Below see a few items discussed at #dasSMACCforce talk by badEM team member @CraigWylie

Are specialised tactical units the answer?

There has been so much discussion in the media around paramedics arming themselves for self defense. We explored this and actually, attacks on medics occur predominantly in the course of “everyday” work, the granny with the broken hip, the minor motor vehicle accident, the asthmatic case… We cannot safely train every single medic to function at the level of a specialized tactical team.  So if you carry a gun and are not in a specialised tactical unit, you will be a liability not just to yourself but also to your partner that works with you.

Police escorts?

There has been a move towards the allocation of “red zones”, which are areas where paramedics should not enter without a police escort. The question is: Do our local police have the ability to escort our paramedics to all emergencies in these suburbs? With only a couple of police vehicles on duty for a gang-ridden community our police officers are overwhelmed with responding to active shootings, murders and robberies. Ambulances have been known to wait for prolonged periods of time for an escort. Can we accept this as a long term solution considering the massive delay and barrier of care this can cause to the community?

Community Involvement?

Extremely violent gangs have low respect for the police, but if the community leaders and elders speak, the gang members are more likely to listen.  Recently, the western cape government has started initiatives where they are trying to involve neighbourhood watch organizations, during emergencies, to respond to incidents and create a strong community presence to ensure safe entrance and exit from the community.

Watch the below video regarding a community intervention called Ceasefire who analyze interventions by use of shot spotter tool (at times recording >650 gunshots a month in one suburb.). They utilize trained ex-gang members to act as “Violence Interruptors” to prevent gang-related shootings. These interventions are the most powerful and this approach to community based interventions is something we need to consider adopting to prevent ambulance attacks.

Training?

At ER24 we recently implemented a training program that was developed in conjunction with the police services, focusing on situational awareness, stress inoculation while exercising live scenarios like ambush drills and live fire drills. The training does not focus on making a tactical medic but rather to prepare the normal ambulance practitioner on what to do when faced by hostile circumstances. See abstract from ICEM 2016 about the training programme.

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