforcement escort model. An important part of the EMS evaluator's role is to support, educate and mentor the participants throughout the event rather than to be a neutral observer giving comments to them only during the debrief. This is not a test, but rather an opportunity to practice infrequently used skills and work closely with law enforcement in a warm zone environment. EMS Evaluators may need to “plug in” as a medic if the need arises due to a “no show”.
EMS Admin Support- are people who help facilitate sign in/ sign out, CEU paperwork, time line coordination, logistical support, medical equipment coordination, meal delivery, transportation and other critical functions needed for smooth operations.
EMS trainers- are Subject Matter Experts (SME) and educators who facilitate the educational component of the EMS team’s experience. We count on dynamic, knowledgeable and credible educators who can convey pertinent information to the EMS teams within the given time frame.
Role Player- EMS and non EMS people can be role players for the various EMS Integration scenarios. Roles might include “bad guy”, injured/dead casualties, non-injured bystanders, or worried well. Some role players are fully moulaged, and others will have little or no injuries.