1. TEMS: Rescue Task Force Tools
PERSONAL PROTECTIVE EQUIPMENT, BALLISTIC PROTECTION, MEDICAL SUPPLIES
Module 3/5
Prepared by B. Carr

2. OBJECTIVES Personal protective equipment—PPE—is designed
#1 UNDERSTAND ROLE OF PPE IN TACTICAL AND IDLH ENVIRONMENT
OBJECTIVES
Personal protective equipment—PPE—is designed
to minimize and counteract various hazards. PPE must
match the range of hazards and risks presented to responders.
A tactical environment can present numerous hazards.
#2 REVIEW BALLISTIC PROTECTION CLASSIFICATIONS
#3 REVIEW TEMS MEDICAL SUPPLIES
Ballistic protection remains central to tactical EMS response.
Some medical supplies provide an advantage in the tactical environment. Thanks to ease of use and design, “TEMS” equipment counterbalances challenges of wounds from ballistic injuries.

3. Personal protective Equipment

4. Personal Protective Equipment
ORGANIZATIONAL PRINCIPLES
BALLISTIC-SPECIFIC PPE
Personal Protective Equipment
Equipment worn to minimize exposure to serious injuries and illnesses. Injuries and illnesses may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards.
Consider preplanned or in-route hazard assessment for wide range of possible hazards: impact, penetration, compression, ballistic, chemical, biological, fire, heat/cold, sonic , optical energies.
Personal Protective Equipment categorized by area of body protected.
Eye and Face
Head
Foot and Leg
Hand and Arm
Body
Hearing
Designed to provide protection against ballistic and impact-energies. Traditional “body armor” does not effectively protect wearer from stabbing or sharp-tipped objects. Body armor generally developed and tested to withstand energies from standard bullets.

5. Ballistic Protection Classifications
Certifying and Compliance-Testing Bodies
NIJ Levels of Protection and Classification
Ballistic Protection Classifications
National Institute of Justice (NIJ) develops standards and performs compliance testing for US law enforcement body armors.
US and NATO military armor designs are tested using a standard set of test methods under ARMY MIL-STD-662 and STANAG 2920 ( 2nd ed.)
Current NIJ standard for Ballistic Resistance of Body Armor (July, 2008) can be accessed using the following link.
NIJ Standard
SOFT BODY ARMOR Ballistic resistant fabric. (e.g. Spectra, Kevlar, Twaron) Type IIA: Usually stops 9-mm full-metal-jacketed bullets from 4-inch barrel, as well as .357 Magnum, semi-jacketed, soft-point bullets fired from 4-inch barrel. Type II: Stronger than IIA. Usually stops 9-mm full-metal-jacketed bullets from 5-inch barrel, as well as .357 Magnum, semi-jacketed, soft-point bullets fired from 6-inch barrel. Type IIIA: Stronger than IIA and II. Stops mandated 9-mm full-metal-jacketed bullet fired from 16-inch barreled carbine, as well as .44 Magnum fired from a 6-inch barrel. HARD BODY ARMOR Rigid inserts for added threat protection. Type III: Designed to protect against the common M-4/AR-15 rofle round and also center-fire rifle rounds. Type IV: Highest and thickest level of protection. Protects against armor piercing (AP) round as usually fired from hunting rifle, Garand, or similar rifle.
JH F/EMS TEMS Ballistic Protection Type
TITAN Assault Enhanced Carrier with Type IIIA armor inserts
Ballistics protective helmet
TEMS PPE CURRENTLY ON SUPPORT 19 in labeled containers

6. TEMS Medical SUPPLIES

7. Emergency Bandage (click for usage video) aka “The Israeli”
COMMON PRACTICE IN UNCOMMON ENVIRONMENT
“TEMS” EQUIPMENT
Tactical environment doesn’t change how medical gear works. It does demand that personnel adapt equipment use to dynamic situations. Protocols and treatment guidelines generally remain active unless incident exceeds aggregate surge capacity of local hospital and necessary legal steps are taken to append or change existing care/treatment guidelines. In other words, maintain scope of practice and use equipment as directed by current guidelines.
Tourniquet
CAT
standard application
Emergency Bandage (click for usage video)
aka “The Israeli”
compression and absorption in single, rapid application
QuikClot (click for usage video)
kaolin infused gauze for packing non-compressible areas (axillae, groin, etc.)
Decompression Needle
rapid, easily stored method for counteracting tension pneumothoracecs
Evacuation Litter
carrying device to support and hasten patient extraction and movement

8. SUMMARY

9. Align PPE to hazards…assuming the worst.
SUMMARY
Align PPE to hazards…assuming the worst.
Know limitations of PPE and ballistic protection.
Maintain familiarity with standard EMS procedures and execute them as needed on TEMS environment (e.g. tourniquet use, tension pneumothorax needle decompression)
Utilize TEMS medical equipment as needed to support patient care operations
Practice patient carries and utilize litters as needed
References
National Institute of Justice, Standard
Forthcoming (Module 4/5)
Rescue Task Force Expectations: Direct Threat Care, Indirect Threat Care, Medevac
Review of each care levels’ goals, principles, and guidelines