EMS and Police Cooperation in High-Risk Operations Explored at KnowEMS

Objective and Scope

The primary aim of the webinar was to share and discuss various models of cooperation between EMS and law enforcement agencies in high-risk scenarios. These situations range from large public gatherings prone to unrest, to complex tactical interventions like hostage rescues or terrorist attacks.

Presentations from the Field

Participants heard presentations from several leading EMS systems around the world, including:

• United States: Tactical EMS response and the evolving role of Rescue Task Forces.
• United Kingdom: The HART (Hazardous Area Response Team) model, offering a unique blend of medical response in hazardous environments.
• Spain (SAMUR-PC): The DEPAS teams and their integration with police operations.
• Israel: Magen David Adom’s structured collaboration with security forces.

Key Insights and Themes

The webinar highlighted several key takeaways:

1. Clear Definition of “High-Risk Operations”
   The need for a unified understanding of what constitutes a high-risk operation was underlined. Definitions vary widely—from volatile sports events to armed hostage situations—and dictate the kind of police and EMS response required.
2. Integrated Operations Are Critical
   Successful models prioritize deep operational integration between police and EMS. Simple standby presence—such as an ambulance parked at the perimeter—was cited as an ineffective approach. Instead, embedded, well-coordinated units were emphasized.
3. Roles, SOPs, and Training
   The establishment of clearly defined roles, standard operating procedures, and joint training exercises was identified as foundational. Consistent inter-agency training ensures smoother on-the-ground coordination and better outcomes.
4. Maintaining EMS Neutrality
   In situations involving civil unrest, speakers emphasized the importance of visual and operational neutrality of EMS personnel, to preserve public trust and ensure safe access to care.
5. Dedicated High-Risk Units
   Investing in specialized EMS units capable of responding to diverse threats—from chemical incidents to wildfires—was seen as worthwhile, especially when teams are versatile and interoperable across disciplines.
6. Training All EMS Staff in Basics
   Given that high-risk scenarios can escalate from routine calls, the need for basic tactical awareness training for all EMS responders was highlighted.
7. From Tactical to Routine Care
   The webinar also explored the transition from tactical emergency care to routine clinical care, such as adjusting field tourniquets to pressure dressings before hospital handover, and the implications for triage and patient outcomes.
8. SCENE SAFER Tool
   Finally, the SCENE SAFER model, developed under the No FEAR project, was presented as a personal safety assessment framework for EMS responders operating in volatile environments. It reinforces the understanding that no environment is ever 100% secure.