Valor Tactical Podcast Ep.11 Guest Lt Charles Myles Elite Medical Training Solutions

🎙️ NEW EPISODE — VALOR TACTICAL PODCAST

The Valor Tactical Podcast welcomes special guest:

Lt. Charles Myles

Owner – Elite Medical Training Solutions

Join us as we discuss the critical importance of training first responders to provide lifesaving medical care in high-risk environments and rapidly evolving critical incidents.

Episode Focus

•  Tactical emergency medical response 
•  SWAT medic operations 
•  Officer down rescue considerations 
•  Immediate trauma care under stress 
•  Medical preparedness for patrol and SWAT personnel 
•  Integrating tactical medicine into law enforcement operations 
•  The importance of rapid casualty care during violent encounters 

Lt. Charles Myles brings extensive operational and instructional experience to the discussion, including over 10 years serving as a SWAT Tactical Medic Team Leader with the . His expertise in tactical medical response and first responder training has helped prepare officers and tactical teams for real-world emergencies where immediate medical intervention can save lives.

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Transcript

SPEAKER_02 0:10

Welcome everybody to another episode of the Valley Technical Podcast. In today's uh episode, we have uh Lieutenant Charles Miles here with uh McCann Fire Department, also director and trainer and owner of uh elite medical training solutions out of McCann. So uh today's topic, we're gonna talk about uh why is it important for officers to be trained on uh how to uh provide medicine out on the road for every first responder out there. So, like I keep saying here on my um podcast is that I want to bring in guys that have been doing this for a long time, have a lot of experience, subject matter experts like Lieutenant Charles Mouse here, also individuals that have a background in providing uh medical training out there, and uh and of course making sure what's uh what's the importance out there for law enforcement? You know, what is what is important now? You know, uh what is the main thing here that every fur responder out there needs to know about providing medicine out on the road. So, Lieutenant, appreciate it. Thank you so much, man. Pleasure being here. Appreciate it. Great to see you all the time. So I know that uh you and me go a long ways back, man. And that when you were young, yeah, when we were young, we were young, right? So but uh I uh appreciate you being here in my podcast, you know, all the viewers out there that are watching, so just FYI, you know, uh got viewers from all over Texas, United States, different countries, and so forth. So uh and uh this podcast has reached many people out there, and uh I think that they like the content, and I think that you know they like what we're doing down here in the South Texas border, you know, uh for with local uh law enforcement, but also the fire and EMS. So and that's what's unique, uh that's why you you're here. Uh unique aspect on the other side of that. We usually talk to law enforcement specifically only, but you have a variety of different disciplines, police, fire, and EMS. So for our viewers out there, hey, Lieutenant, just quick bio intro.

SPEAKER_00 2:07

Yeah, uh so Charles Miles, uh Elite Medical Training Solutions is uh basically a business I started about 2016. Um obviously I've known you for a long time. We got, you know, we've been through the mud together with the regional team where I was a tech med team leader there. Uh currently work for my count fire, uh kind of towards the end of my career here. Uh moved into Arson. So as you mentioned, I am uh tri-certified. I have fire, police, and EMS, and so been doing that for a while. About 28 years of experience in the business, yeah.

SPEAKER_02 2:36

Yeah. So so yeah, uh Lieutenant, you know, so one of the things that I've always asked, and now that I travel, you know, I do training full-time all over the state and around the country and uh meet a lot of law enforcement officers. And uh the question always comes up is that uh I I believe that every law enforcement out there, officer out there, the weakest point is always medicine. Because we don't train a lot on the medicine side. We train on high-risk vehicle style, we train on all this other stuff, but when it comes down to providing medicine or you know, to individuals out there, that's probably one of the areas that we don't get a lot of specialized training in. So uh let's talk about that. You know, uh why is it important? Why has it become one of the most important uh training issues that every department, every officer, uh, and skills that every officer needs to have?

SPEAKER_00 3:28

Yeah, so I think what where it kind of comes back from we're history, right? And so we kind of look back uh maybe you know, 10, 15 years ago, and it was, hey, you joined the police department to be a police officer, you joined the fire department to be a firefighter, EMS, and so on. Um, I think what we're starting to see is a mixture of those cultures to where everybody has to know a little bit of everything for that multidiscipline capability of being able to help someone in need, right? And so from like a police officer standpoint, I think a lot of them probably join to be a police officer, um, but not realizing how many medical calls or medical incidents they actually encounter along the way. And so as they find themselves in these situations and they feel, I don't want to say useless, but maybe helpless in that in that environment, um, they start to see that maybe there's a little bit different application of skill set that they can apply. And so we kind of look at that from the medical training side is absolutely, and so I think Tico's done a really good uh piece of that to where they started incorporating some of that, but they do like their 16 hours, that's the minimum for a you know, BPOC or whatever it may be. But when we really look at it, like the medical training, if you're not practicing it and doing it on a regular basis and training it and cross-training it, um, it's just not effective. So it's super important.

SPEAKER_02 4:40

Yeah. So I know that back when I started 1988 and so forth, and uh, we never had any medical training, you know. And I think that the past, I say within the past five years has become a top-tier training issue, and that most agencies are getting there, right? I know the officers have been involved in officer violence shootings and they got seriously hurt and so forth. And uh there was no training kids in the department or in the officers that carried. I mean, we we just started carrying, you know, I said about 10 years ago or so, you know. But explain to our public here what exactly when people talk about medicine training, and I hear all these words, all these acronyms coming around, you know, uh, where does the components or the elements of uh medical training come from and how do how do one acquires it on, you know, uh specifically you on your specialty, right? But one uh I know that people say I'm a basic EMT, I'm an advanced, I'm a paramedic, I'm I'm an EMR. I mean, what exactly are when people talk about that, you know, like I said, I mean, when I go around, people say, well, I'm a basic so forth and so forth, they're like, you know, all right, explain to me what's the difference, you know, how does that work?

SPEAKER_00 5:49

Absolutely. And so I think that's a that's a great that's a great concept, right? There's a lot of ambiguity in in the actual terminology of what this is and what that is. And so if we look at from the state of Texas perspective, and obviously this is just the state, but there's other perspectives across national registry as well. But we look at the EMR, the emergency medical responder, that's like your first responder, like a volunteer that would be arriving on scene. Um, they have that very basic knowledge to be able to start to control the situation for one, and then initial, just the most basic initial assessment and treatment that they can do. Okay. And we start looking at the EMT and the paramedic and advanced as well, advances in there. So it's EMR, advan EMR, EMT, advanced, and paramedic. And so as we kind of move up that that ladder, we start developing more skill sets. Okay. And so the EMT, um, if you look at it from a state's perspective, that's the the most basic level that generally should ride on an ambulance. And I use that terminology, should, because EMRs sometimes can, but uh, should ride. And so what their job is is the most basic pieces, they do bleeding control, they'll help out, but they're really support, and they're support for your advance and your paramedics. And so when you start moving up on that echelon, uh advanced, uh starting with uh some Ivy skills, some airway skills, some basic, uh basic and uh uh allergic reaction type skill sets, and then obviously we move to the paramedic, and that paramedic has a plethora of uh capability skill sets. Uh you're talking about drug administration, EKG interpretation, uh they're getting the ultrasound now in today's world and in the environment of regular EMS and tactical. Yes, they're doing uh blood administration, they're doing a lot of very high-level skill sets that are truly life-saving in the moment when they're needed. And so those are the different levels that we see. Yeah. And we see like other terminologies like uh TECC, which is the tactical emergency casualty care courses, and a lot of that's based from the military. And so one of the good things about civilian medicine versus military is that when we come from a military standpoint, um, we get a lot of educated individuals because we get a lot of research-based information, and we translate that into the actual civilian world, and that's how the medicine really develops.

SPEAKER_02 7:59

So, you know, I I seen a lot of officers, and they always say, I mean, some of the officers, I can tell you that uh we were thinking of cross-training uh our officers back in the 90s, you know, and uh we had a lot of backlash from the law enforcement side, I don't want to be a firefighter, I don't want to be an EMS guy, I want to be a police officer, which is vice versa, right? But then look at where we're at right now. Yeah. You know, if you have no medical training on your side, under your skill set, you're behind the curve. Definitely. Every police officer, because obviously that is paramount. And and uh so from the training standpoint as to uh uh having some sort of basic training, which is the one that typically you as a with a subject matter expert in this area, with all the years of experience and operational experience that you had with our alert team for almost 10 years, you were uh SWAT medic uh team leader there, but also a lot of calls that you responded to and so forth. What is the basic training that you think that you every police officer out there that's watching this podcast can say, you know what? If I want to know some medical training besides the basic first aid, you know, a CPR, first aid, uh AED kind of thing, besides, you know, that basic stuff right there, I can tell you that there's many officers out there that don't even know how to apply a tourniquet. Yeah, that's as basic as that, right? But what is the basic class or training that they should, you know, uh get and and try to uh acquire that in the skill set so they can have a safe common knowledge when they come upon multiple casualties that are seriously injured, that are considered to be either a gunshot wounds or uh to the chest or uh or someone that got shot in the arm or the leg that might be uh you know um have excessive bleeding and and and a lot of loss of uh blood.

SPEAKER_00 9:48

I mean, what is the basic and so there's two ways to kind of look at this. And so um, if you're talking about like for a certification course in like like 16 hours, something like that, something like the regular classes that we go to as peace officers, uh TECC course is probably a uh tactical emergency casualty care course is a really good course. Okay, it's gonna teach uh tourniquet application, bleeding control, junctional wounds, uh it's gonna teach the life-threatening things that can uh you know unfortunately kill someone the quickest, right? And that's how we kind of prioritize stuff. If I'm talking about sustainment and uh development in oneself, I would probably allude to like the EMT. I would skip EMR for a peace officer, not that it's not a good thing to have, but moving into the EMT, a lot of things that we do is we do medicine, right? But sometimes at the most basic level, we don't know why we're doing the medicine. Yes. And so from the EMT's perspective, once you get into there, you actually have to know, you start to learn why you're doing the medicine, which is super important because that actually helps you treat the person. Yeah, understanding what's going on with their body, their pathophysiology, those things uh super important for understanding and being able to do long-term sustainment. Um, so we have a lot of individuals that go through EMT that are peace officers, we you know, running running the business on my side from the adult ed. Um, we have a lot of police officers that come to our program and they love it.

SPEAKER_02 11:06

What do you think they're going to? I mean, is it because they want to have more knowledge of it? I mean, I mean, I can tell that I've attended some of the training and like I'm always, and I tell everybody everywhere I go. My weakest point is always has been medicine. You know, and so if that's my my my need improvement area, and I've been taking a lot of medical classes to understand the medicine side of things more better now that because I think that it's important, you know. I can tell that in every class that I have, I make it a point that, you know, uh there's a component of medicine in that class to make sure that we are uh are training uh how to uh uh provide medicine on the road immediately, right? Life-saving kind of you know response, right? So I mean, but yeah, I mean those are things that I see a lot. And uh, you know, uh why why is it that a lot of these major organizations, you know, out there have decided that you know what, we are gonna be pushing in any training that we do, we gotta have a medical component there or module there. Wait, what is that?

SPEAKER_00 12:07

I can't really speak for them, but I would hope that the reason they're doing it is that they realize that the human life is more important than necessarily any tactic or whatever they could provide. And don't get me wrong, understanding the law enforcement side and being there as well and being through all that, I understand how important it is to complete the mission and all that. But at the end of the day, if someone gets shot or whatever, you want to be just as skillful as that as you are a CQB or whatever it may be used. It's a cross comparison. And so, but the difference is is what's the value of that person? And so I think a lot of a lot of agencies are prioritizing life, which is a super important thing in today's world, and that's what we should really be doing. Um, and so I think they start to see it, and it's from the officer standpoint. I think they see kind of the you know the same thing that you're kind of feeling is that weakness, right? Yeah, and so we want to be as uh practitioners, we want to be good at our job completely as a whole, yeah. And so a lot of uh law enforcement officers find themselves in these situations before EMS or fire arrives, and so they're there and they want to be able to help, but they find that weakness, that that gap, that training gap that they've missed. And so I think they they feel that over and over, and then they start to want to be able to make that difference, and so they get that education and their training.

SPEAKER_02 13:18

Yeah, I mean I was just talking to uh one of my students recently uh came to my one of my CQB classes. You were there in the class, right? So, and he was saying that he got shot responding to uh an arm robbery at a CVS store in a local town, and uh he got shot in the leg, right? And uh they didn't have any tourniquets. Yeah. So they had to um apply a uh a modified tourniquet with uh with a belt. And uh, I mean, uh and obviously that goes to and he he mentioned the fact that you know uh he wishes they had tourniquets there in that department, and uh eventually they did, right? Uh but walk us walk us through uh uh what type of injuries that you know have you seen and uh what what will be the you know the proper uh medical application and the and the injuries talk about people get shot in the limbs, in the legs, you know, on the arms, and then walk us through uh more serious people that get shot on the on the on the chest. You know, I know that you know uh we we talked about some injuries before, but and then also you know uh injuries that also might come upon individuals that respond to a critical incident and not just shoot a response or a type of car or any type of car, which maybe people get shot, you know, uh in the head and so forth. So I mean, walk us through that.

SPEAKER_00 14:29

Yeah, so when we kind of look at the prioritization of life safety, right? And we look at from an injury standpoint, um from a practitioner's standpoint, we really want to address the things that are going to kill the person the fastest. Okay. That's really how I prioritize it, teach it so people really understand it's like, okay, so I have a femoral artery. Femoral artery is a pretty thick vein, or artery, not vein, but artery, right? And so if you get a laceration or a dissection of that, meaning cut. Which is the one that runs down the road. Runs right down the leg, right? That femoral artery. So if it actually gets shot or ruptured or whatever, you're you're probably looking about three minutes before all the blood in your body is out, right? Before you bleed out or exanguinate, is the thing that you're doing.

SPEAKER_02 15:10

And I hear that a lot. I hear that from a lot of people say that you have three minutes to four minutes. How accurate is that time?

SPEAKER_00 15:16

Uh there's research on that. There's plenty of research. That's uh that's gonna be CoA, uh casuality uh for TECC, right? Those are the the individual agencies that kind of regulate that. Those are the military agencies, the research on that. Um they've done animal studies where they'll cut for more artery on a pig, which is very comparable to the human body. Okay. Um, and so they they know that that that bleeding out cycle, that period. So we know that our body roughly circulates our blood volume every two minutes. Yeah, right. And so we know that if we have this big vessel that's bleeding, we're probably gonna drop that blood, at least not on the first pass, the second pass will be the third pass. Gotcha. So three minutes is an average time. Average, yeah. Um, how it's to the person, right? That's one, it's to the the size of the wound, right? How bad it is, how how what kind of caliber weapon? The location of your location, all those things are super important. Um, so kind of going back to that mythology, like we're gonna start with the legs, yeah. Um, arms. So arms and legs are super easy to fix because all we have to do is put a tourniquet on. Now, proper tourniquet application is super important. If you put a tourniquet on and you don't stop the blood and you're still bleeding it, it doesn't, it's not effective.

SPEAKER_02 16:23

So I hear a lot of people, you know, and we train it as well, right? You know, all the trains that we've done is that people say, Well, you're gonna apply a tourniquet within 20 seconds. So where does it you know I know that uh you know uh that's part of the you know what's been implemented there for for a long time, but you know, uh how how accurate is that time also as well that you know it that has uh I'm pretty sure there's history.

SPEAKER_00 16:46

I mean, there's there's uh I'm sure there's some timelines to that. What it really comes down to is making someone proficient in the skill set that they can apply in that timeline. Um, our goal is to keep every single drop of blood in the body for that for that moment. Every single drop of blood that leaves is something that carries oxygen to our body, to our muscles, to our heart, to our brain. So keeping as much blood in our system as possible is the real goal. So that 22nd is that stress inoculation that we can put on someone so that they're working in that environment so that they understand that their goal is to put that tourniquet on as fast as possible, lock it down, and stop the bleeding, which inherently will keep the blood inside the body.

SPEAKER_02 17:23

Yeah. So have you seen that there's also now different types of tourniquets? And I I keep seeing now there's ones that there's like a leg holster kind of tourniquet, you know, uh something that uh will tighten on you, and and even uh uh an arm one that I've seen that also uh it's uh not vocal, but I mean, you know, what what's your what's your opinion on stuff like that?

SPEAKER_00 17:42

So there's there's always going to be new technology being developed. Um what I would allude to from if from an application standpoint is that you go with what is recommended by research and proof of officers. From subject experts as well, right? And so like the we look at the cat tourniquet. The cat tourniquet is the industry recommended tourniquet. Does that mean it is the only tourniquet that's out there that will work? Absolutely not. But can I tell you that there's 10 to 20 years behind it and in generational uh evolutions of that tourniquet and growth? Absolutely. And so I'm not saying none of those tourniquets work because they probably absolutely do. What I would like to see on them is them part uh start uh you know putting out some research papers, some white papers to where you actually know, hey, like this is the research trials that it's been through, this is the applications, these are a positive and negatives of it, and so that we can actually see the the records for it and so you know apply it and say, hey, yeah, this is what we're gonna go to. I think for people just to go to something because it's the new technology, or it looks tactical, it looks tactical, yeah. We always use that terminology. Um, it's not necessarily a bad thing, but it's something that you really need to consider whenever you're you're making your kit. No one, I'm not here, no one's here to tell you right or wrong, it's just how you go about and making those decision processes.

SPEAKER_02 18:54

Yeah, I I think that going-based and uh research-based you know, response is always great because there's a lot of research behind it. So and and uh what what about the injuries to chest and stuff like that?

SPEAKER_00 19:06

Yeah, so once we start moving from the legs, well, you know, these are extremity trauma, and so they're the most effective ones that we can stop from bleeding. Yes. We start to move into our junctional areas, which are going to be like your joints, you know, your hips, um, you know, your buttocks area. Those are a little bit more uh complicated. They require, I'm sure, a lot of individuals in the the cast have you know looked at wound packing and stuff like that. Um, and then we move to the chest. And so we address those in that order because the chest, although traumatic, um what we're really worried about is rupturing of you know hollow organs and stuff like that. Yes, there's penetrating trauma that happens as well, and yes, it can cause uh drastic things inside of the body, um, but like attention pneumo, attention can develop over it generally develops over time. So we look at that, that's like a 10-minute having not hit the heart or something like that, a major vital organ. So I'm looking at 10 minutes versus three minutes, and so those things we address them in lethality, right? How what time what's the timeline? I got three minutes here for this, and I got a you know, a sucking chest wound that's gonna develop at you know five, ten minutes or whatever. And so you start kind of moving down that that corridor of like, let me uh address this in lethality. What's gonna kill them the fastest?

SPEAKER_02 20:16

Yeah. You know, some officers uh now, but years back, we we didn't used to carry any medical training uh supplies with us. Now it's it's a must for every officer, right? Highly recommend it. And I think that you know, uh, and sometimes we're not we don't we're not carrying it enough. I see a lot of officers only carrying one tourniquet, you know, and uh so there's theories of that, right?

SPEAKER_00 20:36

So some of those theories are you know, you're carrying your IFACT individual first aid kit, right? Is from the military standpoint is for you. Um and suppose if you structure it right, all of your officers have their own individual first aid kit that you treat them with. Um that's a theory. On the teams, um, we carried extra tourniquets from the tech med site. We would carry a whole bunch of extra tourniquets. Yes, we had our own individual IFAC, but we'd also carry a whole bunch of extra stuff. Uh it's just how you're structuring it. Um, does that mean if it was an emergency, I would never use my own individual tourniquet on someone? Absolutely not. I mean, I think that's a a tactical decision that has to be made in that moment um in understanding what your surroundings are and what some of those threats are out there.

SPEAKER_02 21:15

You know, I I seen it also because we also do some training on on that stuff, but I've seen also officers, you know, um everything can be done properly when it's everything is sanitized and there's no stress and there's no uh pressure and there's nothing that you know is is forcing them to apply medicine, a medical adjunct during a stressful situation. But I see that you do this all the time is that you know uh now uh applying medical many medical adjuncts during stress during a in a stressful situation, that's probably the right thing to do.

SPEAKER_00 21:53

I mean it's if you are talking about comprehensive training, that's the only thing to do. Um because how How do you validate what works and what doesn't work? Correct. And how do you validate how someone's going to perform in the moment? Yes. Which is probably more important. I can teach a whole bunch of people, oh yeah, this is how you apply a tourniquet.

SPEAKER_02 22:12

Yeah.

SPEAKER_00 22:12

How do you apply the tourniquet under stress? Are you able to, and there's lots of videos that you can go watch on, you know, online or whatever it may be, and you can see where you know that that one or you know that one time a year training, how it affect effectively works in real life, which is not not.

SPEAKER_02 22:26

Yeah, I don't I don't believe it, you know, training one one time every two years or uh or every three years or or one, you know, eight hours, or you know, uh I think it has to be consistent, you know, in order for it to be uh become muscle memory to them.

SPEAKER_00 22:40

Absolutely. And so one of the things that we currently did at uh in McCallan um about a year ago is that for our rescue task force, so all of our uh firefighters have been trained to be able to respond to active shooter incidents and go into the warm zone and be able to start treating patients under protection of law enforcement and our police officers with support, right? Yes, um, and so not in the cold not in the hot zone specifically, but in the warm zone where they have patient treatment while someone's going to contact, right? And so we kind of look at that, and one of the things that we did during that training is we did the stress inoculation piece, and we really caught some people off guard in that. Uh we had real blood uh or we had simulated real blood where they were applying tourniquets, where they, you know, had wounds that were spraying blood, where they had role players that were really good at being able to, you know, have blood on them. And so we saw that bridge of hey, like this is a bloody patient that's reaching out for you, and then that first instant recognition of it where they walk in and they get that that tunnel vision. I was able to create that tunnel vision, that hold. And so I think those training environments are probably the most accurate environments to see how your people are gonna do it.

SPEAKER_02 23:46

Yeah, yeah. You know, do uh EMS personnel when they're responding to this type of incident, they also get tunnel vision.

SPEAKER_00 23:53

Oh, absolutely. I think everybody in their life at some point has gotten tunnel vision. Um, and or gets it on a regular basis. And the way I kind of like to educate it on my my particular standpoint is is like when you start your your vision is this. When you start your career, your vision is very small, right? You can only see what what your body and your mind can allow you to see. I think the longer you go on, the more experience you get, that vision gets really bigger, uh wider, right? And so that that visual acuity starts to open up. And I think the more experience you get, the more reps you get, the more training, the more real life incidents you get, yeah, the wider that vision gets. And so hopefully by the time you got 20 years experience in the business, that vision is pretty wide where you're getting a pretty good snapshot of everything that's going on and understanding what needs to come, and you're able to think in that environment.

SPEAKER_02 24:42

Yeah, yeah. What what have have been some of the serious uh injuries that you've seen out in your career?

SPEAKER_00 24:48

Uh so I mean it started real early for me um in my career. The one that sticks out uh and really why I probably associated with law enforcement was I was involved, uh I was fresh on to a department up north, um, and we went to a double officer-involved shooting. Uh it was uh early morning shift change. Uh, we made the call, we made the scene, and it was two officers that got shot. It was uh a guy that was cooking meth in a van, um, and he ended up getting approached by officers, and the guy fired through the windshield and shot both officers. Uh they both returned fire. Um they both did their their duty or whatever. When we got there, there were two officers on the ground.

SPEAKER_01 25:28

Okay.

SPEAKER_00 25:29

I had patient contact with both of them. We had to make some pretty critical decision-making processes on them. They got shot in the page or so one of them got shot uh several times, three times, one in the throat, uh, clipped his head, and then got shot in the chest and then the leg. That was one of the officers, and the other officer got shot directly in the chest, just above the bulletproof vest. Uh made contact with both of those officers, and we had to make transport decisions on who was going to go in the ambulance, and it just so happened at that time the the helicopter was flying overhead. So we had to make a transport decision on who was going to the hospital. Yeah, prioritize the most serious. Yeah, prioritize who who had the best, and in that case it was not necessarily who's most the most serious, but who had the best chance of living. Yes. And so that's the triage.

SPEAKER_02 26:12

And that's that's those are ethical dilemmas, you know, because you know, even uh we train officers out there and uh and you you know uh you guys doing more than we do, and uh we always you know we use terms such as, well, I mean, uh if he's uh you know uh you know green, he's good to go. If he's uh if he's uh you know uh yellow, red, you know, or black, stuff forget, we start, we start putting all those terms there, and then uh does he have an arm injury, leg injury, chest wound, you know, uh uh junctional wound? Well, I mean who prioritizes and I think that I see a lot of uh the officers hesitating as to or or not hesitating, let me take that back. I see a lot of officers trying to make a decision who's gonna go first.

SPEAKER_00 26:56

Right.

SPEAKER_02 26:56

So where does that come from? I mean, obviously you want to save, because we do it as well, right? You want to save uh the people that you can save, and uh, I think that sometimes officers have that ethical dilemma that, well, what if I save this one, but this one might not make it?

SPEAKER_00 27:10

I mean, yeah. And so um, yeah, and so just to caveat on that story, one of those officers lived, one of them didn't. So that was a that was a tough, that was a tough decision, right? And so that was a very valuable thing for me. Um that's kind of why I transferred into law enforcement. Going into the the triaging, right? Um, I think that's where getting a little bit more education helps from an officer's perspective. I'm not sure that they necessarily have, and so going through having gone through police academy and and seeing the level of training that they get, it's it's you know, it's a one-day like, hey, this is not enough for you. You gotta you gotta make all your decisions based off of one day of training, which we know in reality is probably not the most you know um practical way to make those decisions, right? And so uh the reality is that you're gonna make decisions where uh someone and so someone lives and someone doesn't. Yeah, what I always try to teach our students is you do the most good for the most people that you can. Okay. And if you can keep that in the back of your mind, it's generally a lot easier to kind of make that determination. It's like, hey, this person uh has a wound that's fixable. If I'm spending a lot of time on one person because the wounds are so critical, and there's four or five other people, and I only work on this person, then those other people may die. So I need to make those decisions. That's what triaging is. It's reality making an informed decision based on what they present and how they present, yeah, and then addressing that in an appropriate fashion.

SPEAKER_01 28:36

Yeah, yeah, yeah.

SPEAKER_00 28:37

And so there's different ideas and principles that uh triage them as you first come to them, or you know, uh casual collection points where you put everybody in one place and you and you push them out by uh the level of criticality or whatever it may be, but there's there's different ideas, and so that's just training and practice. Yeah.

SPEAKER_02 28:52

So that anything was a catalyst of you entering the medical field.

SPEAKER_00 28:55

I truly believe it was, and so and so as a there I was a paramedic already, yeah. Um, but it was a catalyst in me pursuing going to tech uh tech medic school, and then once I got over here, obviously reaching out and establishing uh a rapport with the team and stuff like that, and kind of pushing into tech medicine.

SPEAKER_02 29:12

And I always believe that uh operational experience really matters. Oh, it's it's I I can uh you know you can know everything you want to know, but if you have no operational experience, then you wouldn't know if what you know is gonna be applied properly or not, right?

SPEAKER_00 29:26

Or yeah, 100%. Operational experience is it's it speaks volumes until you practice in real life what you're training on, that's not applicable, right? And so, meaning that if you're not doing that, that being involved in those events or in those operations and understanding and getting that elevated intensity of you know the adrenaline and all that kind of stuff and knowing how you're gonna function, you really are an unknown. And so, and we've seen that in our career where we've seen people that, oh, I want to do this, I want to do this, and then all of a sudden you're like, oh, maybe I don't want to do this.

SPEAKER_02 29:58

And so you really don't know into the true, yeah. So, what's your take, uh opinion on uh all these law enforcement agencies now? Uh I was talking to a few of them, uh, you know, training that I've done recently, and we're talking about medical training, right? We're talking about having a uh, you know, we always talk about specialty uh individuals, right? So we say, you know what, every every agency should have out on patrol, a SWAT operator, a negotiator, you know, someone that specializes in certain things because we've seen a lot more critical costs coming up on. But the other thing also is that every agency should have at least a you know uh uh medic in the agency, you know, or someone with some sort of uh training beyond the basic, right? I don't patrol because they're the first ones gonna be there, right? And I think that the first, you know, first couple of minutes, you know, obviously the average response for for law enforcement is always you know uh uh uh about three minutes responding to a uh call. What's the average response on the on the ambulance side? About five to six.

SPEAKER_00 30:58

So I mean they're required by state law to be there and you know under eight fifty-nine or whatever it is, okay, or something close to that eight or eight fifty-nine. Um but yeah, about five to six. Getting out of the station, getting to the call. And so the the piece there that that translation is the cops are already on the road. They have the ability to immediately engage and be on the road where we are at the station, and it takes us you know a minute to get into the truck and then be on the road, and so then we have that transport time. Um so inherently, officers generally will get to that call faster than us.

SPEAKER_02 31:29

Yes.

SPEAKER_00 31:30

Um, and not every call is that critical call where that life that officer is gonna make that life-saving save or whatever it may be, but there is a chance. And as far as your specialty teams and stuff like that, I absolutely truly believe you should have someone that has the medical specialty on your team in some form or fashion, whether that you're doing SWAT or you're doing rescue task force or you're doing you know narcotic search warrants, whatever it is, you need to have a specialty individual there that is dedicated to medicine and good at medicine. Yes, and so that's the other side of that is how are they practicing? Are they just going to school and then they're your medic? Or are they required to do write-outs every so often? Are they required to go have a working relationship with an ambulance company where they go and ride out for eight hours every month, you know, where they can keep their skills current and apply them and use them effectively, you know? Yeah. So those are different, those are definitely conversation pieces.

SPEAKER_02 32:21

Yeah. You know, uh many years ago, back in the 20, 2009, when we created the original team, you know, I had a when I first approached you, and uh I said, you know what, uh, we're gonna do a lot of operations here. I need uh someone that can take care of our guys, or someone that can take care of uh people if we you know uh execute a warrant and someone gets seriously hurt, that I need somebody on scene, and that's enough that's where you come into play, and uh you became our medical uh tac medic there, and you know, for the next 10 years after that, and then you handle all that operations. But I can tell you that we're probably one of we're one of the first agencies or teams that had a medic, tac medic uh guy in our team. So now I see a lot of SWAT uh agencies all over the place, local and state, and so forth. Now they don't road to calls without a tactical um uh uh medic. I mean, yeah.

SPEAKER_00 33:14

I think that's kind of what we talked about, that prioritization of life, right? That prioritization of life, um which is a good thing. Yeah. Um I mean, you're gonna you you're putting your your team, your guys, your employees in this high risk situation. Why would you not give them the best advantage to be successful? And is there a chance that they can get shot? 100%. Do you want to have hands-on medical right then within 30 seconds? We know that the fastest that someone could get there is five to six minutes, and that's if you control a scene, and they don't have their own policies or procedures where they can't make a hot scene or whatever, and so now you're talking about delayed care. So who has the best capability of treating that person in the moment? And that's gonna be someone that you deem medically competent, right? And so there's all different types of names or they're medics or whatever you call them. But in the individual, it's that individual trained in medicine.

SPEAKER_02 34:03

Yeah, I mean, I I've seen it um when I started doing my own stuff with the basic SWAT stuff. I saw um all these medics coming to the basic SWAT, you know. Uh shout out to uh Far EMS out there. I mean, they they send other guys to uh basic SWAT and advanced SWAT, and now they're they're rocking and rolling with uh, you know, DPS and some of these federal agencies. I mean, and they go everywhere. So I mean, uh, they're doing a great job. Same thing, some of the guys up in the far also that they've received uh the SWAT training, and now they're also medics. I mean, they they get a lot of experience that and it's it's always great for me to see that that you know they are they are embedded within the tactical teams because I think that any team out there that you know uh deploys to you know execute a high-risk warrant search warrant and they have no medic, you know, uh in that particular call, they are placing their SWAT operators in danger. Yep. You know, because obviously, you know, that should be a must. That should be a uh a must in every operational plan is that where's a medic, do we have a medic or uh or or you know or an ambulance standby because obviously you know operating without it is never good. Right.

SPEAKER_00 35:11

And I think I think you addressed that a lot in and from the team stake um and standpoint is that we always had a medical plan in place. Um we always did a 206 or whatever it may be so that we could actually have a plan in case something happens and have a transport decision model, have a secondary model to where if you know Medic goes down or whatever, that we had this secondary plan in place. And absolutely right, on what you said, hats off to the individual agencies that are out there that are doing it because it it's not easy and if it's done right, uh it takes a lot of commitment. And so that was one of the things that we always kind of talked about on the team is like, hey, the medics that come onto the team are gonna do exactly what the guys do, meaning that they're gonna do the same PT standard, they're gonna do the same shooting standard, they're gonna do the same training standard, which I think is important. For one, it gives buy-in of the actual team members that they're working with. Yes, and for two, they can fill roles to help support the team. They're not just sitting there, you know, waiting for something to happen, they can fill in other roles, which I think is super important as well. Yeah.

SPEAKER_02 36:10

You know, I did a basic SWAT up in Alice, and uh, we had the Duval County Sheriff's Office there and Caber County uh Jimbos County, Alice P SWAT, you know, also, and uh all of them are running with medics, you know, and uh some of the medics were in the class, and I can tell you that, you know, I'll setting the tone from the get-go, and uh, you know, uh, it's always great, you know, and uh having the tactics also because uh obviously you can, you know, uh we can use the tactical medics for other stuff before they do medicine, right? So many, which is always great because you all can be breachers, y'all can be support elements, stuff like that, which I seen it happen, you know, uh, because there's no medicine to do until it comes, right? But always prioritizing that side, and I think that that's what I see a lot. And I you know, I always recommend people that hey, you know, I mean, you know, I work for this EMS company, I'm uh I want to do uh go to a SWAT class, yeah. I always say great, because at one point or the other, I mean, uh, you know, even if you're not embedded into a team, you're gonna respond to a critical card where maybe there was a police officer that was shot, or a SWAT operator that was shot, or narcotics officer, whatever the case may be. At least you know tactics.

SPEAKER_00 37:18

Yeah, and it's super important. And I think you kind of mentioned a couple things that are are are important to to kind of bring up, which is I think everybody wants quote quote, we'll we'll call it the black patch. They want to, it's tactical, right? Um, and I think that's the team's responsibility to make sure that they fit the mold and and they're embedded and and that they have the capability of doing that and doing the application of medicine. Uh super important there. Um, but yeah, and then one of the other pieces is that I kind of heard you mention is the different roles. And I would just walk through those roles and making sure that you still are prioritizing medicine over some of those roles. Um, I know that there's a lot of people that kind of throw them around in certain areas. So you're talking about maybe a breacher. Yeah. A breacher's, you know, one of the first ones on the door. Is that necessarily where you want to put your your medic? And I'm not saying it's right or wrong, I'm just saying it's thought process.

SPEAKER_02 38:10

But I mean, if yeah, he gets shot, I mean, who's there? Yeah.

SPEAKER_00 38:12

Exactly.

SPEAKER_02 38:13

I mean, you if you put a breacher as a you know, uh tech medic guy, then you're gonna have a have a secondary tech medication. Correct.

SPEAKER_00 38:19

And if you have multiple primary, secondary, you're good. Yeah, you you know, but and it and there's nothing wrong with that, it's just thought process on how you're applying your guys and your resources, and and that's in every operation that we do.

SPEAKER_02 38:29

Yeah, looking at all the you know uh uh at the tactical dilemmas that you might confront, right? So I mean, and um, and I think it's important. And uh so I've seen it uh more recently than anything else. There's a multitude of agencies providing tactical medicine out there. I mean, uh yours including, right? So what should agencies, because I work a lot outside a lot of the police chiefs, and they always ask me this is that who do you recommend? What should we be looking for if we want some medical training for our officers, for responders on the scene? You know, uh we got this agency offering this training, we got this agency offering this other specialized training. What what what should police chiefs, head of agencies, training coordinators of people, even SWAT team leaders and so forth, you know, commanders, if they want training for their uh personnel, what what are the key things here that they should be looking for?

SPEAKER_00 39:20

And so that's a that's a that's a great question, right? And so I will say that every training probably has something to offer, right? Um what I would be concerned with from maybe an administrative perspective is just being able to vet those organizations, vet those individuals teaching that class. Um ask for a resume. What level of training are you? What level of training are you teaching? And and you know, and so you really start to dive into the curriculum, and that's the very hard part from an administrator's perspective with with you know little little uh knowledge base in it, maybe to say, oh well, you know, I don't understand what the difference between an EMR and a paramedic are, right? Or what are their capabilities? And so we always kind of had those conversations on our team, right? But um, I think that's where you find your medical specialist on your team and they start helping you facilitate some of that information. So you find that person that you've either pushed through a medical school medical class like EMT or paramedic or whatever it may be, and you have them help you kind of vet like, hey, okay, this agency's over here teaching it. Okay, well, are they have they are they just educators and they never really have any operational experience? Sure. And like we've we've talked about operations, educators, yeah. I heard that term before, yeah, yeah. And so that's very true, yeah. Yeah, and so operational experience is is one piece, education is another. True. And you have to be able to mix those if you're teaching it. And so I think when you walk into a room, uh, you know, in certain agencies, we call it the sniff test, right? And where you walk in, has the individual done it? Do they do they can you tell that they've done it? And are they are they a vetted individual that obviously can pass that information to you that you think you know it's not about show boating or whatever, it's about actual application of you know the information and getting that information across. So that's the kind of way I look at it. Um, and that doesn't necessarily fit everybody, but it's a it's a good rule of thumb. Yeah.

SPEAKER_02 41:09

So uh I've seen also training that uh say it's four-hour training, two hour training, eight hours, sixteen hours. I mean, I know the TECC, I mean uh different classes, right?

SPEAKER_00 41:18

I mean different structures.

SPEAKER_02 41:19

Yeah, I mean different structures, right, different components, and so forth, but uh, and obviously they all offer different different things to learn, right? So but a good class should have what?

SPEAKER_00 41:31

Uh so a good class is gonna at the end of the day, a good class is gonna the the crawl walk run, right? So the crawl piece is gonna teach you skill sets that you can actually use. The the walk piece is gonna make you use them, and then the run piece is gonna be scenario driven in in uh innoculous environments to where you're being stressed to where you're apple applying the skills. You're gonna learn the most in that that skill set, but you have to have a good foundation, which is that walk piece and that crawl piece. Yes. Um, you're looking for programs that can provide that. If you're looking to try to get that in two hours, not gonna happen. It's not gonna happen. Um, medical skills are perishable, you don't use them, you lose them just like shooting. Uh if you're not using those skills and not training those skills on a regular basis, you're gonna lose them. So uh if you're talking about you are pulling a guy off the line and you want them to go and become a tech medic, at least send them to EMT school and then you send them to a full functioning tech medic school. Yeah, uh that's somewhere gonna be in the round of 50 to 60 hours. The problem is that's a lot of hours for agencies, and I understand that. Yeah, but what's it worth? Yeah, you know what I mean? And so value value what it's worth. What is that individual bringing back? What are you putting on your team that you have now and you have that medical asset? That's one of the reasons why when we, you know, we were doing our hits and stuff like that operations, yeah. Um, is that I felt bad when I couldn't make when I couldn't make it because I I just didn't want any, like it's not that I could control anything. I just I wanted to be there if something happened. Yeah, I wanted to be able to help when something happened.

SPEAKER_02 43:02

But the good thing here is that you you developed some other tech medics that will show up. 100%. And that's what you do. You start building your core. I actually worked in hospitals and stuff like that. Uh guys that that have done a lot of medicine on their side. And uh we we had a uh a great uh you know a group of tech medics there that in the team, you know. Um what what what would be some of the things that uh you know uh the the don't that you come across and like you know uh when we when we see uh some of this medical training going on, because obviously some of these training say you don't want a in two hours I want all these guys trained. I want in four hours I want all these guys. So the the subject matter expertise needs to be there.

SPEAKER_00 43:45

And that's what I would say, right? So we kind of look at police officers, police officers, firefighters, or firefighters, and EMS is EMS. Those very rarely all come together with the amount of knowledge and experience that you can find. Yes. If I want to learn from From uh someone for tactics, I want to go to the guy that knows tactics that has been doing tactics. If I want to learn from someone on medical, I want to guy go to the guy that knows medical, right? And so sometimes those cross. Yes. Very rarely do they cross, but sometimes they cross. And so when you look at that, I would be going towards the person that has the medical knowledge and has the operational experience to be able to provide that training. And that's the most important thing. And current and recent training, right? So you want them to be up to date on their training level as well. Um, and so have they continue to go to continuing education, are they continuing to develop their their you know their individual knowledge base and stuff like that?

SPEAKER_02 44:41

Yeah. You know, the recently I've seen a lot of um agencies, even local areas here, that we get in armored vehicles, right, to uh do our operations and now Homeland Security uh just receive uh you know many you know armored vehicles for their operations as well, you know, uh all the federal agencies, right? But one of the things that, you know, and obviously our tech medics are embedded there, but you know, one of the things that I would like to see is the fact that you know uh our tech medics are a very key component for anything and everything that we do, right? You know, uh, but sometimes they don't roll into an operation, if they're not embedded, they don't roll into operation with armored uh protection, right? So I know that now we know you and we have been talking about this, that uh I think that we're there already, that some of the you know tactical uh medics that respond or assist in law enforcement, they should also have some armored protection there. And I think that there's a elenco puts out a brand new uh was putting out a new uh uh armored um vehicle, it's called a fire cat. So I mean I I think that we you you think that we're there already?

SPEAKER_00 45:47

I absolutely think we're there. Um and so it kind of goes down to specialties, right? So you look at the the fire cat. And they also make uh an Arbored ambulance now, too. Um so Linko's making great products, but if you look at the Firecat specifically, um we talk about fire as a weapon as one of the newest things.

SPEAKER_02 46:04

We've done some training on fire as a weapon, yeah.

SPEAKER_00 46:05

We've done some training on that, and so you look at that like what are your what are your risk variables? How are you gonna mitigate those? And so when we start adding fire to any dynamic of tactical, it becomes very complicated very quickly. Yes, and you have to have those specialty individuals, and so that's where a like you're gonna lean on your fire guys, like, hey, you know, what is a you know dangerous environment? How do how do I mitigate this or whatever it may be? Um, so cross-training, having those those pieces and parts, those applications that you can say, hey, call up whoever, whoever has it, right? Have them come over here and provide this because environments now are unpredictable. Yeah, um, we're getting into all these different environments, fire as a weapon, all these other environments, hostage barricade, those have been going on for a while. But how are you drones? You know, how are we mitigating those tactical dilemmas, as you always said? Yeah, you know, and that's a super important thing that you know you need to be thinking to that next level because it's only a matter of time before you you should have, and like you said, you're you should always have a primary, secondary, yeah, you know, a third, fourth plan, fifth plan in place so that you can actually make uh make that that mission successful.

SPEAKER_02 47:10

Yeah. You know, what's great to see that what you guys are doing there at Mechanic Fire. I mean, obviously all your arson guys are SWAT certified and and you all continue to build that team. And you you're the only agency down here on the fire side that has a full-blown, you know, uh arson team that's trained basic SWAT and so forth and advanced SWAT, right? So, and I think that you know uh that is the approach to take. And you know, uh, you think that other fire departments should do the same thing? I mean, uh I think that talking about, I mean, I can tell the other weakest part of law enforcement is that we don't know how to handle fires.

SPEAKER_00 47:46

Correct.

SPEAKER_02 47:47

You know, I mean, so we when we talk about fire as a weapon, we've seen a lot of the hostage barricade incidents on domestic violence now, they're becoming the, you know, the perpetrators are using fire against law enforcement. You know, I the uniforms that are that we that we were are polyester. So they're no good in the fire, right? So I mean I think that and I know already a couple of incidents which officers being in critical incidents where the uh fire was used as a weapon against them, you know, and uh so uh I I think that you all taking the right approach and and and I think that I would like to see more of that, you know.

SPEAKER_00 48:19

Yeah, we're fortunate at McAllen Fire to be able to have uh the support from our administrators on the ability for our team to grow. It kind of started with the idea and concept of um the rescue task force platform, right? And so being able uh to provide that safety and security blanket for our guys if we're gonna send our guys in and we weren't gonna stand by and we're gonna do the warm zone and be able to start doing patient treatment, which is what all of the the papers and all the white papers and all that say is like, hey, we can no longer stand outside and wait, right? And so we've taken that concept on, and that's one of our principles is that hey, we're gonna go and help people. Um, and so our goal is to be able to provide that security. Obviously, working with other law enforcement agencies to help build and bolster that that group, but at the end of the day, we can do it. And and so, and training with our guys so that they feel comfortable training with police officers and having that and entering and understanding how safe it is. Um that's kind of where it started. Um, and then we realized that we really needed to make sure that our guys were capable. Um, and having had some background in, you know, the SWAT and stuff like that, I thought it was important that our guys were, you know, qualified. And so having onto basic SWAT and sending them to advanced SWAT, I thought those were super important things. Yes. Uh being able to have the pieces of equipment that we have to be able to support that mission. Um reality is our guys are, you know, small eight, nine-man team that work together, train together on a regular basis, that's uh that have some skill sets. And so we love it.

SPEAKER_02 49:46

And I've seen you guys train, I've seen you guys, you know, uh practice uh and implement that, you know. I think it's great, you know, and I think that that's that's a way supposed to be, you know, uh, because obviously uh just think about it, you know, Lieutenant, is that you know uh police and fire, you know, uh we're doing the same thing. You guys are learning tactics, so it can be embedded with us when we go to critical calls. And then the other side of it, law enforcement is learning medicine.

SPEAKER_00 50:15

Yeah.

SPEAKER_02 50:16

So we can go and assist you guys also while we're on scene. So I mean it's uh we are there already. What's important now is that the partnership and the skill says that we need to know a little bit of that. Everybody knows a little bit of everything. Yeah, you know, either or, right? So we we you know, we don't want to be subject matter experts in in multiple fields, right? But I mean we want to know, hey, I want to know a little bit of that. I don't want to be just standing around. I agree. You know, I I don't want officers or SWAT operators just be standing around. I mean, I think everybody needs to know, hey man, hey, can you do this? Can you do this? Can you do that? Yeah, I mean, I think that that we're there. And also on the other side of that, when we respond to a hostage barricade critical incident, I think that what you guys do in there in Mechanic Fire is that now the fire department can be embedded with us. Hey, can you grab the shield? Can you hey can we put the holes in the shield? Can we uh hey attack this fire this way? And I think that it I can tell you that the last advanced squad we had, it was awesome to see that that your guys were 100% invested into it.

SPEAKER_00 51:15

I agree.

SPEAKER_02 51:15

It was great, it was great, yeah.

SPEAKER_00 51:16

And that comes with that working relationship, right? And training together, cross-training. Um, we want to be able to provide a capability that not necessarily would normally be there, right? And so you look at we go back to fire as a weapon as that thought process. Um we're firefighters. Yeah, you know, most of us have been firefighters first in our career before we became police officers, which gives us a different perspective. A lot of the guys on the team are almost all the guys are attendants and tons of knowledge of experience.

SPEAKER_02 51:44

Even though there's always beef, uh, police.

SPEAKER_00 51:50

It's always been like it's so that's the expectation. And so like I would hope I would I would hate for it to be any different. But when it comes to working and comes to doing the mission, there's no doubt that it's one one team working together. And that's that's really important.

SPEAKER_02 52:04

I agree. I mean, I think it's great, and uh, I think that that's that's that's what we're seeing now. 100%. You know, Lieutenant, I I want to thank you for uh coming up to this podcast, man. I think it's great. You know, appreciate it. I think that you know our viewers here have uh a little bit of understanding on the medicine side, medical training side, and I think that it's always great. We don't uh we don't have enough medical training that as as as we should, but I think that you know hopefully it opened the eyes of many people out there that are watching this podcast and uh venture out. You know, I challenge everybody out there that's police or fire. If you police officers venturing to get in some medical training, and you're on the fire side or EMS side venturing to get in some tactics training, and I think that we're there already. I think that you know uh uh we both need each other. You know, we both disciplines need, you know, uh support from each other. And I think that that's probably the the way that we we should you know uh uh uh look at the future now in law enforcement and police and fire is that it needs to be you know uh together. And I think that that's that will make a difference. You know, obviously, you know, uh the whole intent is to uh priority our life, right? Save as many lives as you can. So uh appreciate you being here. Thank you. So uh a few last words for our viewers out there, Listen.

SPEAKER_00 53:17

No, uh I mean I I agree with you. Um uh I agree with you on all everything that's you we've said, right? Working together, making sure that you know we we accomplish that end mission, which is protection of life, right? Yeah um as far as the other side of that, uh you know, anybody out there reaches out, you know, you can contact us at Elite Medical Training Solutions. Um our website is emt-cool.com. Um be happy just to have a conversation with you. I'm not looking necessarily free to sign up, but if you have some questions or whatever it may be medicine wise, feel free to reach out.

SPEAKER_02 53:52

Thanks for everybody for watching.