had thrown his little I believe it was a 380 like little pocket gun into his uh pocket of some gym shorts or whatnot and ends up pulling the trigger in his pocket while he's jumping the fence and negligently discharges into his leg we don't know how many bullets he has left but we know one of them is inside of him they made approach with the Rook did some uh exchange with les lethal and he ends up surrendering at that point in time we take him off the roof welcome to 56 the pelis County Sheriff's Office podcast with me are our co-hosts Ricky Butler and Ashley coie and no one ever does this so since this is my moment to shine probably my last moment ever I'm going to be kicked off the podcast after ruining this I want to give a shout out to our people over here who never get to be on camera um Bren Whipple and Aaron gutus and Ellison Hernandez who uh handle the audio and video and make this podcast look and sound amazing kud yes 100 yes you've neglected that all the time I but you're doing a great job keep going well it's all about Ricky it really is hence me not doing the intro I I could get hit by a bus and then who where who is the voice 56 I mean try not to it ain't me yes it is you might have you're doing this next week or next month oh no I'm not yes you are if I have to suffer you have to suffer today we're talking with tactical paramedic supervisor Joey Greco now SWAT is a lot more than just guys with guns the team has members who specialize in explosive breaching robot and drone operation waterborne Airborne armored vehicle operation and life saving SWAT Medics or tactical Medics are armed paramedics who work and train with our agency on a part-time basis to follow right behind SWAT operators Into The Hot Zone of hazardous call outs ready to save lives or take a life to Save a Life a mandate among Healers of all kinds is first Do no harm for our tactical paramedics part of their training is to know how to do harm when the situation calls for it if I ever get shot there's no one I'd rather see running towards me than Joey Greco welcome to 56 Joey but before we talk about bleeding out and decapitations and burning alive and other trauma let's start with the most traumatic part of the show Ashley's Icebreaker it is not it I have a silly question well now the new part is just doing this intro thing fun but it's not a would you rather okay so all of a sudden all animals can speak they all can speak who is the meanest when when they're when they're speaking correct what species is the rudest the meanest the in Instinct says cats domestic cats but I have to think that through a little bit more M that's a good one I don't think they would intend to be I think it they would just be like honest just straightforward wait let me think oh Dolphins oh my God Dolphins uh I would initially say cats but that is because we have the most exposure to cats doing cat things they really don't care about their owners and things like that but I also know that there's a lot more species and animals we don't know about so something that is misunderstood gets made fun of a lot would be like a platypus so I I would imagine that a platypus could be pretty spicy yeah they're probably holding a lot of resentment in well nobody knows what they are you know and I just think of an angsty teenager that doesn't know who they are so the Platypus is just they swim right mhm yeah platypus you don't even know they swim they look like a duck but they don't lay eggs they're mammals no they do lay they lay eggs they are Mam and they have a poisonous spine on their hind limbs so there it is so I venomous venomous sorry oh my God I would be upset if I was a platypus I'd be mad at the world every day I am mad at the world every day and I'm not even a platypus Joey if cats is taken I'm going to have to go Bears because I think that they would just be completely unbothered by anyone else just railroad their way right through you it's solid yeah I think that I'll have to follow what I've seen in some TV shows that squirrels are just evil there is there is I don't know if it's like legit all the way out yet but there's a video game called squirrel with a gun oh really yeah and it's a it's a normal size squirrel with a hilariously large regularized gun and it just runs you just run around and shoot people as a squirrel I saw it on Tik Tok and I'm like anyway yeah that was the question okay finished it that was good I like it was a good one uh all right so uh Joey Greco what did you say paramedic swap medic supervisor right yes yeah yes so this is the part where we do your uh superhero origin story tactical paramedic supervisor tactical paramedics we I I've been using all the words inter interchangeably so tacm tactical medic SWAT medic what you have a prefer titles a few times okay we'll just we'll just call him Joey uh that's easier because and this it should be noted too that I mean this program has kind of been evolving over the years and and I want to I want to get into that but first uh let's talk about uh Joey where'd you come from where'd you grow up so super interesting right I was born in Morton Plant so all so uh born in Clear Water um grew up in Largo local the whole time um so you know interacting with Sheriff's Office and all the uh local fire departments and stuff with the little touch of trucks and things like that right um basically uh pretty uneventful through high school just uh Sports and things like that and um kind of was thinking military for quite a while mhm and um what what branch were you thinking Marines yeah and uh what really changed that for me personally was um I was already in the uh fire Explorer program at the time with uh with clear water fire having a lot of fun with that definitely but still was thinking more towards uh military side and uh my dad got real sick and uh he had to have open heart surgery and everything and kind of started voicing a lot of um not wanting me to leave the area to you know go and Military and all that um so was Aaron on the side of staying local and stuff and started investigating more like the the medical side the fire side and uh getting more involved with that riding with those guys and stuff and having a good time and decided uh I'll go to EMT school I'll go to fire academy and and kind of go from there and uh was a good decision for sure because it it bought me some more time with him and everything before he passed uh when I was 19 and uh by that time I was already like pretty down the um the rabbit hole of EMS and and having a good time with that and decided to switch paths and cut out the military side of it and go now but you you did the fire Explorer thing yeah I'm interested in hearing more about that that for sure um but but that was I mean you were a fire Explorer still planning on doing the military thing is yeah yeah I was uh just kind of using it for experience at the time and it was defitely like an interest but not what I was thinking my career path was going to be so you know police exploring law enforcement exploring now they're called cadetes under the the current umbrella that they're in uh but fire exploring I don't it hasn't been around as long as law enforcement exploring is that right or it just wasn't as popular I would say probably just not as popular um I know it's been around but um they've they've cut back on it as far as my awareness of the program is and stuff I don't I don't see them as much with the agencies I don't know if it's become a liability thing or what not I didn't even know if they had them anymore CU I haven't I haven't heard about them lately some some of the Departments still have excuse me fire explorers but um how so what was how did you get into that I mean you were always you were always interested in the Fire EMS thing you just said I'm going to do the military thing instead I was yeah exactly I I was just thinking more military kind of the the way I had grown up and family in the military and everything like that and um basically just honestly the way I got into the the fire side of it is I had a buddy in high school and uh his dad was with clear waterer fire and he was in the Explorer program and we're talking about it and was like why don't you come out and check it out s try it and yeah and I went a couple times and was like yeah I think this this might be for me I like it and then as a fire Explorer um you got to ride yeah so we we were able at least back then to ride 24-hour shifts and everything you is Bunker wow MH cool so really uh did you did you follow around or did you get to like participate and fight fires I mean participate within your scope right we weren't making entry on Fires or um you know doing EMT or paramedic level skills but we were running the calls alongside those guys helping cook meals and clean the station up and stuff and kind of learning a little bit of responsibility at that age was was a good thing for high school meh it must been so exciting though at 16 to be able to tag AOG on those those kind of things learn got to jump right in the deep end with it see everything so yeah that um you know you definitely like you're out on the road at 16 seeing things that no one else is and probably going to high school with stories that you probably shouldn't have but yeah yeah it was it was good for me did you have you saw like trauma trauma did you see that yeah of course you like the first time you saw somebody die or somebody injured so my my first um Cardiac Arrest right was was pretty um what most Medics would consider to be like very routine call right but this was as an Explorer as an Explorer yeah so I mean I'm 16 or so at this time right um but yeah just like a nursing home kind of find walk in to check on a patient and find them without a pulse and and all that so um you know I rational that in my brain as expected death and not really was pretty unbothered by that um did they check on you and make sure you were okay psychologically had you know I felt like they probably were like man we got this kid with us like let's you know follow up so the lieutenant in the station um kind of pulled me aside like hey man you good with all this and it's like yeah I'm good like what are we what are we doing for dinner okay he's good it was it was a different time sure as far as like mental health and thought process on that went but I I was legitimately fine with it and you know so we kind of just moved right on but um first traumatic one um some motorcycle versus a semi actually that hit the back of a semi moving probably 120 plus and um no helmet so that was the Smoothie yeah oh jeez and you know kind of similar thing I didn't have all that much life experience yet at that point or a kid or anything like that and I was like all right that's wild but happen cool well nothing we can do just Another Part of Life everything's new when you're 16 so that's yeah yeah so it was you know in my mind at that point it was like job experience you know you're going to see it you know what you're getting into so right for real that's interesting though because that's something that we hear a lot when it comes to life experience that's like super valuable because anytime that we're talking uh to a a community group especially like youth or kids we have kids with the teen Academy we talk about how important life experience is yeah and it's something that's not there so that's why exploring programs like the fire explorers or law enforcement they call them Cadets now are really important because not necessarily in the context of getting to see some of the things but you just don't have anything to draw from and you need to know what you're getting into if you're going into a career like that absolutely whether it's fire or medical or law enforcement if if you get on the job and you've never seen a dead body before you don't know how you're going to react if you've had at least a little bit of a taste of that at a young age you go into it with open eyes yeah I I mean I don't have anything but positive stuff to say about the the fire Explorer program there and everything and uh it it definitely did a lot of good for me um not only from like the EMS side and stuff and kind of knowing what I was getting into and starting to get some experience prior to um what what would end up being my career but also um like just the station Shenanigans and everything and kind of getting just be you know you're 16 getting to be around guys that are 20 30 40 years old and learn from their experiences as well and just all the the talk that would happen in a station and everything you're like oh man I didn't even think that would be an issue thing right so yeah you kind of get to learn from other people's mistakes too so you have that experience fire explorers family you know your father's health things like that so so then you say all right we're going to we're going to go this route so what does that look like at that time what's the process um so for me it was uh you know I graduated high school and took the summer just kind of um by the time I graduated there wasn't openings in the EMT school um slots at that point so I took the summer just kind of took some basic classes that I didn't necessarily even need to just not stop the momentum of being used to school and um started fire academy or um sorry EMT school in the fall and uh powered on through that and actually um overlapped with uh fire academy so I was finishing EMT school as I started fire academy and I ended up going through the um the summer program so it was like the part-time that way I was able to work and everything at the same time and um that was a three-day a week process and going through the summer for fire academy was definitely um not the best but it was you know it was 3 days a week and that was another like learning Growing Experience for sure um just a fun time you know and you kind of like you really in that that zone of just hanging out with the guys every day and doing what you're supposed to be and laughing and joking and having a good time and um just being real physical with it and I I enjoyed fire academy a lot and kind of um brought like another side of my personality out that I didn't really like necessarily was there from not being pushed physically yet yeah yeah um so well just kind of responding to like that um the PT test and and being pushed and actually like really enjoying the challenge and uh kind of just coming out of my shell on that aspect so thriving through yeah finding that that actually liked that and needed that definitely eventually transl SW beginning of a yeah gee I wonder how that worked out so so your plan was to go work for a fire department yeah and in order to do that you have to go you have to have a you have to go to fire academy yeah so you need emt2 do do most people do they get both but because they're separate things I mean if you look around in our County right most of your firefighters are going to be paramedics as well um but back then it was really the majority were EMTs and then you had your paramedic units okay and the EMT stands for emergency medical technician yeah I'm like What's the difference cuz like I feel like people use that interchangeably yeah so it's all scope of practice right and um basically as an EMT they as far as the schooling goes they teach you how to assess a patient um how to recognize major life threats and basically help patients with limited amounts of their medication maybe help them take aspirin if they're having a heart attack or their own like nitroglycerin tablets um their own EpiPen if they're having allergic reaction things like that and take them to the hospital rapidly but as far as actual treatment carrying medications carrying a cardiac mon they you're pretty Limited in that scope okay so a lot of uh EMTs who find that they're actually into medicine will then progress to being paramedics fairly rapidly okay yeah so back then you you had some what we call slick sleaves um and you see guys on the fire side running around with just an American flag on the one side because they had no EMT no paramedic was kind of the old school like just firefighters right um you still see some of that with like FDNY and stuff but for the most part around here that's there there's probably one running around somewhere but that that's a Dying Breed right okay so basically everybody on the fire and the Sunstar side local is going to be at least an EMT okay and then you have your um EMR emergency medical responders which is one level lower than EMT um that Sunstar basically use as drivers for like uh inner facilities hospital to hospital okay okay yeah so on Sunstar there could be EMTs and paramedics or yeah so so most system trucks that are actually responding to 911 is an EMT and a paramedic partnered together okay on on Sor on the ambulance yes and then on a fire trck would be responding that that could be F firefighters who are also cross trained and as either EMTs or paramedics exactly in this County you kind of have a mixture there are still some what we call uh BLS or basic life support ambulances and um fire apparatus running around that will just have EMTs or they may have a paramedic but they only have EMT level equipment okay um whereas ALS means you have a paramedic and they have paramedic level equipment so most units in this count yeah exactly uh we have remember to transl all I know I know a lot got the CR course on it so yeah um so basically there's most of the fire and Sunstar units that are running around actually running 911 calls in this County are going to be ALS predominantly okay so the that's the goal of this system is to get a paramedic to the the patient side pretty rapidly good so fire academy goes well get that done EMT school goes well then you start working or you went do through the process yeah I started working um at sonstar okay and uh as an EMT and initially my thought was I was kind of all in on the fire side um not as much on the medical and uh found once I actually started like really taking care of patients and everything and and being involved in it that actually really enjoyed that part what was it that you loved about it um just the challenge something different all the time right and and even on the fire side I I think somebody's going to correct me but I think the stats on it are like 93% medical calls in this can right so that's pretty much what you're going to do every day so if you're not into the medical side of it like if you're into fight fires you're probably find a different yeah go to Chicago or Detroit or something you know um so yeah I I definitely got hooked on that side of it and this time I was still applying for fire jobs and stuff and I'm you know I'm Mr 19-year-old EMT I'm competing with guys coming back from Iraq and fistan is combat medic like I think I'll be a firefighter and you know they're getting scooped up we're like 2008 recession time and everything oh yeah yeah B time to try to look for a job yeah right so I'm like all right how do I you know continue to grow my uh resume here so I spent a very short stint um over at Hillsboro just doing like the volunteer firefighter thing um exploring that and uh that was that's a long drive to not get paid quite a drive for free and uh like you know the days I'm doing this I could just work an overtime shift over here get a little bit more experience and start you know gunning towards uh getting my paramedic license so that's what I decided to do and um went to uh Hillsboro Community College actually for a paramedic school and um definitely really grew a lot with that and the nice thing with that was um they're a different system right so I was working over here in pelis under our medical Direction and everything and then getting to do my rides over there at all the hospitals in Tampa and and with Tampa Fire and Hillsboro fire and kind of getting to see how they do things and what their protoc calls are and and uh that was definitely an interesting time and and a lot more um exposure to calls and actually like being you know obviously having a preceptor but being responsible for patients and dictating care and um fortunate to have a I had a really good preceptor um that I kind of stuck with the same one the whole time and uh really let me uh grow as a medic and Let Me Drown when he needed to and and figure it out I don't know man you're going to kill this person if you don't figure it out so stress that you know you'll have as as a who's alone in the back with of a unit right and uh instead of just kind of letting you Coast through and and put the hours in and uh so definitely was like really fortunate for that had some more um you know hard calls and everything over there for sure and then uh finished do you remember any of them in in particular oh yeah um so I had one that uh was a group of um kids really like 16 17y old kids coming back from church right and um basically it was a very like dark stormy night um low visibility wet roads and from the best we could tell they weren't doing anything wrong they just slid right off the road and went right into a po look wow and um unfortunately the driver was unrestrained and was ejected and um the passenger in the back was also unrestrained and was ejected into the front seat and hit into the passenger and the uh passenger seat so when we got there um we thought they were all dead and uh quickly determined that the one in ejection was not savable yeah and um so we're we're triaging and everything and we were the first rescue on so it's just you know myself my preceptor and uh the medic that was driving the unit M and um we pulled the one off of the uh passenger seat and uh we thought the girl underneath and was dead and then she starts moving a little bit and we're like oh okay so we we get her out and we start working and everything and uh and transfer care and all that but that was uh you know maybe 20 at this point so that was definitely like a a little bit of a reality track of like kind of identifying with these people a little bit and you're like man look at everything they're going through and they didn't do anything wrong nobody's drunk or you know single car mhm as best we could tell no speeding so but um ejections though those are rarely survivable right yeah so um in this case right they just went head up with a like telephone poll yeah um but a lot of ejections will come from rollovers and actually the way that the cars are designed and everything like if you're seat pelted and the car rolls chances are you're going to be fine like statistically speaking right um they they actually handle really well but as soon as you remove that seat belt um provided that the airbags don't catch you and retain you in the vehicle when you're ejected from the vehicle it's your odds drop to like single digit wow so where your seat Bel yeah yeah yeah no kidding totally yeah long is paramedic school yeah so paramedic school um for Hillsboro's program at least was 11 months 11 months okay yeah all right from uh EMT to paramedic school like the end of paramedic school for me was about a two-year process and took some time off of course um working in between because I didn't want to make that jump from EMT to paramedic without gaining some experience and becoming a good EMT um it's in my mind it's like all right this is you know Step One is let's figure out being an EMT and then we'll take that jump so yeah yeah then what well um then I I patched up at Sunstar as a medic and um spent the next while just figuring out how to be a medic same thing and just you know let's step away from school again and and work that and running calls and uh just growing over there and um then I took a an interesting detour um my wife's family actually got got married in the middle of all that right and how do you guys mean I never did ask you that was it on on the job or no um so I had a friend that I was hanging out with just uh mutual friend and um she met her like two weekends before and uh we had been hanging out a lot just completely platonic and she's like I met this girl that you're going to love like you're trust me you're going to date her and uh my birthday was coming up a week later and she's like I'm going to bring him to I'm going to bring her to your birthday and you have a great time you're going to like this and uh so she did we went out to a club and everything and she brings her out and we met and hit it off and uh yeah I asked her out that night and wow got her number and everything and we started hanging out and started dating pretty rapidly after that and yeah dated for I think almost 3 years and uh then took the plunge got engaged and married so very nice so she was right yeah she was right yeah why why don't I have friends like that that just deliver me the perfect person you guys better up your game well they make apps you know oh well yeah anyway uh so your detour yeah so uh her family is she's from Italy M um and uh they had an Italian restaurant and uh basically um wanted to grow the business and everything and uh we both of us and she so my wife was uh working for Bay Care at the time and uh we both stepped away from what we were doing and and kind of went all in on the family business for a little bit we helped her uh helped them grow the business and uh ended up opening a couple locations and uh we had our kid and uh my daughter who's seven now and uh basically realized that while the restaurant business is fun and lucrative and all that um it is an absolute ball and chain and and when you introduce family into it um that you know little kids that totally complicates everything right because we were like married to the business and uh her parents at the same time were getting to retirement age and kind of wanting to scale back and and step away from that maybe towards like a catering type thing and uh we kind of had a mutual discussion about hey the econom is getting better maybe we should look at selling this business and so that's what we did and uh I was really still being drawn back towards EMS and and medical side in your blood yeah like I was I was not satisfied at all in the restaurant business what what did you do did you on the business side or did you cook or yeah both yeah so like you know small family business you're trades yeah so um what what's your specialty dish so I can't brag too much on my cooking right um I can make a good pizza and uh that's pretty much what I did wrong with that and my wife on the other hand all the dishes um so her and her mom are interchangeable in the kitchen but uh for me yeah Pizza and appetizers and um right Tian with an American twist and uh the restaurant's not there anymore is it yeah yeah so um we ended up selling the clear waterer Beach location and then uh there was one on S key as well that um her uncle actually took over so he still runs he still in the family yeah he what's it called do say the name yeah yeah yeah Alan Stellas okay alen Stell authentic Italian yeah he's over um off uh San Key by The Duncan there okay okay yeah yeah I haven't been there have to get out there what should I order what's the best thing to get sorry I'm going off on tangents but I like I like food yeah I like the the fruity deari um so basically Seafood dish right um pizza's good he's got all the same even though you're not making it yeah even though I'm not making yeah's probably better than I am yeah restaurant was not my forte I had a good time and again learned you know life experience going back to that right learned a lot um about you know how to how to just manage things how to talk to people um and and just interact and uh marketing and and kind of some of that so it it was a good time it was a good experience for sure um but I was also happy to not be doing it anymore came yeah cuz not not anything against that other than um I was just being drawn back to EMS yeah invest a lot in it so it's always there see seeing hear you know seeing s lights and sirens and everything running around I mean it's yeah and my wife um was in nursing school when all of that occurred and and we stepped off and kind of took a pause from our side of it and uh she was really feeling like a pull back towards that so it's interesting that we both ended up in medicine but yeah it uh it was a good time it was a good experience when it was but I was I was happy to not have to be uh working seven days a week with a baby at home anymore and and dealing with that and all the limited sleep and everything that that comes with so yeah but more experience in working under stress and staying calm under stress so right yeah in a a restaurant on the beach on Clear Water beach in the middle of spring break is most definitely stressful a different kind of stress right you know I was used to dealing with people dying and everything and then people are coming at you and the way that they're acting about their dish or their weight time or whatever you're like nobody's dying here what are you feel exactly crazy but did you die you're not worth the $50 just get out so yeah it's I could never do that um okay so you go back to Sunstar yeah so um went right back and uh picked up where I left off right so um I was I went back and uh working my regular shifts and everything and a buddy who was on the team here um I just name drop him Dave Grabowski MH um we were like workout partners and uh he had just gotten on the team he probably been on the team about coming up on a year so on SWAT yeah sorry on SWAT and uh so he was like all in on SWAT talking my ear off about it and I'm like well I'm back at Sunstar I've got time as a paramedic i' you know maybe I'll go for it too and he's like absolutely you should like you you're going to like it you're like and I think just to we got to pause and just to back up a little bit here so what would the the SWAT medic program at the time that we're talking about was uh it was in Partnership it was collaboration with Sunstar yeah uh there were Sunstar employees that trained uh with our SWAT team exactly so it's basically uh Sunstar our employees subcontracted out to the Sheriff's Office um we went through like the Tactical combat casualty Care at the time and uh SWAT school and basically we're tasked with under SWAT um to help with SWAT calls help with narcotics and that was pretty much the extent of it that's about it yeah so paramedic on standby and armor ready to respond out with escort and treat a patient um so and and before we dive into all that because there's a lot there um the paramedic is complicated right so you're school's 11 months and I have a good understanding of uh from my perspective at least of law enforcement e things uh but obviously this is entirely different world so like what are as succinctly as you can what are some of the basics of being a pragmatic because I mean because you learn all this right and then I don't to me it just it's mindboggling that you can go back into your mental Rolodex or hard drive or what whatever is relevant these days for that reference and say oh this is what it is yes so um basically as a paramedic right it's like you're you're expected to somewhat function like an ER physician right you you're showing up to a scene and you're making a determination as to what you think is actually going on and you're just going down that that rabbit hole sometimes based on pretty limited information absolutely yeah so we're expected to make perfect decisions with imperfect information on a day daily basis and easy no problem right do it repeated life and death are on the line yeah so um basically the way that you do that is you you have Physicians who put protocols into place right protocols being a um a road map to that specific incident right so say um you're responding out for an allergic reaction right you have protocols for basic life support and advanced life support that is going to dictate what you do right and you're making a determination as far as what category you think this call is and then you just following that road map so the memory part of it that comes into play is knowing what your Protocols are right studying your protocols and getting to the point where you're proficient with them um but then at that point once you've made a determination based off of the signs and symptoms that you see you just proceed down your protocols right and then if you get to a point where you're finding that you know a certain medication dosage or something is not enough and that you need to push it past that and work outside of the scope of your protocols um or you're in you're into something that they haven't thought of or is so you know exposed as so little that uh they don't have a written protocol for it then that's when we're calling our doctors so basically we've got a online medical direction we can contact over the radio paint that picture of what's going on and uh tell them what you want to do and both part parties get into agreeance with it now you're you're basically working under the doctor's license to uh step outside of the scope of your practice at that point okay so so like kind of what are the basics are there Basics I mean there's uh basic categories per se so what you're going to run right so paramedic school um really your your main function is going to be like categories of trauma um neuro your uh cardiac GI things of that nature allergic reactions um and then we separate obviously the minor differences between adults and Pediatrics as well okay um so you'll have a protocols for all of those in this County it's called our our Mom's manual right our medical operations manual and every paramedic and and EMT is responsible to know what their Protocols are otherwise you know you're showing up to a scene very unprepared right right so so since we're talking about SWAT and we're thinking in terms of trauma can you walk us through like you get a call gunshot wound that's all you know or or shots fired and then there's a person down and you're you're the one there yeah like working the ambulance yeah yeah so um everything like how would you evaluate you get on scene certain things are are no different than law enforcement right you're going to start with your call notes and your dispatch information and uh that's going to be typically very limited and a lot of times wrong right uh not no fault to the dispatchers but just people say things that aren't actually occurring all the time right and um so you you make a decision based off of uh your your response out there um a lot of times on our end we'll be told whether we're going to respond with lights and Sirens or without based off of um what they have and there's actually is like you brought up rod decks um they basically have run cards MH and they ask like set questions and just roll right down and that determines the response right um so for us basically we'll we'll respond out we're mainly starting with seen safety right as far as not putting ourselves in In Harm's Way we don't carry guns on the ambul or the fire apparatus so um determining whether we're going to Stage for law enforcement or just proceed right onto the call and um so you stage you're basically like waiting around the corner until they say no one's going to shoot you you out of sight out of mine but but close enough that if law enforcement gets there and it's you know we need a paramedic right now like you can be there inside of a minute okay um but once we get there right then you're you're basically putting on your protective equipment as far as our for us as standard is going to be gloves um scaling all the way up to all the suits that we were wearing during covid and whatnot and and uh basically start evaluating your patient so you've got your general impression of what you see that's basically we call like doorway assessment okay that initial look at the patient you know and most anybody that's human but especially you know your experienced paramedics and stuff can walk into your room and be like that guy looks like this he's sick right um so is that a technical term yeah yeah in the prot and um you know or he doesn't really look that bad like let's let's kind of give it a minute and figure out get some information and go from there it doesn't mean he's not sick that doesn't mean that we might not find something that we're rushing out of here but we've got a second to figure this out right um and then from there right you're you're basically going to address any major bleeding and on the swad side as far as um trauma right I'll just talk through like the March assessment specifically um so you're going to address major Hemorrhage first right now that's not um cuts to fingers and elbows and things like that that's arterial bleeding specifically right so the type of bleeding that's going to kill you inside of a couple minutes so so if we look remember that the video from uh from Dave stangs yeah that that would be Arial you can see it from the helicopter that's bad yeah spurting out yeah yeah exactly and um so those we're going to stop with um whether that be a tourniquet or wound packing specifically right into the junctional areas so we'll Tate the limbs we'll we'll pack the junctional areas and then we're going to move on through the assessment okay um while we're on a massive bleeding talk about tourniquets a little bit because that that's interesting the the way that they've kind of evolved they used to be you know never use tour unless it's to save the life you're going to lose the limb um and now everybody has them every Deputy has at least one a lot have multiple everybody is is trained in it and it's Tas the thing to do so how did that change yeah so when I started went the EMT school they it was kind of like an afterthought and Trauma of like no we're going to teach you this but you're not going to do it you might as well just cut their limb off at this point you're going to ruin it and um we've obviously found that that's not the case so they were used a lot in World War II and then they scaled back majorly after that because they had so many uh limbs dying off U because of it right and just left on way too long yeah and then it was like a bandage or a handkerchief or something and then you wrap the exactly right and and that carried on all the way really to Afghanistan um so the first deploying units to Afghanistan were going with like you said like bandanas and and cut wooden dowels that were often like made in by their Medics and everything so you've got SF units deploying overseas with like that's that's the line one primary plan which is where we're at right now it's insane to think that only 20 years ago that was that was it right and um they were putting them on and they were finding of course that they were effective um when actually applied properly and uh they were saving lives now something that changed the tourits majorly was body armor right so you've got guys wearing helmets and vests and everything so of course they're taking rounds or damage from from fragmentation and stuff that would otherwise kill them and now the advancements in body armor it's it's leaving the limbs exposed so the tourniquets are saving lives now right and um basically what came out of that is all the commercial devices that you see today where they found that the tourniquet are working and how can we make it faster right because pulling a a handkerchief and a wooden dowel out of your pack isn't the way to go so then you only have maybe 3 minutes right you saw the um like the cat tourniquets that we use now um with the agency as well as like the soft te wides um basically just two competing uh tourniquets from different companies um they really came to fruition and you would see people storing them on the outside of their shoulder straps of their plate carriers and whatnot and they found uh through trial and error overseas that the ultraviolet light can actually break those down and cause damage to them so then they went into the pouches and stuff that you see today where they're a little more covered up but still accessible with one hand right and uh so really the the importance of the data is that you can apply tourniquets um stop bleeding very quickly and leave them on a lot longer than we ever thought right and some of that how long so I believe the longest study that I've read and I wouldn't recommend it right was that one was left up to 18 hours with while they were able to keep the limb with fairly minimal uh damage um that was that one was in Afghanistan and really as far as like we go locally the importance of that is on normal circumstances outside of mass casualty um or just a total disaster we're never going to come anywhere close to that timeline right we're going to have somebody at Bayfront in less than an hour hopefully less than a half an hour um or any other local Trauma Center either by ground or air and they're going to get vascular surgery and some of the best treatment in the country right so um the big takeaway is just don't be afraid to apply a tourniquet in the continental United States really um a few hours is not going to do any damage right and the whole point is you're you're now taking a patient who is going to die with inside of a few minutes right lose Consciousness inside of 90 seconds die within less than 5 minutes and now you're buying them hours we can work we can do a lot in hours you know yeah so that that's the big thing and it it's taken off in law enforcement it's taken off in EMS um when I started in EMS we didn't have commercial tourniquets on the trucks we were wooden out you know the triangular bandage and all that and putting a light or something in there you're like yeah but don't really actually do that and you know all the way to carrying them on the plate carriers and everything even on the civilian Ms side and then they're easy to use they're easy to train right yeah people can self-apply you I get good shot in the arm and just one-handed so yeah we teach the guys um you know set yourself up for success with one hand as well so keeping it in a central location that can be accessed with either hand um and keeping the the time stamp out of the way of the windless so that it's you're turning it you're not turning a one-handed process into a too so actually like the way you have that one set up is is stage just fine but yeah you want to be able to just take it out whip it open and swing it over a limb so our standard practice is you we're going to basically follow a tourniquet up with pain medicine as soon as we get the patient to the point that they're hemodynamically stable enough to give them hody means their blood flow is stable enough yeah so the so basic maybe they're Noto means blood yeah my wife told me to avoid the words like that um so basically that the patient is stable enough that you're not going to kill him with pain meds or um introducing some other movement or anything into that right you've got to have a high enough blood pressure and uh oh okay yeah how theoretically okay so theoretically even if you're you know with a tourniquet on your blood pressure should go back to normal um so it it's all going to be dependent on how much blood you lost right and that's why like one of our biggest things on on the team team is teaching right and teaching The Operators self- Aid and Buddy Aid because if you were to be shot and you get a tourniquet on yourself within 15 20 seconds MH pretty easy day right for us um you've kept a lot of blood in your body and now it's it's externally controlled so you basically with tourniquets it's like you just shut the water off at the house right um and you stop that leak the leak's still there obviously but no water's leaving anymore so we're good no more damage is being done right so now on our end we can get you away from that situation and we can finish fully assessing you see what your vitals are at right treat you as far as if we need to give a little fluid to get your blood pressure up and then get you some pain medicine and get you rolling towards the hospital we're going to do all that on the way take the focus off of this bleeding and work on the rest exactly right so in our world we're just we're stopping timers so the moment you were shot in the limb right and it severed an artery you started a death timer essentially right if the blood continues to leave the body unchecked you die in you know depending on the artery right as little as 90 seconds so we've got a lot less than that 90 seconds to stop that bleeding because you you know so on average normal sized guy's got about 5 lers of of blood in his body so if you figure in in about 90 seconds of bleeding you're you're losing most of that right all right I've got a 30 seconds or less to get this tourniquet on right um before you start to really show signs and symptoms of shock and then the less blood you have the less you're perusing your kidneys and you start this big Snowball Effect that could kill you days later in the ICU bad things happen so we want to stop that fast so if we're waiting to drag somebody out all the way to Medics we're losing a lot of blood in the process if the guys are on point and they're starting a self application a buddy application they're coming to us with a tourniquet on and we can assess that blood loss is pretty minimal we're very happy right because we we can handle everything else on our own that's no problem but I can't put blood back in the body with our current situation which kind of leads to another point but right right and that all started with you talking about um when you arrive on a scene and match was that the acronym March March March so that was Major hem hemorrhaging and then what's after that Airway Airway yeah so that's going to really that's your next timer right so if you've got an included Airway you're not breathing um you're not pulling oxygen into your lungs you only have a certain amount of time that you can make it for that right and we've got a lot more time than we do bleeding you know you hear all these stories about somebody goes crashes a car and it goes into a river and they're drowned unfound for 30 minutes and they get them out you know maybe not 30 but uh you know i' I've heard up to like 16 minutes they pull people out and everything so um you've got more time with that but that's the next thing that we're going to address so um on our end right if we need to if they've got no Airway they're not managing themselves at all they're completely unconscious um you're going to be looking for the like the snoring respirations they call it um or that completely Airway and we teach the operators you know basically start with a a jaw thrust or a head tilt chin lift to open that Airway up similar to like CPR class C class on our end right we're going to start putting basic adjunct in there like an NPA or Opa basically in their their mouth or nose to scoop that tongue up out of the way that's about as basic as it's going to get from the EMT level all the way up to um intubation and catomy for paramedics which that's the is that that's uh word basically cutting into the throat and you see in the movies where you can ball Point pen them in the Thro so we all carry pens that situation I'm ready ready going to be a scalpel cut down and everything and then we're basically putting that same endot tracheal tube that would normally going through the mouth and through the throat if you have such an obstruction to the the main Airway dang yeah okay yeah that's where it starts to get real yeah no kidding so uh and then R so R is going to be respirations right so so you've now fixed the airway youve fixed the way that they actually get oxygen in now you want to assess are they breathing and if so are they getting an adquate amount of oxygen in um so that's more looking at like what the rate is equal chest rise so somebody who was say shot to the chest um and then developing a tension pneumothorax or collapsed lung that's when the and gets and fills up the body chest cavity it's going in between the actual lung itself and the the cavity of the chest and as that builds it's almost like a um like a boa constrictor wrapping around their chest right that air is going to start to form pressure and push the lung out of the way right and as it does that it's actually going to Kink off the heart and all the vessels that run up to it shove them up out of the way and it's like taking a hose and just clamping it and and now none of that blood flow can go so now you you code the patient so then the chest thing what was that the chest um needle decompression yeah so you're just you just you just get stab stuff when it goes out stabbing yeah not just random stabbing very very precise stabbing so then that takes the blood off and the pressure off yeah so um the needle decompression won't evacuate much in the way of blood but it will get all the air out right if the blood is the problem because that that would be a a tension uh hemothorax right okay um then on our end we're going to do uh basically we're going to start a a finger thoracostomy which is basically the medical director is going to hate me for saying this but it's a chest tube without the tube so we're going to create the hole and we're going to evacuate you're basically going to put your finger into their um chest cavity and pull a little bit of tension and evacuate that blood out of there and then we're going to seal it with a chest seal now when they get to the ER they can just feed a chest tube up in there seal that process off and drain them with the chest tube dang you just get to stick your finger right up inside somebody and yeah not without risk right um shots to the chest creating uh fragments of rib and things like that can uh put the the first responder at risk as far as cutting their he's processing this still but you would all so but I'm you're talk cuz I was thinking if you get shot in the chest or whatever if you sticking anything up there could impact whatever is still stuck in there right I mean or is that like if you get shot and the bullet creates a hole you're making a new hole right yeah so okay okay so we're growing up in here real without going in too much till we're going up real high in the ribs okay so you're not going that cavity yeah and basically you're feeling that texture of of you're only cutting just through that plural space in between the the ribs MH enough of an opening to get in there yeah Ricky's ready just to stick his finger in the Bullet Hole and wiggle it around until he helps that should be good enough screaming through the whole thing Joey told me to do I listen to this podcast once and it just said stick it in you know no um yeah I uh wow okay what's the next letter c c yeah so circulation um so that's when we're looking at skin color temperature condition uh we're checking pulses right so radial pulse uh good rule of thumb is the blood pressure is going to be right about 90 give or take um that's not 100% but they're perfusing everything right so all their organs that are sensitive to lack of blood flow and oxygen they're getting blood and oxygen um if we don't have that right then on our end we're going to look at uh IV or or IO which is um I'm sure you guys have seen or heard about where you're drilling into the bone um if you can't get IV access to get fluid right so um that's I not heard about drilling into the bone oh we can't get into your but just get to drill into your bone yeah there's a lot of YouTube on it there's guys on YouTube doing it to themselves which is crazy but um apparently the drill it's I haven't experimented with this myself and don't intend to but um the drill itself and the needle into like your your tibia um actually doesn't really hurt it's when you push the fluid through and you push that marrow out of the way that uh yeah they off the bed oh what kind of drill you like DeWalt or so it's all uh easy iio it's called it's like a little red drill um it's all you know how medicine is it's all all right because it's medical it's expensive and yeah yeah it's probably why would you do that to yourself um to teach yeah mostly army guys I've done it to myself so I can you know teach you how to do it yeah oh there's videos all over YouTube it's pretty wild but we'll have to look for that after I watch a little more squirr content yeah so on the SWAT side right just kind of a off topic but to save weight in our backpacks is is a big consideration we don't carry the drills we just carry the needles so then at that point you're just hand boring it in oo which is yeah is another experience entirely You' done that before yeah so part of our research every year we have to um so we we do it on like cadavers andb all that um and then never been the practical applic yeah uh so yeah I mean that's good for a lot of people probably well for me right I wanted to to try it um so you know cardiac arrest and stuff and let's play an IO all right let's try and handbo it and see you know how how is it on not aever and which bone is the so you can do a few sites um one of our primaries is going to be in the tibia okay U mainly because it flows really well and it's out of the way of everybody else's trying to work on the chest and and Airway um you can also go into the humoral head up here which is nice cuz close to the heart um but yeah it's kind of dealer's Choice sometimes right best site you do some things that probably give all those tough slot operators Willies I mean they probably can't watch half of the things how do you know when you're in like on a like is there a certain distance you have to go in or so Landmark um it's going to be Universal on everybody and uh once you're in that proper Landmark right you'll feel it set um you can feel the difference between when when a needle's in bone versus Muscle um and then basically we're actually going to hook up like an i normal IV flush and and pull a little bit and you'll see the marrow actually return I think you'd have to put a tourniquet around my neck if you're going to do that to me so now typically we're not doing this on conscious patients if we are we're pushing a medicine called lie through that's going to numb the area that's okay yeah that's okay that makes all right yeah and Fentanyl I want fentanyl if you're doing this too yeah please all right so what's next H H yeah so um did you forget for a second yeah I was like you looked at the ceiling we never make it they die before I get we're way down the uh the rabbit hole and ios's here yeah are yeah so hemor uh hypothermia and Heat injury right or let me back up here yeah head injury and hypothermia okay um so basically we're going to keep the patient warm um and I know that like we'll explain this to people the first time that they're going through our classes and stuff and they're like looking around like it is 100 degrees outside what are you talking about um so you will not clot if you're cold and basically when you bleed right you're losing you're losing more volume and you start to get colder regardless of ambient temperature so we're going to wrap the patient up after we've addressed everything keep them nice and warm and monitor that right that's like you know on the way to Bayfront we're going to be heat blasting in the Sunstar unit sweating our asses off and uh wrapped up in blankets and all that so that we're doing everything we can to get this patient to clot and then uh we're going to address head in injuries at that point in time right so that's like your your patient's mental status and taking that helmet off you know maybe when they got shot they fell backwards and held their head on a countert top or the ground or whatnot um and and addressing all that now is that throughout this is this all before getting in an ambulance yeah so this is all going to occur in less than a minute so this is um wow if you're just running through this assessing M your assessment is going to take less than a minute it's when you start having to really go down rabbit holes of fixing things that it starts to slow things down because we're not going to move on to the next timer until we've stopped one got so if we're stuck addressing an airway with a cke all obviously that's going to take a little bit of time to accomplish and you're going to knock that out before you're moving on to your respirations gotcha but still even even if that's the case and that's what you did and let's say they also have a head injury you're not in the ambulance yet when you're at that h mark no it it's all dependent on if your transport unit and everything is already there right then we we would do a very quick run through of all of that addressing life threats get them in the back of the unit and start moving and anytime you move your patient you w't obviously reassess everything so we're going to start right back at the top and roll right back through it now the thing that changes that is obviously your your M your massive Hemorrhage now is just going to be assessing did my tourniquets pop loose when I moved this patient does anything need to be readdressed or something shift around which shouldn't take much time at all right you've already mostly addressed and then you're just moving on you're confirming your Airway again and so on and so forth yeah got all right that way you're not you know 30 minute transport to Bayfront meanwhile they're bleeding out on the stretcher the whole time and you didn't notice yeah that's yeah that makes sense that would be embarrassing yeah yeah no we got him but he's dead yeah okay so um we have to go back to the SWAT tryouts yeah well we can go back to the SWAT thing now so so uh your buddy somebody you know your workout partner is talking about SWAT doing this thing and then you decide all right I'm I'm going to do it what does that look like um that looks like August o oh you do every hard thing in the summer yeah so I I picked yeah I picked the worst possible uh year I don't think we've ever had one in August since um so that was yeah they always been in April since I've nice pleasant April so and I it's actually funny um Sergeant Johnson Mike Johnson on the team uh was trying out to come back and uh I didn't know anybody you know other than Grabowski who was a pretty Junior medic at the time and and I show up I got my workout stuff on I got one Zephyr Hills bottle of water and uh Mike looks over at me and he's like holding the gallon of water he's like you can have some of mine uh that's not going to be enough and I'm like I thought we'd have a chance to fill it back up he's no and then it was just full sun the rest of the day but overall I had a I had a good time at tryouts it was again it was fun it was challenging it's long and intense so I want you to tell us I I was out at one of Ashley and I were out at one of the um the swap medic Tri outs and it's the things you guys have to do marathon and then rescue somebody's life save somebody's life so run us through that what the day looks like so um there's a uh warmup in the morning um which I just have to say like 20% of the people drop out during the warm-up when I was there is is that typical that's yeah that's 100% typical um and what's in that warm-up I know there's like so calisthenic movements yeah right um push-up sit ups squats burpees flut kicks hello dollies what is a Hello Dolly Hello Dolly is uh kind of the opposite of a flutter kick legs go in and out right um different muscle groups and uh yeah it's the warmup is is a smoker really um and uh I think what gets people in in the warmup is more the um not knowing when it's going to stop right you're not the one that's counting their reps um and I mean without deol's going to read through this anyway so uh without giving too much away right it's like yeah we're not going to do 10 reps you know you might think you're going to do 10 reps of something very hard but we're going to do 12 just to mess with you just so you're like oh yeah wait 11 like he didn't and you see and you just see people's faces totally change like yeah just take their soul you say that right and they're like oh my God I can't do 15 or you know you take them to 16 or you take them to 28 random numbers just to mess with them and it's funny and um for you not for yeah yeah maybe yeah maybe not when I tried out but honestly I had a good time with it um I was looking for that challenge maybe had like a little chip on my shoulder and um and I got it for sure and uh so yeah after the warmup you get a little bit of time to decompress and then everybody starts running one at a time and that's where really like they're looking in the warmup for you to come together with your your potential teammates um and to be loud and really get out of your shell and uh which going back to earlier right um we're holding a front leaning rest a top push-up position and everything the mo the worst most misnamed thing there is no rest about that and they just write down the line tell me something about yourself we don't know right and uh Josh Jones was leading PT he's like tell me something we don't know about you and I was like I owned a restaurant and it completely caught him like he's like what mhm so yeah that was a a little like fun fact that I think I actually got him a little bit flustered on and um so then yeah you uh for the Medics at least um after the warmup we basically uh you put body armor on and uh go for a mile run and your timer starts as soon as you start your run and um coming back from your run you go do a dummy drag and then uh I tried out a clear the old Clear Water O course that's gone now and so they didn't have a a Tower to run so instead of the tower um they just decided you're going to carry a tool and do walking lunges the rest of the way to the oor so uh went through that dropped the vest run the oor um tell us about the O course obstacle course yeah um I had a good time with it um it's like a playground right everybody else is dying and Joy's like this is great if you were if you were 10 years old you'd have a blast on it right and everybody's like intimidated by it and um there's things to climb over and things to climb under I don't like I'm not an oakor guy like there's you know million people that are going to run it way faster than I do like wath white Hurst um but everyone though yeah right um yeah I'm not not I'm okay with that he can have that um there's a part where you're like waterboarding yourself where you have to go under the the water and the mud with the mesh on top the gate on top of you and you yeah and I was strangely intimidated by that one particular obstacle and like losing sleep about that like mhm like a psychological get lost in this thing and not come out of the other end and it was so easy just going to leave you there yeah it was like it was so much buildup it was so underwhelming like oh that was it all right yeah and uh so basically finished the obstacle and uh I'm like trying to catch my breath and one of the senior Medics at the time just grabs me by the shoulders and he's like let's go you got an officer down and runs me down about another hundred yards down to the end of the range and there's a mannequin laying there all mued up bleeding and everything all right it's time all right and I and I was pretty well prepared for it oh probably close to 200 yeah I felt pretty well prepared for that I had kind of been running a lot of scenarios through my head and everything and and I was an experienced paramedic going into it um so that was really pretty uneventful I just um worked the assessment worked the algorithm right and just one one task after the next and about halfway through and it's funny being on the other side of it now because you'll see it with the other candidates your brain like turns back on halfway through the scenario and you realize you've just been on autopilot just working through your training right and now you're all of a sudden critically thinking again and you're like wait did I address these things um so yeah I finished that scenario and everything and had you ever worked a real gunshot wound before okay okay yeah so and that was kind of the interesting thing um going to the SWAT side and everything already having that experience and in this County you have to be at least a three-year paramedic before you even try out okay okay um but it was still a it was like you know we're taking pretty season not that 3 years is a super long time but we're taking pretty seasoned paramedics yeah and you're like hey you're the new guy and you don't know right and um I dealt pretty well with that as well cuz in my head I was like yeah I I don't know anything about this environment but I want to learn right um so that was the basic try out there and then for the Medics um there's also a written test right um phtls based or uh prehospital Trauma Life Support and um we had a swim test um but those those parts are like separate they're not part of that when we went out there I couldn't believe it was SWAT operator so our guys and the Tactical Medics that were trying out and you guys went through the whole thing The Operators were done they were all done and they're like yeah good job and then your Tactical paramedics you know like you said you grabbed them by the arm and brought them over and they're heaving yeah we basically just drag them dry gu's dying and here's here's the situation and I'm just like oh my God like and they're still heaving while they're going through it and they're like okay they have respirations okay now I'm going to check like cuz they have to verbalize what they're doing to you at the same time it's like holy H there's a method to the madness right it's not just to to be mean or any form of hazing or anything right it's it's because you know what all right you're now you've been on integrated on this team for a long time and all of a sudden your friend is shot right how what do you think your heart rate is going to be and how you're going to feel right so we're definitely for a certain type of person yeah um and and that it's funny because between that and uh SWAT school and stuff you'll see people that you didn't really necessarily think had it completely come out of their shell and it and it just changes their personality and and you're like okay now like I woke you up what you were talking about with yourself pH honestly yeah yeah so the the try out is one one piece but then there is SWAT school yeah but kind of in the so I I would imagine imine that the our SWAT operators were happy to you know the concept of having a medic is is good they like that uh but you're still a civilian you're not law enforcement and you're kind of coming into this new realm and you're going to have to earn your way in which obviously it sounds like it was a cakewalk for you the way you're talking as far as well I mean it's like it wasn't like oh my God you know you you had that life experience you'd been prepared and and you know obviously you prepared more than others may have but I would imagine that besides the physical piece and just the technical pieces of it you have to kind of earn your keep there you have to earn your way in when we talk to um I think it was when we were talking to Sergeant Debold we were talking about you know how the the um the Drone guys and the robot guys wanted to they felt like they wanted to earn their keep to have that um to make sure they're they're not looked upon differently by the team what uh what was that like for you and and for swap medics in general so at the time right we were we were unarmed uh Sunstar subcontractor program so there was there was definitely a little bit of a split at that time versus um now I feel like we're uh we're we're really that one team concept and we've definitely come a long way in that um credit to a lot of different people on that and they know who they are but um at the time right uh being a new guy period was they were going to have fun with you right and they should um but being a new medic was even more so like they don't they don't know you from the road from Patrol or anything like that or theic might know you you know they may have recruited you and know that you'll be you'll do well but the operators don't know you at all and they've got a lot of trust to build um so on my side of it I I showed up to training the first night and um figured I'm not going to shoot I'm not going to participate in anything but I'll bring everything and have it just in case you know but they're probably just going to sit me off to the side were you a gun person I was yeah yeah kind of always have been um and yeah I did do a lot of shooting on the side and stuff um so on that aspect I felt like pretty well prepared but um basically uh I get there and walk up and they're like all right well like you know your first training night like tell us a little bit about yourself and I probably get like two words and they're like yeah nobody cares sit down fair enough all right and uh they're like well you should like yeah they're like you got got your guns with you yeah did they even know your name at at this point no no uh so actually I started with another guy um Austin figary and uh yeah we were new guy one and new guy two wait which one were you I believe I was new guy two at the at that now this is coming in under the the Sunstar partnership initially though right okay okay and uh yeah to the Medics we had names right but on the operat side not much right we hadn't proven ourselves medical guy yeah and um not even right because at this point they don't trust you at all they want the they want the Medics that they know and um so I go I I I run the first course of fire it's just a number of uh different movements down the 100 yard and and kind of transitioning between the long gun and handgun and uh they go down and check my targets and everyone's kind of like oh all right you can he can shoot and um could the other guy shoot um oh answer he wasn't he wasn't a gun guy at that point in time but it's amazing how fast the team can take somebody who has no experience and make a shooter sometimes people with no experience are a lot easier cuz they don't have bad habits and all that stuff yeah and within six months you know he was crushing it but um they're like oh all right new guy can shoot all right you're new guy won now so that's awesome so yeah that um kind of started that way and then um basically just spent the next few months get from uh from really I I was fortunate I had from August all the way through the next October to get prepared for SWAT school so um at the time we were doing our tecc in uh or um tactical emergency casualty care and which is basically medic SWAT School June so um I got to go to that which physically was a not as intense as SWAT school but it was a step towards that and and learning how to be a medic in the Tactical environment and um I just really I just spent the whole next year just working out really hard and getting ready for SWAT school and everyone just being like you're going to die have fun and uh really like taking that to heart and being like man I don't want to be that that anchor in swat school that's causing everyone else PT I'll PT for everybody else but I don't want to be the problem yeah and um so yeah I I just hit it really hard and felt like when I showed up to swat school I was I was pretty well prepared and I think our guys really do a great job with that too um getting you up to spe and some of the other agencies they they really like throw their guys to the wolves like figure it out you know um so that seems counterproductive CU yeah it was like uh you know almost kind of using that as a form of try out at least back then it's it's changed a bit but um yeah I felt like all all the so guys were pretty well prepared and um we definitely like stuck together the entire time and I honestly they they say it's the the best two weeks you'll never want to do again and I would do it again it was it was a blast I had had a good time shot a lot of ammo and and just spend two weeks with the guys having fun and PT in together and kind of like really coming out of your shell and I'm like hey this is you know better than 12 hours on the road on the ambulance so uh and you're doing nothing but SWAT related stuff at this point for for these two weeks none none of the medic stuff all the same stuff that the operat they actually will will rip everyone's um patches off right so like in the minds of the instructors there's noo there's no Medics versus as operators or whatever it's like and it'll actually mix you up so you know you may be with a clear waterer guy Nels Park guy a tarpon guy and have another you know random medic with you on your team and you're just there to figure it out and so they don't really care or want to know who's a medic and who's an operator and everyone's just treated the same so how long so when did the transition cuz at some point uh the dynamic kind of changed and they were no longer it was no longer a sub contract situation and our swap Medics became agency employees uh when did that happen you came you came in when 17 or 18 18 18 okay so what was how did that transpire I know I know it's complicated but just a basic um long story short um margerie stonan Douglas shooting right um so unfortunately the way that that whole thing unfolded um and with the sheriff being on the board with that mhm uh basically their tactical Paramedic program was extremely similar to what our situation was um you had but they were integrated no you had well yes you you had the exact same situationally right you you had unarmed um private ambulance contractors right who were taken on as employees with the Sheriff's Office subcontracted to be with the SWAT team right and those guys uh were brought into this situation this Hot Zone unarmed with escort obviously sure um and everyone was fully willing in that situation right as you should be um but it identified a potential problem of hey we we just brought more unarmed guys into a Hot Zone that's not really best practice like how do we look at fixing this so the sheriff spearheaded the the program with um kind of just trying to figure out what the best solution was and it ended up being to take us on as employees directly and uh create that situation where they were able to arm us and actually it created a new um state statute for the armed tactical medical professionals right um so then we we came on as a sheriff's office employees and there was some more boxes to check and now we became more responsible for we were shooting before and and obviously the team wanted us to know how to shoot and there was kind of that Unwritten like hey if things go down and I'm injured like by all means grab my stuff and and do what needs to happen here so you can work on me um but it changed to now we're responsible for for carrying gun and and adding another level to that right um and for us it it's been good it's it was definitely a a confidence booster for the guys to know that like we're armed ourselves and able to protect ourselves and a lot of the guys all of the guys who were um and girls who were doing the swap medic program um were shooters or had become Shooters secondary to being on the team at least and concealed carrying in their personal time and now you're going from walking around as a civilian everyday concealed carrying to coming to work and being brought into Hot Zone situations and you can't carry right right um so that definitely uh Chang the game but more importantly than that um cuz you know we were already doing the job unarmed so at the end of the day we didn't really care um it was probably I mean maybe this is too I'm making too big of an assumption but it had to be also a big relief for The Operators because they were I'm sure even though they were doing their damnest to do what they're trained to do and stay focused on the task at hand they're also worried about you guys because of that cohesive team right it's like you're you're escorting a a VIP or dignitary through a Hot Zone all the time now and of a fully functional teammate who can also have your back and I think kind of just bigger picture context for listeners is um obviously a whole lot of things change related procedures with the STA Douglas shooting but it also comes down to a Time piece and and being able to because we talked about a little bit um when you're talking about staging on the FD side waiting for a scene to be clear and a scene to be safe um the less that you have to worry about that the faster you can move in and and start helping people right because it goes back to those timers right stopping those timers so it the faster we can get to the point of injury the better MH so so the and I kind of forgotten that so the the agency the sheriff's office employee piece and arming yall piece that was that was a single single move yes right so more importantly than the Firearms right um for us is the fact that coming on as as Sheriff's Office employees really changed the game it actually changed our job title really from SWAP paramedic to Tactical paramedic right and that whole move opened us up to other divisions so instead of just being really solely tasked to swat and lent to narcotics um that's kind of when we really St started this whole process of getting out with the Marine units getting involved more with the Training Division and doing some teaching and and assisting with the mobile field force and things like that getting more exposure out to the patrol guys um and hopefully expanding moreon from there right because in my eyes if we can really start to teach more of this knowledge to the deputies you know the the running joke with FD and with EMS is the second responders right and uh really in in all reality the police are going to be there first M you know and that's what they're being paid to do so if if we can give them those mental tools right um to really put all the equipment to use and and know these assessments really well get a little bit more interaction with the Medics then that's giving them the tools to save you know not only their own life or their their partner's life potentially but citizens as well and potentially give better information absolutely when when EMS arrives on scene so absolutely makes sense yeah because now with with the Medics as employees we utilize them for events too where we normally have we usually have Sunstar on standby we'll just have a swap medic instead because and you guys you guys frankly have a cooler cooler vehicle but yeah big bban but uh but no I think it's worked out really well well and uh it it really just to me is a it just makes sense uh if you're going to have you know it it I like you said in your intro that was very well written um you know that was extemporaneous you want to have yeah you want to have I don't know what that word means you want to have one of these guys coming to help you uh because you know them and uh not that we don't have quality paramedics and all of our yeah absolutely fire departments all that but somebody you know and and um and as you said any paramedic could have six months experience or is you know you have a minimum and then extra training right you have a minimum you you have um an expanded set of protocols um and really when when you're functioning in this and this isn't specific to pcso this is to you know every Tac Medic in the county right you're really you're on a firstname basis with the medical dect there's there's a different level of trust there because of the responsibility that you saddle with and because of their expectations of you right as far as the professionalism and how you're going to carry yourself on scenes um so so you can do more things on scene you can take steps that that like what kind of things yeah so um the finger Thor costom for one right um we have an expanded set of like sick call medicine and everything that we can do for the guys um so you know anything from as mundane as need to pop a blister or give somebody ibuprofen for a headache um things that you're not going to call an amulance out for right or give you know silly as it sounds right give an operator a modium on a call out so that they're not having diarrhea because you know they they they're down with some sort of uh stomach bug and now they get called out and they show up and they're like in their head about it right you can fix that um so you know we really bring a a different uh set of skills to the table for The Operators to keep them in the fight so uh you make you're you're on the team we've got the integration that we see today Rock and rolling any memorable call outs or stories you have I mean unfortunately knock on wood we haveen a needed for the bad stuff right but any any um notable stories over the last couple years yeah I mean um so the last time we had a uh like a true injury on scene is um really as fortunately as mundane as his injury actually was was uh that dun Eden um SWAT call it now this is all like SWAT Pacific injuries right um we had a uh suspect that basically had fled from Patrol and from understanding of it initially there was some shots fired um on his part and uh jumped a fence and had thrown his little I believe it was a 380 like little pocket gun into his pocket of some gym shorts or whatnot and ends up pulling the trigger in his pocket while he's jumping the fence and negligently discharges into his leg and um so he and keeps running oh yeah and uh he makes it up onto a rooftop uh of an occupied residential structure and is hiding behind the chimney up there and of course there's a live stream of him on the eagle M and he's claiming that he's bleeding out and we're looking at the thermal like I don't see any blood on the ground but all right and uh so we're trying to come up with a solution to a get the family out of the house and uh B get him off of their roof so a few different things were um thrown around we ended up uh making a rescue of them with the armored vehicle get them out of the house and then we start to get a little bit more direct with him and you don't know if he's armed at this point I mean you know that he was putting down yeah no I mean we knew we knew he was armed just from the the shots exchanged initially and uh we don't know how many bullets he has left but we know one of them's inside of him so we um ended up they made approach with the rook and uh did some uh exchange with les lethal and he ends up surrendering at that point in time we take him off the roof and uh the first medic to make contact with him was was Dave Kowski and he's reporting back to me like yeah I mean he's he's shot but uh really not much for me to do here a small caliber just right through the muscle really uh like flesh wound M and um basically just wrapped it up and got him into the ambulance um but his kind of funny thing was uh you know as soon as he first makes contact with this patient he turns around to hear the sheriff right over his shoulder he going to be okay oh there he is um but yeah no the guy was fine and it was taken to Bayfront downgraded and and that was about that um so good outcome there and then uh go ahead but you you mention you mentioned the Rook what is what is the uh tell us about the Rook yeah The Rook is awesome so uh the rook's basically an armored Bobcat um with a number of different attachments and they've really like totally exploded around the country with SWAT specifically um I mean you can search them on YouTube and see all sorts of different ways that they're used on CS but it it basically makes nowhere in your house unreachable um to barricade and really like if you look back to um 2011 in St Pete with the the Hydra Lacy situation I mean you could have just claw that roof away from the guy and yeah that would have been that um so it's an awesome piece of equipment um worth every penny but for us that night what we used it for is uh you can put an armored platform up and raise it up to essentially either make entry to like a second story or put guys on a roof of a single story and that's what they did is put them up on the roof with them yeah it really just kind of allows I I'm thinking of another story in my head where I didn't do this but it allows us to be a little more strategic and uh less destructive to property or more destructive or more destructive you have options it's good to have options but but uh you know as far as trying to get folks in there without because instead of having the knock funds it fits it fits between the houses you're not worried about trying smallish right and it can also um it has like a claw attachment you can pick a car up out of the way and move it um it basically makes you like unb barricade if we don't want you because a hydrolac situation when uh yitz and uh boner was was shot I me we tore the front of the house off with the gbv with boom and that's all we had um that would definitely Now The Rook was also used at the um Golfport Golfport but then the um on Al Maron the hotel the gas yeah it's a limited effect there um The Golf port one was hilarious because we basically just pushed the ramp through his front door and he was like nope I'm done don't destroy the house yeah um but with yeah with Thon that one was a little bit more complicated being a hotel um and I don't want to speak too much to to the guy's tactics and stuff but uh essentially pel's Park had been out there for hours on end lobbing gas rounds in and um their guys were were pretty well smoked and it was coming to that time where like unfortunately their Commander had to make that decision to rotate a new team in um and not put them at a higher risk level right so we get the call from them and respond out about 5:30 in the morning and uh the way we ended that one was actually a a very destructive way uh an explosive breach that did the job and got us in there and um we we took him into custody and when he came out of that uh did you have to treat him um so we evaluated him and uh he didn't want any treatment he ended up signing refusal with Sunstar and uh went to jail where they promptly told us that they sent him right back to the hospital for medical clearance because uh yeah he took a so he his situation was he had actually pulled his arms up underneath the blankets he had wrapped himself in the comforters um to basically filter out all the gas yeah I think between both teams we lobbed like 67 uh gas grenades in there as well as a number of like actual riot control grenades uh zip tied onto roof Hooks and such and it was actually as far as they go he's pretty uh Innovative he took the blinds of the hotel and tied them to the air conditioning unit and they were like trampol leaning the gas rounds back up so if you us had to go up on the roof with one of the long like FD roof Hooks and stab it through the curtains and start ripping the curtains up out of the way and then at that point he had tied himself up into the comforter and uh so when the guys made entry they couldn't see his hands and uh they just you know they did what what SWAT does and saw his hands so yeah so when you uh go to one of these call outs as tactical paramedics are you in a separate space from The Operators or what does that look like yes and no so that's going to be dependent on your role um the way we function is the the senior medic is eventually going to take command of that scene um the first in medic is going to initially take command and then they'll be relieved right if if there's a senior guy behind them but uh what they'll do is they'll establish if there's not already see the thing is a lot of reactive SWAT call outs are already incidents that are ongoing so we're showing up and there's already Patrol units there there's already typically ambulance EST stage and fires involved and um we'll get the full picture of what's going on we we leave them on the medical command side and and take establish That Joint Unified command with law enforcement being um Sierra 1 and Then star one and um we'll stage the units that we feel are appropriate the for fire suppression as well as EMS and then typically that first medic is going to deploy with the team and uh get in with the arrest contact team so then after that they'll they'll be back filled out and um eventually what we want our goal is we start to get the appropriate amount of Medics on scene typically at least three um is to have somebody at Star one at the command post and they're basically medical advisor um seen command on the Le on the um EMS side to coordinate those resources and take some of that that burden off of the Sierra one position as well as um just basically kind of keep all that to themselves until it's needed and then they they kind of come alive at that point um but basically um no the the first in medic is going to want to be with the arrest contact team so that if all of a sudden the guy comes out and presents a challenge and we take shots or we take an injured operator in the team they're right there so the goal is always to get Medics as close to the point of injury as possible so that the treatment is as rapid as possible and what if the situation is this may be a dumb question but maybe like it's an active shooting kind of situation is that still the case yeah we're still going to want to get them as close to the the sight of injury I don't know for some reason I thought you guys were kind of off to the side and they kind of called you when they needed you kind of thing not so if the goal is to make entry for like a warrant um will typically be outside with the perimeter units um there's it's all risk versus benefit right risk a lot to Save A Lot risk a little save a little so um you're not going to there's no point in having a medic immediately make entry or be a number one or two guy right and now something happens to that said single medic on scene and now you've got operators working on the medic and that's definitely a contingent that we plan for um because it is a possibility but ideally you want them far enough removed from it so that if something happens the medic is there to treat them right um but that's also why we're running multiple Medics to scenes and all of that thanks interesting was there any call out any situation you've been in anything at all cuz again you just seem like you're like yeah it was you know it was hard but I was prepared no big deal uh was there anything we were like okay what did I get myself into at any point outside of SWAT or well General scary or something horrible or so I mean definitely being a parent now um I have a new respect for the the Pediatric side of things um so you know I I've had my share of bad pediatric Claws and um if I never had to run any of those again I I would be okay with that right so um every time you know you get those call notes and it's you see and again like I said earlier a lot of times call notes aren't necessarily right right so all the time we get call notes that are way inflated and you get there and you're like oh this is what's going on okay we can fix that right um but showing up to a truly like bad pediatric scene is is not something that's very fun to deal with uh and you definitely like okay I want to get through this and have the best possible outcome but I'll feel better when this call is done it's done right yeah yeah is is there such a thing as sism for you guys are kind of yeah yeah so um County on the EMS and fire Administration side functions basically this the same way right so they have um like sism certified guys that will come in and talk to you immediately debrief calls like that when it's applicable okay uh and then they have the extended resources from there if things continue on says them again is what critical incident stress management Stress Management okay so basically just immediate yeah opportunity yeah debriefing um I mean talking with people that are doing the work though in most cases right there's definitely a a role for that but in most cases a lot of things can um just be hashed out with your crew MH and and and talked with amongst co-workers and stuff and on the hospital side right that's that's a big thing for us is just kind of like decompressing with the other RNs and all that and and working through that and you know you get feedback from them as well as like all right what could we have done better with this and and make it a constructive thing and you have that kind of built in with your wife because she's a nurse yeah yeah and in a lot of our conversations definitely uh right devolve into that telling each other about situations that we had with patients and and all that and I think she's learned a lot from me and I've learned a lot from her and her role um on the hospital is kind of a totally different side but um The Experience from that has has made me a better medic as well for sure so fortunately you don't have to flex your medic muscles very much with the sheriff's office but obviously you still need to keep that sharp so um do you still uh spend some time with sun Sunstar is that right yeah yeah so um I still am with Sunstar on a limited like part-time basis um and it's it's one of those things right it when you're doing it every day you can definitely burn yourself out um just like Patrol is here anything like that right um but when you're only doing it on a limited basis and you can kind of pick your days um it it becomes fun again right so it's almost like uh re awoken that the less that I work the ambulance because it's something different right um kind of get the best of getting getting back out there right and then um yeah so I'm I'm a registered nurse at plant er um so I I spend about 36 hours a week uh working on patients over there so uh definitely still putting in the work and still enjoying it and everything and the hospital is a whole different side than EMS MH um but yeah I kind of uh I I was drawn more towards the nursing side and the hospital side um the more time I spent around patience and running running those messed up calls and you're like okay I feel like we did a good job with this but what was this patient's final outcom MH and you have at the time they've they've changed a few things but at the time you really had like no recourse to follow up on these things and uh that part would bother me too like well what what could we have done different or better you never get a chance to follow up with the doctors or or know get the rest get that feedback all you know got I think we did good but you know yeah so um the hospital side and the expanded uh protocols and everything over there and taking care of multiple patients at the same time is um it translates well to paramedics right so kind of being a nurse makes you better paramedic being a paramedic makes you better nurse MH um back to swat just a little bit uh which is a part-time position I don't know if we mentioned that important to mention because wait 36 hours do man never stop working yeah it is the SWAT the SWAT medic piece is a is a part-time gig how many hours more or less you put in a TP typical week between all the jobs of SWAT oh between SWAT all the jobs too yeah so that's going to vary wildly right um sometimes I'll you know I'll take time off from the hospital and come in here for things like SWAT school and stuff where it's like you know it's a 40 Hour Week SWAT week um Camp Landing we were um month ago right 40 hour week so um yeah I would just take time off for that but on a normal weekly basis right I've got some admin things to do we have to constantly rotate medications and make sure we don't have anything expired right it's fun fact it's a uh felony in Florida to push an for a paramedic to push an expired medication on somebody uh so we're constantly uh keeping up with all of our equipment right and uh I have a strug that could save your life but expired yesterday so you're out of luck yeah so and I'm not going to cat a felony for you that's a a great point right because that's never a situation you want to be in right um so we're constantly rotating all those outs there's a lot on the logistics side um and with us not really we're not an EMS agency right so um we're constantly dealing back and forth with uh EMS and fire Administration as well as trying to stay in the loop since we are such a small group of people not um have you know oversight or be forgotten about so trying to go to meetings and things like that but um stay visible yeah so for for paramedics though looking to become a tactical medic as far as like the minimum training requirements and everything on paper um so we have every month a tactical day 8 Hour tact day with SWAT and uh two 4our ranges basically you have to attend one of each every quarter okay so it's not a huge hours demand obviously for the neurom Medics and everything right we want them to show up to as much training as possible and actually learn how to do the job so that the guys can trust them and get that FaceTime as well um but yeah minimum requirements really aren't aren't too bad and how many do we have uh so we currently have eight and how many do we want well full Staffing for us would be 13 which would be awesome um we haven't been full Staffing as long as I've been around um and kind of person so I imagine it's hard to get people who are interested and then who are qualified and then who can actually get through all the tri outs and that's the thing and like at the end of the day you know we would rather do more with less and have the right people in the right positions and we definitely have that right now um so we we don't want to compromise right quality over quantity so to speak but at the same time yeah I mean guys who or girls who can do the job who want to come out and and try out yeah I've got positions to fill for sure so yeah we're you know what what what are what are you looking other than like the actual qualifications of of certifications what um what kind of personality what kind of Drive are you looking for so for one The Heart Right somebody who wants to be here for the right reasons um that doesn't just want to like not an ego thing a cool uniform or be able to say you know put that swap pin on their class a uniform on the fires side or whatnot and um but who actually wants to be a good teammate and is going to be around so that it's makes sense for us to teach them the these tactics and teach them the medicine and then they get to be there for the team and and pay it back right pay it forward and and leave it better than they found it and um yeah I guess all I can really say on that is is we have that right now and uh we don't want to compromise the quality of candidate that we have um but conversely right um we're always looking so okay the problem becomes uh people they get a little they get that time on the job they get that 3 years and they find that fire recliner and they're like yeah I mean maybe I won't do swap Wheel of Fortune's on I have because it I mean it is so much above and beyond what you're I mean beside this is a whole other conversation I think for a whole episode but I mean you know paramedics and anybody in the medical field is looking to preserve life yeah but you're you're in an environment where uh you might have to take one to save one or just take one uh that's and there's is that hard to hard to reconcile just mentally emotionally no I I think it's a I mean it's obviously a big deal right um nobody wants to well some people do but nobody in this this environment wants to set out to take a life right um especially as a paramedic right you're you're biggest fear is to like hurt somebody accidentally or whatnot right um but the the way I view it is for one we're responding with a lot of guys who really know what they're doing right and they're carrying machine guns and they're wearing body armor if my guns even need to really come out of its holster right things have gone so horribly wrong um one of our guys is probably on the ground and So the faster I can put that guy down then the faster I can work on ours right and now rather than it being care Under Fire we're back to normal protocols I can do a lot more at that point in time so so no it's not really um it's not really something worth losing sleep over it's just you know if you're put in that position you're put in that position yeah you're not necessarily making that decision somebody else's right I didn't tell you to come out with a gun right um well we uh appreciate you coming on yeah um we always try to give and I think I know the answer but we would like to give all the our guests an opportunity to just kind of tell us what say you know share with the public what would make your job easier uh or anything and and obviously if you have friends that are paramedics talk to them about being a tacmic but is there is there anything else that the public can do to make your job easier yeah I mean on the EMS side a number of things right um I would love to say sell your motorcycles in pelis County no not sorry R motorcycle not in peak times but yes you wear a helmet of course all right yeah uh if not right next best thing wear a helmet ideally a jacket um don't ride it in flipflops because I've run that call before um yeah yeah meat crayons y right on the back of the Sunstar units uh a big thing they're pushing right is the back sleep safe for uh babies right um SIDS is is something that we're commonly uh too commonly running yeah MH um let's see seat belts I would love to yeah seat belt yeah seat Bel that before yeah that's a gimme um the fact that there's people in 2024 not wearing seat belts under normal circumstance especially if you're not just the fact that your car is annoying as hell if you don't yeah yeah um I mean from my perspective right I'd love to see everybody having a little trauma kit in their cars and actually knowing how to use it but outside of that I mean like as far as County initiatives go um we're doing the uh leave behind Naran program so as far as like the Fenty overdoses and and all that um they're you know EMS is giving out in Aran uh so that's fantastic yeah it's it's all federally funded from my understanding and everything so well it's also Catch 22 because then the users just start carrying our can and don't we still want to save them but the fears to just make them more bold about it um but you know on the other hand you're you're saving lives so yeah they're they're going to probably do it either way so um you know giving that to those family members and everything right you're potentially stopping their trauma yeah good stuff so um let me see the last thing I would say from the Marine side CU that is a a part of our job um and something that we've run right is a don't mix alcohol and boats yes um you're going to yeah put it in neutral and shut it off before you swim around the back of the boat um cuz you will more than likely get a prop strike and then we'll see you on the water oh my gosh well that and um I've getting ready to put together some Marine tips and some of the stats that I'm seeing that accidents that do occur um in boating generally when there's a fatality it's a drowning so people need to wear pfds yeah and they have ones that aren't like crazy like yeah and the Marine division is typically like some of the easiest going deputies around here but that is the one thing that they will absolutely Hammer somebody on is miners without life jackets every single time they're they're going to give a ticket um just because the the risk of that I mean they go off the boat go to the bottom of the channel and never come back up right so yeah people just don't think it'll happen they just don't or they get drunk and try to swim across a jetty and get pulled out into the Gulf yeah mhm H I do have one more question before we before we close what uh what is the future of TAC Medics what uh what are some new innovations that might be coming out or things are used in hospitals that you can start using or or what would what would your ideal be what changes would you see for um Tac Medics at our agency my ideal might different from the future right but um in a perfect world right there's there's a lot of uh major technology advances uh one that the County's been looking at is the Lucas device um which we're using all the time in the hospitals that's that basically that CPR machine okay so your first compression is exactly the same as your last compression and I can tell you statistically we're having better outcomes with it wow so um not cheap but awesome and uh it reduces the amount of hands that you need on a scene which in the Tactical environment um it could be you know could be a game changer um whole blood is is like kind of a it's this medic team's little like project of passion right because that's the the thing that could make the biggest difference because right now you can only yeah right now you get the volume up we're normal sailing um everybody will jokingly call it pasta water um it it doesn't carry oxygen right um so all we're really doing with that is we're getting the blood pressure back up and keeping that next heartbeat coming so you're just saying to have blood yeah yeah I didn't know if whole blood was a whole blood a company not skin blood whole blood no I'm not pushing any company whole blood just being like if you were to draw blood directly from you and put it in a bag okay um a transfusion you could do in a hospital Stova is a type of blood no no almond blood it's all of soy blood vegan um sure that uh really is is was pioneered by like the flight side of things and critical care right um that they're carrying that they're carrying IV pumps videoendoscope for Innovations all things to just improve patient outcome what prevents you from just carrying blood I'm sure it's regulated like oh I got some blood in my Yeti over here yeah uh Logistics right so there's no arguments uh for medical direction or or any doc that you talk to there it's not Superior right um it's it's cost and Logistics um regulations like you said as far as uh how it stored and and monitored and in our case right it comes down to case usage right so how how many things of blood are we carrying around versus how much are we actually going to use what's the waist what's the rotation going to look like right um there are systems doing it it is the future uh but we're not there yet that's what we're moving towards and that's what we're talking about right now the future so I might as well yeah full send right yeah absolutely um yeah so in my eyes right I'd love to see a full-time tacmed program and and guys getting out um with the patrol initiatives with ti with the high-risk calls and kind of um similar to how K9 is is floating and jumping the the hot calls right medics in areas where they can you know make a difference and be there for these these pointy care injuries like a North Tech Medic and a South Tech Medic just available wherever yeah yeah I would I would love to see um you know is there is there talk about that um not much outside the team right we talking future right so why not yeah well I mean I hell you just think about uh Lieutenant Stang situation and the one of the head guys for St Pete happened to be around the corner and could get there you know faster right not that we we don't have great response times for EMS but just it helps for sure but any expertise that you can you can add absolutely for sure only helps all good stuff uh thanks again for coming hey we've had we've gotten things out of these conversations before so at least uh the conversation will start somewhere but yeah um thanks for all you do all you have done and for coming uh talking with us hope it wasn't too scary but you're a cool cucumber about everything so what's your what's your what's your what's your pulse rate right now what's your heart rate yeah what what m still has from the from the tour okay a little elevated maybe yeah so do I do I do your part at the end since you did my part of yeah let me hear you say say it in the sultry voice oh I don't know about that say say it in my podcast Voice come on come on no no you want me to do it for you no so there are uh one one thing we always like is to hear from our listeners and there are a few opportunities to do that so uh one is via email uh l56 PCS onet.com and we also have the dedicated uh 56 podcast Instagram which is 56 spelled out podcast on Instagram so please follow us engage and let us know what you thought about the episode yeah thank you now now you say what what's your closing line do you have a closing line I change it up but uh until next time thanks for listening until next time thanks for listening [Music]