A Primer on PPE Training for Tactical Officers

Law enforcement and intelligence agencies face myriad challenges in their efforts to combat terrorist organizations. Recent acts, and attempted acts, of terrorism, Congressional reports on “failed readiness” capabilities, and the Department of Justice’s concern over the nation’s ability to respond to Weapons of Mass Destruction (WMDs) all indicate that the United States is not yet fully prepared for a chemical, biological, radiological, nuclear, and/or explosives (CBRNE) attack. Moreover, although recent intelligence reports indicate that al Qaeda’s infrastructure is weakening, its efforts to acquire WMDs have not – and neither have its intentions to use such weapons against the United States and its allies. The continued efforts of terrorist organizations to acquire one or more CBRNE weapons means that the United States cannot afford to be unprepared. In short, being prepared is no longer just an option – it is a very high priority.

Although there are many factors contributing to the current lack of U.S. preparedness, inadequate training should not be one of them. As a community, U.S. first-responder agencies cannot afford to train only 10 percent of the time to deal with a theoretical “10-percent chance” that a CBRNE incident will occur. Often, the question of why al Qaeda has not yet attacked the United States again – as it has done overseas in smaller-scaled and isolated incidents – perplexes almost all of the experts in this field. Many of them have in fact suggested that al Qaeda is planning an attack that would be both lethal and spectacular. If intelligence agencies give any credence to the information gathered over the past several years, they would also certainly agree that a CBRNE attack may be looming just over the horizon.

Knowing that the storm is approaching, but not knowing when and where it will strike, is an unfortunate reality that law enforcement agencies have learned to accept. Those agencies know that they must be ready, prepared, and equipped to deal with any and all facets of an attack, particularly and specifically a CBRNE attack. For the tactical operator, moreover, preparing for a CBRNE attack goes far beyond intelligence gathering. Once the unknown becomes known, agencies must have people in place who are equipped to deal not only with the situation at hand, but also prepared mentally, physiologically, and tactically.

Life, Death, and the Risk of Infection For a tactical officer, it is particularly critical – of literally life-or-death importance – to know how PPE (Personal Protective Equipment) clothing works and how wearing it affects the body. Sometimes the risk of infection from a CBRNE attack may be relatively small, but the effects and health consequences associated with it might still be extremely severe. Because PPE is not designed to do anything other than what it was originally intended to do – i.e., protect the wearer – it must be well maintained, in strict accordance with manufacturer recommendations, so that it works when needed.

When concerned with hazardous materials such as a chemical, biological, radiological, or nuclear (CBRN) device or even a clandestine drug laboratory, the responders’ first enemy is contamination. To cope with that specific danger, SWAT (special weapons and tactics) personnel protect themselves by donning coveralls, gloves, masks, chemical protective clothing, and respirators. Wearing the correct level of protective clothing is of vital importance, and for that reason PPE equipment should be selected based on the known properties of the specific hazard.

Unfortunately, of the many factors that must be considered when beginning a dangerous operation, the specific hazards likely to be encountered are usually unknown to the tactical operator. Because of the unique characteristics of each situation, therefore, tactical officers dealing with a CBRNE attack must be prepared at all times for the ultimate challenge – engaging a hostile subject who is equipped with a CBRN weapon or device. When the hazard is known to be relatively minor – sometimes just a simple nuisance – minimal protection is perhaps all that may be required. However, when conditions are unknown, tactical teams should always use the greatest level of skin, respiratory, and eye protection – collectively known as “Level A Protection.”

U.S. responder agencies themselves, at all levels of government, should be assigned the responsibility (and given the resources needed) for: (a) outfitting tactical officers with the proper levels of PPE clothing and gear; and (b) providing adequate training – and training time. Because all or almost all PPE clothing is much more cumbersome than the typical uniform worn by a tactical officer, team members should be provided ample training in equipment preparation as well as in the performance of specific tasks while actually wearing the PPE clothing. Today, most federal law enforcement officers are accustomed to wearing suits to work. Nonetheless, they must be prepared to change, at a moment’s notice, from a Brooks Brothers suit into SWAT tactical gear and outfitted PPE. Moreover, while wearing a tactical vest, web gear, and duty belt on top of the PPE, the officer must be confident that those items will not compromise the integrity of the PPE suit. The ability to maneuver and to address the task at hand is the ultimate goal – and effective training is the only way to ensure that that goal is achieved.

Time, Trips, Slips, and Other Hazards Not incidentally, individuals wearing PPE must be concerned not only with the hazardous agents they may face but also with issues – heat stress, for example – that in other circumstances might safely be overlooked or ignored. Moreover, military and civilian users must develop and use “best estimates” of an acceptable operation time for wearing PPE that will avoid excessive heat stress – which could threaten their ability to function as well as their health and safety. Current approaches to determining operation time tend, understandably, to be conservative and err on the side of caution. Such conservative estimates may therefore require a responder to prematurely cease his or her work efforts and remove the PPE. At the same time, care must be taken to avoid an overly aggressive approach that overestimates operation time and could threaten the health and safety of responders or others. Proper training will, or should, familiarize operators with the limitations associated with operation time.

Being a tactical operator is a dangerous occupation in itself; and it is impossible to work in a hazardous CBRN condition without donning PPE. Although most recorded injuries result from innumerable factors – e.g., trips, slips, falls, hostile engagement – wearing PPE can add the hazard of heat stress to the equation. Heat stress can and does occur most often when the PPE interferes with the body’s own built-in ability to cool itself. In most if not quite all operational situations, tactical teams do not face the hazard of heat stress, but they still must be aware of the danger. When members are sealed up in protective clothing, the body cannot cool itself properly. The longer that situation persists, the higher the body temperature rises until the body eventually succumbs to heat stress. If the same conditions persist and the body can no longer cool itself, heat stress can evolve to heat stroke.

Heat stress and fatigue are important factors – especially in situations in which quick judgments are necessary. Tactical operators rely on their training, skill sets, and judgment; when these factors become impaired, poor decision making can quickly follow. It is highly recommended, therefore, that tactical officers routinely wearing PPE obtain medical clearance by reporting for regular physicals. It is also important that tactical teams regularly address such closely related factors as medical readiness, physical fitness requirements, on-scene rehabilitation, and hydration strategies.

The Three Essentials: Teamwork, Training & Temperature Awareness The use of PPE and insistence on medical monitoring are obviously important for the individual officer’s own safety as well as the safety of the entire tactical team. All persons serving on a team are individually and collectively both crucial and integral to the team’s success. If the individual fails, the team fails. Furthermore, wearing the wrong equipment, or ill-fitted equipment – or even the right equipment, worn improperly – can have fatal consequences for the entire tactical team – and for their mission. It is important that tactical team members understand not only the benefits but also the limitations of their PPE.

The importance of training cannot be overemphasized – the operator and the team must understand the potential limitations associated with PPE. Operators will know through adequate training that PPE requires a specific amount of time to put on, and should therefore make adjustments as needed to allow for that time during an operation. Through adequate and effective training, operators gain understanding of the limited dexterity and impaired mobility they may, and probably will, experience while wearing PPE. Many, but not all, will probably have difficulty dealing with the impaired communication and reduced vision associated with PPE. In addition, most – again, if not all – operators will have difficulty dealing with the psychological stress, use limitations, dwindling oxygen availability, increased weight, and heat stress associated with their PPE.

Numerous studies have shown that working in a high-temperature environment creates greater physiological and psychological strain than performing the same work in a neutral environment. Most chemical protective outfits are both heavy and cumbersome; for that reason alone, wearing PPE both decreases the body’s ability to deal with stressors and restricts freedom of movement. It is important, therefore, to become accustomed to the limitations and physical demands that PPE places on the operator, but that can be accomplished only through adequate training.

The optimum way for the human body to combat heat stress is to allow the body to cool normally – i.e., through evaporation. But that is not possible while wearing PPE or other “non-breathable” clothing in which the body temperature can rise both rapidly and unexpectedly. Because each operational situation is unique in at least some respects, tactical teams are not afforded the luxury of taking a break during an operation. More specifically, tactical officers cannot, particularly in “the hot zone,” afford to remove equipment due to extreme heat and therefore must remain hydrated without compromising the integrity of their PPE.

Tactical operators can expect large volumes of sweat loss during tactical operations due to: (a) their strenuous work; (b) the usually extreme heat conditions encountered; and (c) the impermeability of the PPE materials. During taxing work in a hot environment, or while wearing impermeable clothing, a typical adult human might lose more than two quarts of sweat per hour. It is common, therefore, for tactical operators to lose even more sweat per hour when working in hot temperatures while fully PPE-outfitted. That sweat loss contributes significantly to a decrease in plasma volume, imposes additional strain on the cardiovascular system, and decreases thermal tolerance. Tactical operations usually involve performing strenuous activity in a hot and aggressive environment while wearing restrictive and heavy PPE – and that combination of circumstances makes tactical operators more susceptible to heat stress.

Deadly Combinations & a Two-Team Approach to Survival Heat stress and the resulting increase in body temperature have innumerable, and almost always harmful, effects on the human body – e.g., increased cardiovascular strain, dehydration, the rapid onset of muscular fatigue, and interference with cognitive functions. The inability to process information quickly, combined with physical fatigue, can be a deadly combination for tactical operators. Decision making capabilities deteriorate rapidly with extended exposure to heat stress – which has been shown to reduce the cognitive and mental-processing abilities essential to decisions involving both simple and complex tasks. The degree of decrements of these tasks is directly related to the deep body temperature, which is a function both of duration and of the time and intensity of heat exposure.

The best way, almost always, to treat heat stress is to address that potentially lethal problem before it happens. High temperatures and humidity caused by PPE stress the body’s ability to regulate and cool itself. Among the more obvious symptoms of heat stress are dizziness, cramping, nausea, severe headaches, hot and dry skin, and extreme body temperatures – as much as 106 degrees, and sometimes even higher. Knowing the symptoms, recognizing the limitations imposed, and preparing the wearer’s body – primarily through adequate training – can help significantly in reducing the chance of experiencing heat stress.

To reduce the harmful effects of both heat stress and fatigue, tactical teams should be prepared to outfit two or even three operational teams – which should be strategically positioned and prepared to rotate in an orderly sequence to address a “typical” hazmat situation. Rest cycles usually: (a) give the body an opportunity to rid itself of excess heat; (b) slow down the production of internal body heat; and (c) increase the body’s blood flow to the skin.

Tactical teams should focus on reducing the harmful effects of heat stress by, among other things, acclimating themselves ahead of time with the PPE they have been issued. Donning PPE equipment once or twice a year does not provide enough time to prepare operators with the specific knowledge they need to operate effectively. Operators should therefore: (1) allow their bodies to naturally and gradually acclimate to the equipment they are wearing; and (2) familiarize themselves, beforehand, with the specific limitations imposed by the equipment they will be wearing. Drinking plenty of water before, during, and after can limit the effects not only of the water loss itself but also of the weight loss caused by water evaporation during an operation. Operators also should avoid the excessive use of alcohol, not only because it can so easily lead to mental confusion but also because it causes dehydration – which imposes an added burden to the body during very high temperatures. One of the best protections against heat stress, of course, is overall physical fitness, which not only can improve an operator’s coordination and concentration but also increase his or her alertness, strength, and durability.

Once again, the best means of combating heat stress associated with tactical teams is addressing that adverse circumstance before it happens. An “operator down” due to heat stress can defeat the team’s overall mission – and endanger a large number of lives. Knowing individual limitations, addressing the problems caused by inadequate training, and taking the necessary precautionary measures to combat heat stress can make a major and frequently life-saving difference in the outcome of a CBRNE incident.