A deputy slumps to the ground.
"Officer down! Officer down!"
Three members of the Harford County Sheriff's Special Response Team, essentially a SWAT team, corner the suspect with their guns raised. As deputies scatter to secure the living room, the fallen officer lies motionless. An unarmed man in a black Kevlar bulletproof vest rushes in. Unlike the others, he carries no weapons, just two huge black packs, loaded with medicine and supplies.
The unarmed man in the practice drill is Dr. Eric Nager, an emergency room doctor at Franklin Square Hospital, who often accompanies the team in barricade situations.
"I'm there as a person who's administering care if someone is injured, whether it be a police officer or a victim," Nager said.
Like many SWAT teams around the nation, the Harford County sheriff's department has a medical staff. Nager and two emergency medical workers, Jeremy Mothershed and Gregory Young, make up Harford's group.
Every week, the 19-member team, including Nager, practices different scenarios, such as this one where a deputy is injured during a forced entry.
The drills force the deputies to think on the fly and keep safe.
"Treating people in a standard fashion, it ends up getting people killed," Nager said. "The initial response is to run over to them and administer first aid. There's a good chance you become a victim."
When the team is deployed in barricade situations, regular first-responders cannot be in the "hot zone" -- the area where people are in danger and the situation is unfolding. But Nager, Young and Mothershed have been trained to enter these areas.
"You can't bring a volunteer EMS [emergency medical services personnel] into a tactical operation," said Mothershed, a paramedic. "This allows us to have law enforcement with a specialty for life-saving right on the front lines."
The amount of time to shuttle a patient from the hot zone to an ambulance could be deadly, the medical team says.
"A gunshot wound could bleed out in the time it takes to evacuate the person to the ambulance," said Young, an emergency medical technician. "By having a doctor or an EMT, treatment is there. That's a life-saving factor right there."
In one incident, a distraught man barricaded himself inside a house and pointed a hunting crossbow to his chest, threatening to kill himself.
"We had materials -- IVs and tourniquets ready in case the man would shoot himself," Nager said. "Had this individual shot himself, it would've been seconds, rather than a delay of 10 minutes and that would've been the difference between life and death for either the victim or one of the officers."
The man eventually tired of holding the crossbow and was subdued with a Taser gun.
In August 2006, when a sergeant was accidentally shot in the left elbow while training with the team in northern Harford, Young was there to immediately dress the wound.
"We were in a remote area, so EMS response can be extended," Young said. "I knew what care needed to be done, and it took about 20 to 30 minutes because of the area we were in, and I was able to immediately respond."
The sergeant was flown to Maryland Shock Trauma Center and made a full recovery. The officer has since returned to the force.
Tactical emergency medicine focuses on supporting law enforcement special operations and originates from the military, Nager said. Just like military medics who treat wounds in volatile environments, treating patients in the field can be difficult.
"You put on 60 to 70 pounds of gear and try to squat with a helmet on," Young said.
In 2004, Mothershed suggested bringing the medical component to Harford's tactical team after reading about them in journals. He and Young had been emergency first responders before becoming deputies.
They attended sessions on tactical emergency medicine training in Bethesda, where they specialized in treating combat injuries such as wounds from gunshots, explosions or falls.
They were approached by Nager in June 2006, a Baltimore doctor with an interest in law enforcement. After attending 50 hours of training in tactical medicine in California, Nager volunteered with Harford's Special Response Team for eight months.
He became a contractual employee of the sheriff's office after completing a three-week SWAT training course last March.
Nager advises Mothershed and Young on medical matters, and treats injuries at the scene when accompanying the tactical team.
"Anytime the SWAT is deployed on a mission, I would be notified and go out with them as a member of the team, as long as I'm not [working] in the hospital," Nager said.
Unlike Young and Mothershed, Nager is not a sworn officer and cannot carry a weapon.
"I have to rely on them to protect me," he said, referring to the members of the Special Response Team. "I'm not armed. At times, it can be very scary. I've come to trust them. They're trusting me to take care of their lives -- it works both ways."
He also monitors the health of the team members.
Knowing their medical history, he looks for subtle signs and symptoms.
"You can nip these things in the bud if you're right there when something happens," Nager said. "Recovery time becomes shortened and they can get back to duty a lot quicker."
After a drill last month, the seven officers who had been practicing the officer-down scenario said they felt better knowing that a doctor is there.
madison.park@baltsun.com