Numerous Minneapolis-Saint Paul area EMS agencies, headed by the U.S. Secret Service, undertook special preparations to handle EMS operations during the Republican National Convention held Sept 1-4, 2008. Following is an inside account of the experience along with some lessons to take away for future events.

Make Ready

At 1300 on Monday, Sept.1, Ambulance Strike Team (AST) 2 was called out to downtown St. Paul by the U.S. Secret Service. Local media had just reported that some "splinter" protestor groups were becoming violent near downtown St. Paul. In response, a strike team leader in a Chevrolet suburban and 4 ambulances left the undisclosed EMS garage facility in St Paul. Each ambulance had a painted orange ID number on its sides and each rig was from a different ambulance service.

In the Metro Region EMS communications room, a dispatcher said, "Ambulance strike team 2 reports to location on ETAC 4, reply back on arrival and switch to ETAC 3 and wait for assignment on ETAC 3 channel." The Metro communications room had 5 EMS personnel, again all from different ambulance services in the Twin Cities metropolitan area. The table was full of 8 laptop computers, and a large screen on the wall displayed all EMS/Police/Fire calls on a Google map of downtown St. Paul. The Google map was a "real time" map of incidents and calls from the U.S. Secret Service (USSS). Dispatcher J.D. said, "We even know where a suspicious package was left, where a bridge was blocked, or where an anarchist type group has been sprayed by police."

At EMS Command

A Metropolitan Emergency Services Board member, Mary, handed me an EMS bag, clipboard and an ANSI Level II vest. I responded with Metro Region EMS Coordinator Ron Robinson and Minneapolis Fire Chief Charlotte Holt, in Chief Holt's Ford Explorer, to supply additional first aid items and to provide lunch and refreshments to (AST) Ambulance Strike Team 2. AST 2 was now dispatched to a second location by the USSS, on the north side of downtown St. Paul.

Horse Patrol Sheriff's Officer Saved

At the Minneapolis Police Public Works building, we learned that a horse patrol sheriff's officer had arrived on Sunday and unloaded his horse stock and food/hay supplies in the parking lot in preparation for horse patrol coverage for the City of Minneapolis. Suddenly he dropped to the ground from cardiac arrest. The garage employee placed an AED on the patient and shocked him twice. As Mpls Fire and HCMC Ambulance arrived, the sheriff had a return of spontaneous circulation, and was alive. The Mpls Public Works garage had just received the AED's and training this year!

AST 2

We arrived in the parking lot at the Sears building near the Capitol and downtown St. Paul, and saw 5 ambulances and a strike team leader's Crown Victoria vehicle. All members wore blue Metro Region EMS shirts and vests with "MN Metro Region EMS Strike Team" letters as identification. Also present was a controller, John Bundt from the Twin Cities Hospital Commission, and Dr. Marc Conterato, emergency room physician and assistant Medical Director at North Memorial Ambulance.

All 5 ambulances were from different ambulance services, but a St. Paul Fire/EMS rig was present in the southern end of the parking lot, on standby and providing local 911 coverage. The purpose of the AST is to serve and handle a potential "surge" of EMS calls, and to respond to USSS requests close by for EMS coverage. We could see the protestors and demonstrators peacefully walking the fenced designated route, some carrying poster signs on the south side of the parking lot.

One person stopped by and said, "I got trapped inside the protestor fenced route and could not get back to my car and ended up walking further." AST 2 staff and Dr. Conterato provided him with a chair, water and a cool ice pack. After about 15 minutes, he said "thanks" and headed out to his car "about 2-3 blocks away." About 100-200 or more persons walked through the Sears parking lot, some carrying signs, and the temperature was 86 degrees with a warm to hot southerly breeze.

Cleared and Deployed

At 1545, dispatch reported protestors spraying other protestors with bleach. At 1600, SWAT command cleared AST 1. Fox 9 KMSP-TV News reported that a splinter group of protestors charged police, and police bicycle officers redirected the crowd. At 1715, at the end of the protestor route along the Mississippi river some protestors were becoming violent, and police were making a number of arrests, according to dispatched radio reports. At 1735, AST 1 was deployed along the south side of downtown St. Paul by the USSS.

At 1800, Fox 9 News reported "up to 30,000 protestors and demonstrations were in downtown St Paul." 1830 dispatch reports "about 100 officers were sprayed with urine and feces downtown and were now being decontaminated." Back at EMS command, J.D. showed me a map of St. Paul that was divided into 7 sections, according to the protestor and demonstration group's plans and responsibilities. J.D. said the 7 section map indicated which group was responsible for the demonstrations assigned as a task. At 1930, I turned in my EMS bag to Robinson.

Prepare, Train and Make Ready

I was amazed by the "magnitude and security" of the EMS AST Team response to the event. Our safety, public safety and patient care must always be first and foremost on our minds. Coordinated by Ron Robinson, Metro Regional EMS Coordinator, AST 2 Day training was held in August by the TEEX, Texas Emergency Extension Service for 58 EMS Responders, at the Mystic Lake Casino Convention Center in Savage, Minnesota. The AST model we create will serve as a template for future teams from each of Minnesota's eight EMS regions.

After the AST training, specific RNC classroom training was provided by Jeff Czyson, Operations Supervisor and Emergency Management Coordinator at North Memorial Ambulance and Cory Kissling, Paramedic, RN and liaison to the USSS and the FBI. In the 2 hour training class, AST members and EMS responders discovered the RNC preparations and potential problems. Similar training was delivered to other metro ambulance services.

"Remember," Cory said, "most protestors are non-violent, and they all have a "civil right" to express their opinion, whatever the subject of the opinion might be here in America, it is a constitutional right. However, some groups, activists, or anarchists, or persons can become violent." The training also included the items, devices and potential chemical substances to be used according to updated intelligence sources just prior to the RNC. Sunday, just before the RNC began, Fox 9 KMSP-TV morning news reported, police had "raided a number of protest group storage locations and confiscated many items."

EMS Working Together

Robinson said some protest groups met with EMS services and discussed their event protest plans with each other. Protest groups had their own first aid workers and "street medics" and some "clinics" located in the city of St. Paul. Robinson said the groups seemed positive about our EMS system and ambulance services in the Twin Cities. According to Robinson, "approximately 1000 protestors or anarchists were seen by their own staff for a variety of medical needs, during the week of the RNC."

Preparation

The Republican National Convention (RNC) expected 45,000 convention staff, delegates, and dignitaries to attend. This was declared an "Event of National Significance" by the Department of Homeland Security. The intelligence gathered by federal, state and local law enforcement agencies told us to anticipate 50,000 to 150,000 protesters. In addition, 20,000 Federal employees were in town to support the event. The RNC alone reserved 16,000 hotel rooms. This declaration awarded the city of St. Paul $50 million dollars to be used for preparation. More importantly, it established a clear chain of command. The USSS became the lead agency in the planning of the event. During the week of the RNC, over 800 protesters were arrested. Homeland security reports that 8 were charged with "acts of terrorism." Two Texas men were charged with intent to blow up law enforcement vehicles with homemade Molotov cocktails.

Flashback to Cities

New York and Boston hosted the party conventions four years ago. Neither city saw an increase in ambulance run volume. However, both cities did report that response and transport times increased. Intelligence organizations were receiving information, early on, that there would be large scale protesting and anarchy in St. Paul. Of course there were similar reports in Boston and New York that never came to pass. Balancing this knowledge was the experience of Seattle, Washington in 1998, during the World Trade Organization (WTO) conference. Seattle received the same intelligence and warnings but, consciously chose not to prepare for the anarchists and protestors based on their own prior experience. That mistake cost Seattle over $46 million dollars in damage and destruction. Csyzon said, "An FBI Agent with the Medical Planning group in Washington, D.C. stated he would like to implement a comparable AST system from the Twin Cities" for future national presidential events.

Fake Ambulance Spotted

On Tuesday, the second day of the RNC, a Twin Cities Paramedic spotted an "ambulance" with unusual generic markings in the city of St. Paul. The medic had attended RNC briefings on the need for heightened awareness, and as an Iraq War Veteran, he was well-educated and possessed a keen eye for things that are out of place. The medic reported the location of the vehicle he had seen to a supervisor, who then forwarded this information on to the USSS MACC. St. Paul Police were dispatched to investigate.

Police found the vehicle unlocked, and inside found a large cache of weapons, bags of urine and feces, and related items to cause criminal damage to property. St. Paul Police turned the "fake ambulance" over to USSS. This find was invaluable to authorities and went a long way toward keeping people safe. And furthermore an intelligence report detailing the incident was shared between all the three letter federal agencies including the CIA, FBI, NSA, and the Department of Justice. The paramedic did exactly what his RNC training said he was supposed to do, and we couldn't be more proud of him for spotting the "fake ambulance," according to a USSS representative.

Fake Ambulance Lessons Learned

We all know the about the potential for ambulances to be used to carry explosives or other contraband into hard to reach areas to harm persons or property. That only happens overseas, right? WRONG! This is just one of the reasons ambulances should NOT self dispatch to incidents. During the RNC, MNTrac was used to identify ambulances from the five-state area that would be entering, or passing through, the Twin Cities. The MNTrac system identified ambulances and vehicles that didn't belong and provided the crew with information. All ambulance services, both local and out of town, were to notify regional control centers when transporting patients into the Twin Cities.

Maintaining a high level of awareness needs to become a common, everyday EMS Responder practice; it doesn't just become a concern during large scale events. In the months leading up to the RNC, the FBI released an official alert making Public Safety and 911 responders aware of the potential use of suspicious or "fake" vehicles, ambulances in particular. This warning went out nationwide and was not specific to the RNC. All Minneapolis and St. Paul ambulance services were provided RNC informational classes aimed at raising situational awareness. It's been built into the Incident Response Plan training, related article below. Remember, prepare, train and make ready.

Responders Recognized at Convention

Four responders were invited to be specially recognized for their service and dedication by being seated in the front row on the final night of the RNC. A National Guardsman, North Memorial Paramedic Kelly Oberlander, Wayzata Firefighter Brett Springsted, and Rogers Police Officer Joseph Zerwas Jr. The responders were able to shake the hand of Republican presidential nominee John McCain. Ms. Oberlander was able to speak briefly with Senator McCain following his speech, and received a hug that was televised on CNN, FOX and MSNBC. Kelly said, "I was honored to be chosen to attend. It was just an amazing experience."

Author "Bike Medic" Rides Incognito

On Thursday night, the author rode his mountain bicycle from EMS command into the RNC area in downtown St. Paul to observe and photograph the protest activity. Some protestors dressed in costumes. I dressed in black and wore a cycling vest, and rode "incognito" around the 12 foot high fenced enclosure around the Excel Energy Center. Taped to my torso underneath my jersey was a first aid kit, AST ID badge and a "redress kit."

Checking in frequently with EMS command by cell phone, they directed me to the Marion Street Bridge area, on the north side of downtown St. Paul. Police had several hundred protestors who had not dispersed from the State Capitol area after their permits to protest had expired. A group of 200-300 protestors were surrounded by police and moved toward and onto the Marion Street Bridge. Many protestors were given the chance by police to leave peacefully. I saw 2 plow/sand trucks and a water cannon truck move to the south side of the bridge, to prevent the crowd from moving south into the Republican convention at the St. Paul Xcel Energy Center. One by one, I watched the protestors arrested, searched, placed on buses, and taken into custody. At midnight, I pedaled back to EMS command by bicycle light, and less than half of the protestors had been arrested from the bridge. It was going to be a long night for the officers!

References:

• Ambulance Strike Team Training by Texas A&M: www.teex/org/esti
• Alexandra Nelson's Photo stream: http://www.flickr.com/photos/30315576@N04/
• RNC video and protestor photos: www.myfoxtwincities.com
• RNC 08 Citizens Report: www.rnc08report.org
• Department of Homeland Security: www.dhs.gov

Related Article:

• Twin Cities Medics Train for Updated Incident Response Plan

Dave Long, Medic, R.N., known as The Airbag Detective, is a national EMS presenter as well as EMS Educator for North Memorial EMS Education and Driving Chairman for North Memorial Ambulance in Minneapolis for 25 years. Dave has also worked as a flight paramedic and as a law enforcement park ranger in Yellowstone. Dave spoke at the 2008 EMS Expo in Las Vegas on: Defensive Driving Tips from the Experts, Highway Safety for First Responders, New Car Anatomy from the 2008 Detroit Auto Show, and 27 Cars That Can Shock You: Hybrid Vehicle Safety. For security reasons, some names and actual locations have not been mentioned in the article. Contact Dave at dave.long@northmemorial.com.