ATF’s Tactical Medics Support Search for Eric Frein in Pennsylvania

October 31, 2014 -- The recent search operation for Eric Frein, the suspect in the murder of a Pennsylvania State Police Trooper and shooting of another, posed unique operational and medical challenges to ATF’s tactical medics.

ATF SRT was deployed with the U.S Marshal’s Special Operations Group, FBI and other agencies in support of the PA State Police-led search operation. ATF tactical medics from across the nation were deployed on weeklong rotations with each ATF SRT team that provided support to the PA State Police during the seven-week search.

SRT was formed to manage the inherent risks associated with the investigation and apprehension of some of the country’s most violent criminals, accomplished through promoting survivability by protecting the public, the Bureau’s agents, other law enforcement officers and the suspects.

Averaging 211 activations over the last five years, SRT components respond to high-risk operations involving the service of arrest and search warrants, home invasion investigations, robberies, buy/bust undercover operations, rural operations, tracking of personnel in rural areas by human and canine operators, high-risk surveillance, use of highly-trained, precision marksmen and precision weapon systems, quick reaction or response to natural disasters and public safety concerns, as well as high threat protection detail assignments.

ATF Tactical Medics are special agents also certified as NREMT-B or higher with expanded-scope training via the Johns Hopkins-Division of Special Operations. ATF Medics complete an NREMT-B course, the ATF tactical medicine course and annual refresher training prior to becoming “operational” with SRT. A small, elite cadre of SRT operators and tactical medics cross train as both SRT operator and tactical medic. Each requires passing separate training and completion of each programs requirements.

While SRT and ATF’s tactical medics train for woodland operations, the rugged terrain and extended operational timeline in the Frein manhunt posed new challenges. Specifically, the need to balance ease of movement during patrols in deep woods with readiness for both major trauma and primary care complaints resulted stripping down of medical gear to save weight and improvise. Conducting multi-hour patrols with SRT while carrying a tac med backpack, M-4 rifle, ballistic armor, trauma plates with other gear made weight a critical issue as opposed to conventional urban operations.

Some medics created improvised “mini” medic packs with tourniquet, chest seal, needle chest decompression equipment, IV start kits, basic wound care supplies, OTC medications and only essential medications, i.e., Toradol IV–pain control, Epinephrine–anaphylaxis, and Zofran–anti-emetic, from our limited expanded scope formulary.

A full complement of medic gear and medications was often secured in the nearest SRT armored vehicle, but rapid access to this equipment could take over an hour if an injury occurred while operating in the deep woodland search areas.

A level III trauma center was approximately 45 minutes away but factoring in extraction time, medical preplanning estimated 2+ hour transport time if a patient was critically injured in the woods between injury and arrival at closest ER. Several patients were medevac’d out, not due to meeting trauma triage criteria, but due to the tremendous complexity of efficiently evacuating injured.

Expanded scope primary care skills were put to good use during the weeklong rotations with each SRT team. During downtime between missions many wounds, musco-skeletal complaints, ocular injuries and other “sick call” type cases were evaluated. In addition to caring for SRT operators, the public and suspects, ATF tactical medics have the additional responsibility of treating K-9s, which is an entirely new set of skills for those comfortable in the traditional EMS environment. Nighttime K-9 tracking and other night missions required ATF Tactical Medics to rapidly become familiar with night vision equipment as well. In conclusion, the search for Eric Frein provided a number of new challenges for ATF’s tactical medicine program and at the same time, a tremendous opportunity for growth as a medical provider and a newfound respect for our rural and wilderness counterparts.

Special Agent J. Benagh JD, AEA (EMT-I S. Africa), NREMT-B, is with ATF Public Affairs.

Sean Kivlehan, MD, MPH, EMT-P, is the emergency medicine chief resident at the University of California San Francisco and a former New York City paramedic for 10 years. Contact him at sean.kivlehan@gmail.com.