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Is TEMS Worth It?

Written by Kelly Sharp

Police administrators sometimes question the value of a Tactical Emergency Medical Support (TEMS) team, wondering if they provide value for the cost. For Vancouver Police Officer and SWAT member Chris Leblanc, the answer is definitely "Yes." In July 2007, while responding to a SWAT call-out with an armed, barricaded suspect who had a developmentally disabled hostage and was shooting at officers, Leblanc went down. Fortunately, the Southwest Washington Regional TEMS team was there.
SWAT was already on scene when the suspect gave them a timeline. He was going to shoot his hostage, cut off body parts, and throw them out the window if they didn't withdraw within the next five minutes. With time running out, Leblanc and his team raced into the home, heading for a bedroom in the back while the suspect continued to fire at them. As Leblanc pushed open the door, he felt the impact of a gunshot.
"When I first got hit I did not actually think I was shot," Leblanc said. In accounts Leblanc had read by officers who had been shot, they always commented on feeling a burning sensation. He felt like the wind had been knocked out of him, but nothing burned, so he was unaware how badly he was injured.
The gunfire continued and the SWAT team moved back into another room. "When we got out of the room I was noticing I was having a much harder time breathing," he said. "It felt like the worst kind of getting the wind knocked out of you. I'm kind of trying to suck in air and I see the other team member stacking up. I pull myself out of the stick and actually put my hands on my knees and try to get a deep breath." He looked at fellow VPD officer and SWAT member John Key and said, "I think I've been hit."
Key grabbed his portable and called out "Officer Down!" Leblanc remembers thinking he was overreacting. "I wasn't 'down', down, I was just standing there having a hard time breathing," he laughed. He still didn't realize he had been shot.
TEMS members VPD Officers Chris Kershaw and Jeremy Free, stationed just outside the back door, rushed in. They covered Leblanc with a ballistics blanket and extricated him out of the house to behind an armored vehicle parked outside, where they were joined by medics VPD Corporal Doug Rickard and Washington State University Police Lt. Dave Stephenson. "They pulled his body armor off and discovered he'd been hit in the armpit, which is every cop's worst nightmare," Rickard said.
Leblanc remembers insisting he was fine, he just needed to catch his breath. As the medics pulled off his gear, he began to feel a 'crunchiness' in his lungs. "I needed to spit," he said, "and when I spit it was just all red blood. At that point I knew I was in trouble."
The medics went to work, each assuming his own role. One started an IV, another delivered oxygen, the third worked to prevent the sucking chest wound from collapsing Leblanc's lung and the fourth assessed for any additional wounds or injuries. They called for the ambulance staged nearby, but it could only get within two blocks because of the ongoing shooting. Instead, two of the perimeter officers had to run to the ambulance to get the gurney out of the back and race it on foot to the TEMS team waiting with their wounded officer.
Leblanc began to worry. He had heard Kershaw say he had found a hole and knew he had been hit in the armpit. "And what do we get taught in the academy?" he asked. "Those armhole ones are like the killing spot. If you're a cop and you get shot there, you're dead. All I could think was that I had a toddler at home and I'm hit in the armpit."
Plus, he could see the reactions of the officers around him. "I'm watching two patrol officers who are on the perimeter who just had this ashen look on their faces. They've just got this look of, 'oh man.' And those two things put that second of doubt in my mind. The look on their faces and the location of the injury."
But even though he knew he had a potentially mortal wound, Leblanc wasn't worried. "In my head I'm going, 'I'm going to be OK' and I think that is extremely important," he said. "You could go the other way, everybody around you could be frantic and freaking out. Even the medics could be frantic. And you are looking at people who are looking at you like you're already dead. But here's the difference.
Doug Rickard is standing in front of me, and he's very calm, and he's very collected and he's watching his guys work. He's asking me these questions, and he's saying, 'A you having difficulty breathing?' 'Yes.' 'Do you feel like you are going to faint?' 'No.' He's going through this list of questions in such a manner that it was very calming."
That is exactly how it is supposed to work, according to Rickard. It is up to the TEMS team to treat the injury and keep the patient calm while the bullets are flying. This can help prevent shock, which could have killed Leblanc as fast as the gunshot wound. "The important part during that contact time is you have one person with that patient, talking to that patient, reassuring the patient that everything is being done." Rickard said. As a result Leblanc remained conscious and oriented, confident in his team's ability to treat him.
Leblanc credits much of his faith in his TEMS team to having seen them treat officers injured in training exercises. "Fast forward, now I'm the one who's shot. There's a confidence there I have in them, and that confidence helped to kind of keep me under control."
This confidence, this knowledge that he was in the hands of medics who knew him and knew how to care for him, kept Leblanc focused. "I went into the hospital and I was actually waving at people. A lot of that I attribute to just the influence of Rickard, and the influence of having professional medics who were competent, confident, and under control at the scene and who knew exactly what to do."
For Leblanc and the member of SWWTEMS, the question of whether or not TEMS is worth it never even comes up.

Kelly Sharp has been a 9-1-1 training officer and dispatcher for 18 years. A speaker and author, Sharp also works with Portland Community College's Emergency Telecommunicator/911 Dispatcher program in Portland, Ore. She can be reached at Kelly@kmsharp.com.

Published in Tactical Response, Jul/Aug 2012

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By Craig Walker, EMT-B

The article was a good war story, but lacked the essence of the title. TEMS is necessary, but other that this one story, why? What about the psychological effect of having a dedicated medical team that is trained to deal with SRT response. I think it should go more into depth about the numerous benefits of TEMS other than a war story.

Submitted Oct 10 at 8:15 AM
 
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