Hot Zone, Warm Zone

By Michael D. Wright

In 2010, I took over as the director of the Milwaukee (WI) Fire Department (MFD) tactical emergency medical services (TEMS) team. Established in 2005, it was a team without funding, direction, or a voice. As a former paratrooper and a believer of not if but when, we began to cultivate this diamond.

Sell TEMS To the SWAT team

The challenge I saw with achieving buy in began with the understanding that the fractured relationship between TEMS and special weapons and tactics (SWAT) stemmed from a lack of recognition. The recognition is seeing the value of having a seasoned advanced life support paramedic inches away from the point of impact. Making the comparison of emergency medical services (EMS) and SWAT to all Tier 1 special ops teams, such as Navy Seals, Rangers, and United States Special Forces, aided in illuminating the fact that the MVP of any of these teams is “Doc.” Now that it was beginning to sink in, I needed to move to the task of building trust.

Joint TEMS and SWAT training, off-duty outings to build relationships, and a sense of comradery with our law enforcement brothers and sisters made the difference. We are now one.

Into the Hot Zone

The relationship was put to the test August 5, 2012, when we were called to respond to the Sikh Temple shooting in Oak Creek, Wisconsin, a suburb of Milwaukee. What I saw was nothing short of amazing. In conjunction with the multitude of agencies on scene, the City of Milwaukee provided three SWAT teams, three TEMS members, command staff officers, and myself as TEMS command.

All protective services on scene did their job selflessly with honor and courage. In an effort to not overshadow countless proud moments, I just want to highlight two.

Phase two of the operation entailed all law enforcement on scene to physically walk in a line in an open field with high grass to look for additional suspects. The grass was knee high, and someone could be hiding five feet in front of you and you would not see them until it was too late. Not good.

We had five armored vehicles at our disposal. Unified Command (UC), in conjunction with TEMS command, devised a plan to space the armored vehicles out equidistant among law enforcement with a TEMS operator in each to function as an emergency field hospital if the unthinkable happened.

Highlight 1: During the above operation, one of our TEMS operators riding in the back of the armored vehicle with the rear doors open was asked by her SWAT counterpart, “Do you remember how to use this thing?” (referring to his sidearm). She replied, “Yes.” He instructed her that if anyone comes in the rear doors to not hesitate to take it and use it!

For anyone who has ever carried a weapon for a living, the last thing that will ever happen is that you will give up your sidearm to anyone! The bond grew.

Highlight 2: After the lengthy search, all but one of my TEMS members had returned. I called her on the radio inquiring about her whereabouts. She said the armored vehicle that she was in had mechanical problems and was still in the field. I reached out to one of the sergeants on our SWAT team and asked him to assist with the recovery of my TEMS operator. Without pause and almost unconsciously, he said, “You and you, go out and get our TEMS operator!” Bonding complete.

Currently we have one of the few, if not the only, full-time 365/24/7 TEMS teams in the United States. They respond to all high-risk warrants as well as any exigent emergency citywide. Hot Zone covered.

Into the “Warm Zone”

Combining a police department of more than 2,000 officers and a fire department of more than 800 firefighters is a different story. In 2011, prior to the Sikh Temple shooting, I decided to tackle the question, “What would we do when a medium- to large-scale attack occurred in the city of Milwaukee?” Being smart enough to know not to reinvent the wheel, I turned to the most published plan available, the Rescue Task Force (RTF) doctrine from Arlington, Virginia. I was intrigued by the thought of using nonTEMS firefighters and nonSWAT officers to move into the “warm zone” - it made perfect sense. This move would put math on our side. The special teams chief and I worked on a plan, and he scheduled time for it to be presented to the command staff. Unfortunately, it didn’t go well; we weren’t ready yet. The plan was put on the shelf, and I continued to focus on the TEMS team.

Fast forward to June 2013. I was summoned into the fire chief’s office, and there I was met by the chief and the assistant chief. Not knowing the magnitude of the conversation, I inquired jokingly, “Do I need union representation?” I was told to sit down! (I guess it wasn’t funny.)

The chief stated, “I was asked by someone very important what we would do if an active-shooter incident occurred in the city of Milwaukee.” My reply was, “I had a plan that wasn’t very popular in the past.” He inquired and I gave him the summary of the RTF plan. The chief asked me what was wrong with the plan. Confused and slightly frustrated, I stated, “I don’t know.” The next words out of the chief’s mouth changed not only my career but my life! He simply said, “We’re doing it.” Outside of his office, the plan had not magically gained popularity with the membership or the command staff; my heart sunk.

A series of meetings reaching the chief of police occurred, and I was introduced to Lieutenant James MacGillis of the Milwaukee Police Department (MPD). The connection was instantaneous; we were on the same sheet of music and, go figure, I liked him!

Jim and I had a huge task ahead of us: figuring out how to get firefighters and EMS to get over the body substance isolation and scene safety mentality and law enforcement to transform from skilled individuals to “escorts.”

From a fire department standpoint, we knew that we couldn’t just throw our people into the fire without an understanding of why we should do it. We produced a series of videos using the TEMS team and the SWAT team to demonstrate the many facets of the active-shooter response. A montage of scenes from actual events accompanied by the Columbine reenactment video drove the message home.

Our goal was to let our members feel how long minutes can seem in this environment, and I counted on the fact that, as always, we would respond to the call. I was surprised at the level of acceptance from the law enforcement officers who took very little coercing.

The entire fire department was required to log into our distance learning platform and view the videos as well as a message from the chief of the department. In the video, the chief stressed that it was about firefighter safety. We know that our members would want to act when this event would occur, but would they take the correct actions if not properly prepared? This is no different than sending line firefighters into a Level A hazardous materials (hazmat) environment with no training or protection. We would be doomed to failure without the proper equipment and training.

The Preparation Began

As we began to prepare for the actual training, we needed a coalition of experts to not only find the right location but perfect the tactics. The coalition consisted of MacGillis, the SWAT team, and myself. We visited several locations and found a vacant school for the site of the training.

While working on the tactics, we began to consider the logistics. The location had to be in the city, be multilevel, have restrooms, be heated, have functioning utilities, and have adequate parking for the heavy apparatus. Parking was a huge consideration because of the scale and duration of this training. The first location did not meet the needs. Finally, we settled on another school that had a large playground that would accommodate our apparatus as well as squad cars and command vehicles.

The following were very important for the success and security of the training:

  • Secured entrance and exits for personnel accountability.
  • A single entry point and a thorough search of all who entered.
  • Lockers for law enforcement to secure their actual weapons during training. (This is one of the more important points, as an accidental discharge is unacceptable.)
  • External security. Think about it: What is a better target than a school full of “unarmed” law enforcement officers and firefighters? District officers patrolled and monitored the surrounding area for our safety.
  • Door-to-door notifications to the citizens who reside near the school were made. This not only quelled any potential fears of there being an actual event but also gave us an opportunity to engage the public in a positive manner.
  • Choreographed media engagement showing the scale of the training as well as the commitment that we had to protecting our citizens.

The Stage Is Set

All the preparations were complete. We were scheduled to train every day from February to May 2014. It was now day one.

True to form, the first participants began to fill the auditorium of the school and, you guessed it, we sat on opposite sides of the auditorium! Each session we had approximately 60 law enforcement officers and 20 to 24 firefighters.

The moment of truth had arrived and, quite frankly, my knees were shaking. I understood the importance and magnitude of the moment. This could be a historic paradigm shift or a failure that could set us back to square one. We purposely designed a presentation that showed what it looked like if you don’t train and prepare together.

At the end of the video presentation, which showed law enforcement transporting patients to the hospital in squad cars, I asked the following question of several law enforcement officers, “How did that make you feel?” After some coaxing and ensuring them that they were among family, the anticipated response was given, “Proud.” Next, I posed the same question to several firefighters, and the begrudging response was, “Where were we? We feel like we failed.”

Bingo, this was the moment of transformation. We couldn’t let the mood of the crowd remain at this state for long without bringing it full circle.

Becoming a Team

The following points were made to get everyone to function as a team:

Law enforcement: The acknowledgment was made that under the same circumstances we would have chosen to transport the patients in our squad car if we were law enforcement in that situation. But, transporting unrestrained patients who have not been properly triaged without interventions en route to the hospital (although appropriate for the moment) has significant negative effects on potential patient outcomes. Also, if there are any hiccups in the transport, the municipality is exposed to significant potential liability and litigation. (It might not be important to you, but it is to someone above you.)

Fire/EMS: There is no doubt that we didn’t sign up for a few things: (1) being a spectator and (2) running into a situation where the “scene is not safe.” But this speaks to the example previously given. You would not send an untrained firefighter into a hazmat scenario without the proper training. This was no different.

At the end of the day, both professions did what they were trained to do: think on their feet and be a part of the solution, not the problem. They were all heroes in my book.

Once the case was made that we must train together, it was no different than anything else we train for. The goal is to minimize the risk, mitigate the hazards, and put the odds in our favor. Our training had multiple facets that included a refresher for our patrol as well as administrative officers on “contact team” tactics. This was followed by how to become an “escort.” The firefighters reviewed triage and rescue taskforce principles in a classroom setting prior to live scenario training. After lunch, the scenario training began.

One of the most important components of the training was to form UC. Every day, we had the highest-ranking law enforcement and fire officers corralled in one physical location. Each had scribes and radio contact with the forces throughout the school. The beauty of UC is that we worked together to manage the teams. We learned from one another, and lasting friendships and bonds were formed.

The rank and file began the scenario training, which tested their skills in a new environment. The goal was the formation of a joint police and fire/EMS team that takes lifesaving treatment into the “warm zone” and to the point of where the wounded are. We collectively worked out the kinks, asked questions, and got the job done.

At the conclusion of the training day, we always had a wrap-up session with all the participants. We asked the commanders to come to the stage and give us their appraisal of the training. They were all amazed and humbled by the experience.

There were several calculated questions that we asked the participants. For the firefighters: “Did you feel safe during the training?” For every session for the entire training, the answer was “Yes.” For law enforcement: “Do you feel that if you were injured, we would have your back?” “Yes!”

At the completion of day one, a patrol officer approached me as I was speaking to “Car 3,” the shift commander, and stated, “Cap, the next time we do this training, we should use simunitions, because we want to show your people that we would take a round for them!” I must say that was one of the proudest moments of my career, if not my life!

[Oh, by the way, “Car 3” is the same guy (a battalion chief at the time) who was the special teams chief who helped push the concept from the beginning.]

Paradigm Shift Complete

At the conclusion of the training, our policy was finalized, the equipment was deployed, and we began the next chapter. The MPD and MFD had jointly trained together for the first time in history! We now know each other by name, face, and rank. Paradigm shift complete. The future will dictate how we must continually adapt to the threats of the new world. The protective services are on the “frontline” of this war, a war that we didn’t start but are prepared to finish.

Remember, there is no 912; we are all they have. We have a responsibility to prepare.

Michael D. Wright, NREMT-P TEMS/CP, is an 18-year veteran of the fire service and a captain with the Milwaukee (WI) Fire Department (MFD). He started his public service career in 1982 as a member of the United States army. Wright’s career spanned eight years, and he has served as a paratrooper with the 82nd and 101st Airborne Divisions. Serving with the MFD since 1999, he has served as a member of the hazmat team and is licensed as a nationally registered paramedic for 12+ years as well as ACLS instructor, Wisconsin tactical medic, Wisconsin EMS instructor II, and community paramedic. Wright holds the position of mobile integrated healthcare coordinator (MIH), with development and implementation of the MFD “Community Paramedic program” as the primary focus. MFD is committed to serving the citizens of Milwaukee through this new healthcare delivery model. Wright is also the service-director of the MFD Tactical Emergency Medical Services (TEMS) team, the largest team in Wisconsin. He is president of Southeast Tactical LLC and is dedicated to aiding others in navigating the “new normal.”

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