Miami-Dade Fire Rescue Tactical Paramedic Program: Two Decades in Development

For the past 20-plus years, Miami-Dade Fire Rescue (MDFR) firefighter/paramedics have accompanied the Miami-Dade Police Department's (MDPD) Special Response Team (SRT) on responses involving drug raids and serving of high-risk search and arrest warrants. For the most part, our crews were assigned to the tail end of a convoy consisting of SRT vehicles, officers working under cover, and marked units. Our job was to provide care for any officers injured while carrying out their duties, clearly identified hostages or victims, and any subjects after being placed in custody. Our rescue units would stand by at a safe distance on those responses, but due to the potential for injury, paramedics were not allowed to enter the hot zone until the scene was secured.

Both MDPD and MDFR realized there were gaps in the system. On-duty firefighter/paramedic crews were not being notified of the impending SRT response until 30 to 60 minutes before the actual operation. Since an SRT response could last several hours, the compressed notification time frame frequently caused extended move-ups of crews well outside their primary response zones. This would cause an adverse domino effect with other frontline units that at times affected response times. By providing earlier notification, we would be able to better pre-plan a distribution of resources.

Our rescue apparatus are outfitted for firefighting, light extrication, dive rescue and, of course, medical response. When fully loaded, they weigh about 20,000 pounds, making it difficult to keep up with the convoy and be in place prior to SRTs making entry. If time permitted before arrival, our crews would set up for a worst-case scenario with two large-bore IVs, backboards and trauma kits placed on the stretchers for an immediate response should there be gunshot victims. Occasionally, our crews would arrive at the meeting area only to be told that the convoy was leaving immediately. Personnel would then try to set up while enroute or immediately upon arrival at the scene.

What Was Missing?

Numerous law enforcement agencies across the country, and specifically in South Florida, have had paramedics as part of their SRTs for years. Surprisingly, MDFR and MDPD, two of the largest fire-rescue and police departments in the southeastern United States, had never come to an agreement to establish a tactical paramedic program.

In the mid-1990s, several of our personnel attended SRT training on their own through various agencies both within and outside of Miami-Dade County; unfortunately, this did not lead to the establishment of a formalized SRT medic program. In early 2009, MDPD and MDFR began serious discussion regarding the establishment of a tactical paramedic program and what changes were necessary to ensure success. Tactical paramedics would operate as integral members of the SRT, primarily functioning in a support role. They would function as tactical operators only when acting in self-defense or to protect their team members.

In August 2009, MDFR firefighters were invited to participate in a MDP SRT training course. This was a grueling three weeks that required an eight-hour physical skills assessment and firearms qualification prior to the course, followed by daily strenuous physical training, firearms training, basic rappelling, exposure to chemical agents, water rescue, training in diversionary devices, and victim and/or hostage rescue operations.

The MDPD SRT is widely recognized as one of the best and most difficult to join in the nation. Due to the high caliber and intensity of the training, the failure rate for its average SRT course is substantial. Forty-two personnel (24 police officers from multiple law enforcement agencies and 18 paramedics from MDFR) initially qualified for the course. By the end of the three weeks, only 13 personnel remained to graduate, with eight of them coming from our department. One police officer and one firefighter received injuries significant enough to prevent them from continuing in the course.

The current construct of MDPD's SRT consists of three 10-man teams, with each team consisting of a sergeant (team leader) and nine tactical operators. They provide assistance during the serving of high-risk search and arrest warrants, incidents involving armed barricaded subjects, hostage rescue situations, dignitary and government official protection details, major aircraft disasters, civil unrest and demonstrations, and multiple other scenarios.

What's Next?

The next phase of the program is to have all paramedics who have successfully completed the SRT training become certified as reserve MDPD officers. Several MDFR personnel are former police officers and have retained their reserve officer status; two have remained involved with the SRT program on their days off. Since the 386-hour reserve officer course will take approximately six months to complete, the candidates may be assigned to MDPD on a 40-hour week to complete their training, or a shift-friendly program will be developed letting them complete the training in an off-duty capacity.

Once certified, two tactical paramedics will be assigned to each team. The remaining MDFR personnel not assigned to teams will be required to maintain reserve officer certification by completing 16 hours of ride time with MDPD each month. Tactical paramedics will be issued the standard tactical protective gear provided to SRT police officers. They will be issued the Glock 34 semiautomatic handgun and will be trained and qualified to use the Colt Commando M4 assault rifle and Remington 870 shotgun. All medical equipment will be provided by MDFR.

The Miami-Dade Police and Fire Rescue departments have a camaraderie not generally seen between law enforcement and fire services. Both agencies are working in partnership on multiple programs, but this tactical paramedic training in particular may one day reduce the response time to a gunshot wound, ultimately saving an officer's life.

ROBERT PALESTRANT has more than three decades of experience serving South Florida as a paramedic/firefighter, registered nurse and emergency manager. He is the Miami-Dade County, FL, Fire Rescue Department's first division chief for Domestic Preparedness and has served as the administrative division chief for operations, operations district chief, and director of the Office of Emergency Management and Homeland Security for Miami-Dade County. Palestrant is a member of FEMA USAR Florida Task Force 1, Miami-Fort Lauderdale Urban Area Security Initiative Working Group, South East Regional Domestic Security Task Force and Fire Service Intelligence Enterprise Advisory Group. He has a bachelor's degree in public administration and a diploma in nursing, and is a Florida Professional Emergency Manager and a Certified Emergency Manager.