An Ada County Paramedics TacMed Paramedic lets a child try on his helmet.Written By: Bo Madlinger

It’s 4:00 am and I am awakened by a loud continuous beeping sound coming from my phone. It is a text that reads: “SWAT activation..barricaded subject with hostages….370 xxxxxx Dr….TOC (tactical operations command) will be in large lot south of address..need Entry Team, Negotiators, and Tacmed.”

I quickly wipe the sleep from my eyes and sit up on the edge of my bed. I hear the rain outside hitting against my window and immediately plan on wearing extra layers to combat the cold, wet, dark morning. I then begin the process of activating other members of Tacmed and notifying them of the impending mission.

My name is Bo Madlinger and I am the Tactical Paramedic Team Leader for Ada County Paramedics.

This team was created in 1998 in response to an identified need for an immediate medical and rescue element in the Boise City and Ada County Sheriff SWAT teams. Our focus is to increase officer survivability in case of a major life-threatening event and to provide medical care to all subjects involved in the mission.

1. What Does a Tactical Paramedic Do?

Our Tacmed team (tactical-paramedic) has 9 members who have gone through a physically and mentally tough selection process and have become Level II reserve Ada County Sheriff Deputies. This gives us the ability to carry sidearms for defensive purposes and provides a greater comprehension of the legalities involved with law enforcement. We also attend a nationally recognized week long Tactical Paramedic course and have training each month working with our SWAT teams and practicing our tactical medic skills. Tacmed has working relationships with the doctors and trauma surgeons of the St. Alphonsus Emergency Department and we have received specialized training in the care of the acute trauma patient.

Ada County Paramedics TacMed vest and supplies.

2. How Do You Become a Tactical Paramedic?

The selection criteria for becoming a tactical paramedic can be rigorous. The first step to qualify for the testing process is to have experience working as a paramedic and to be recommended for the position by one of our EMS supervisors. The candidate must have shown skill and efficiency in his career with special focus on how he/she has handled chaotic calls involving major trauma. The candidate must have a clean work record with no current infractions. The next step is the physical assessment comprising of 3 events.

1) A timed 40 yd sprint from the prone position while wearing  a bullet proof vest and helmet
2) Dead hang pullups while wearing the bullet proof vest and helmet..minimum of two complete reps
3) A timed half mile run which incorporates a dummy drag of 40 yards and spaced cones requiring the candidate to drop and touch their chest to the ground

The next step involves scenarios based on working out of a medical kit with sensory deprivation, multiple active shooter simulated missions with actual SWAT team members, and an assessment of advanced skills while in a pepper spray filled environment.

After successful completion, an interview is scheduled with the leaders of Tacmed, Boise SOU, and Ada County Metro SWAT. All scores are tallied and a list of names in order of ranking is established. The selected candidate then has all pertinent gear issued to him/her and runs as an extra person on Tacmed missions for one year. During that time, the candidate is to attend all missions possible, be available for a week long Tacmed school, and demonstrate the ability to function in the role as a tactical paramedic.

Ada County Paramedics TacMed Medic

3. What Kind of Emergency Calls Do TacMeds Respond To?

We respond to all SWAT missions involving the Boise Police SOU (Special Operations Unit) and with all missions involving the Ada County Metro team which is comprised of Ada County Sheriffs, Meridian Police, and Garden City Police. Some of the other missions we are utilized for include dignitary protection, bomb dispersal, and the medical element / liasion for federal SWAT teams when their mission brings them into Ada County. Our gear is comprised of digital camo top and bottoms, bullet proof vests with armor, composite military helmets, and special communications gear. We carry basic medical equipment in our vests that allow us to stop major bleeding and to keep a patient’s airway open. We also have a large medical backpack that supplies us with IV fluids, bandages, simple splints, and advanced airway control devices.

It can be a time consuming, dynamic job with little or no notice of urgent missions. Most of our events take place in the dead of night, in all weather conditions, and awake us from a deep sleep. It takes family support and an understanding of the sacrifice of leaving loved at the drop of a hat even during birthdays, holidays, and anniversaries.

It is now 4:30 in the morning. I am standing against a strangers house in the dark with my teammates in a row in front of me. I am being pelted by wind driven rain and can feel the cold begin to creep into my boots. The weight of my BP vest is comforting in a heavy, half-hearted hug sort of way. We are waiting for the “initiate command” to proceed with the mission. I hear the last-minute intel updates filter through my headphones. I check my vest one last time for my tourniquets, bandages, and airway devices. I see in the streetlight that my target house is two lots down on the right. The rain begins to turn to snowflakes and the wind picks up. I hear the “initiate” command given and we take off. I look up one last time taking in the scene, smile to myself, and follow my teammates to the front door.