Originally created 09/14/03

Doctors learn how to work in crisis



Jason lifted his pale face and blood-streaked torso off the ground and gave a thumbs-up to the man who shot him, now hiding just inside a glass door in a nearby building.

Then he lay back down, revealing a red splotch on his chest and another on his left arm. In minutes, a white van approached and stopped nearby. Armed, black-vested Special Response Team officers leaped out and moved toward the building.

The van sped around and jerked to a stop in front of Jason, as two more black-vested men jumped out of the back.

Doug Olson and Mike Blaivas, physicians from the Medical College of Georgia, each grabbed an arm and a leg and hoisted Jason into the van.

Moments later, in another part of the parking lot, Dr. Blaivas knelt by Jason's head and rhythmically squeezed a respirator over him, pretending to give him oxygen.

"You guys saved me," Jason said after he stood up, the pale makeup on his face beaded with sweat. "You guys are my heroes."

Dr. Blaivas and Dr. Olson train regularly with the Columbia County special response squad, as they did during this exercise at Savannah Rapids Pavilion with Jason, a narcotics officer who asked that his last name not be used.

Such training could pay off if an officer or victim is injured and needs to be treated before it is safe to send in emergency medical technicians. That need was brought home by the Columbine High School shootings, Dr. Olson said, when ambulance crews were kept out of the building while police tried to determine what had happened to the teen killers.

"Since Columbine, there's been a larger realization of why there's a need for medical support on special operations or SWAT team support," Dr. Olson said.

"We're not here to be the SWAT team," said Richard Schwartz, the interim chairman of the MCG Department of Emergency Medicine, who also trains with the squad. "We're here to be able to treat someone in the event we have to go into an (unsafe) area."

The approach is meant to solve an unintended consequence of creating a safety "bubble" around the area of an incident to protect the public, said William Fabbri, a medical officer with the Federal Bureau of Investigation.

"It also has the effect of isolating everything inside that bubble from services on the outside, including conventional emergency medical system access," Dr. Fabbri said. "We, certainly, in the FBI are of the opinion that a tactical medical component is important so that everybody inside that bubble ... has access to the emergency medical system" and all the care that can be reasonably provided.

ONLY ABOUT 20 PERCENT of SWAT teams in the country have some kind of regular medical support, but it is increasing, Dr. Schwartz said. At MCG, the Office of Tactical Medicine, which Dr. Olson directs, offers residents the chance to specialize in it.

"I don't know of another program that is like this," Dr. Schwartz said, other than those in the military. In fact, the program employs combat concepts, such as using tourniquets to squelch bleeding in cases where civilians might use pressure dressings, which can be more difficult and take longer to apply, Dr. Schwartz said.

"If you're in an environment where someone is shooting at you, you really don't have time to do that," Dr. Schwartz said. "(The training) really focuses on the things that kill people on the battlefield or in a law enforcement situation."

MCG has developed a course called Law Enforcement Life Saver, based on the military's Combat Life Saver, that it hopes will become the model for training other agencies. The school already has a contract to train FBI paramedics and emergency medical technicians, Dr. Schwartz said.

IN COLUMBIA COUNTY, the medical support has already paid off in hostage situations. For instance, in the case of a man who was barricaded and threatening suicide, the officers were able to find out what drugs the man had taken and consult with the physicians on the scene, said Columbia County Lt. Andy Shedd, the Special Response Team's leader.

"They helped us in determining what to do, whether to go in on him or wait him out," Lt. Shedd said. "They're a huge asset to us."

Dr. Olson, who proved to be a crack shot on the shooting range, said the support is mutual.

"As far as working with a team, once you become involved and become an integral part of the team, it's like your family," Dr. Olson said. "You really trust each other."

Reach Tom Corwin at (706) 823-3213 or tomc@augustachronicle.com.