The fact is, where you’re shot directly shapes your odds of surviving. One study of firearm injuries in Philadelphia found that each extra minute of drive time to the nearest trauma center was linked to a higher risk of death, contributing to 23 percent of fatalities. Communities hit hardest by gun violence often face the longest response and transport times. In Chicago, gunshot survivors told The Trace that they waited more than 15 minutes for an ambulance and drove themselves rather than risk bleeding out.
If we can change that math of time and distance, it stands to reason that we can improve survivability rates for shooting victims. But how?
States should consider testing the use of National Guard medics as short-term backup for local emergency service workers, especially in the warmer months when shootings often spike. The goal: Get potentially life-saving treatment to victims faster, through a governor-activated, medical-only deployment, not a federal law enforcement mission.
Guard deployments in the name of public safety have already occurred, sometimes stirring controversy. New York state sent guard troops into the New York City subway to beef up security. New Mexico has used its guard personnel in non-enforcement roles like traffic control. In some instances, guard members stationed in public spaces have acted as first responders. In Washington, D.C., for example, they helped revive a man struck by a Metro train.
As courts scrutinize how and why guard members are used in U.S. cities, leaders should consider deploying them on a clearly limited, civilian-led mission focused on saving lives instead of street patrols. Using guard members to bolster medical response is safer and far more consistent with their purpose than asking them to serve as substitute police.
Recently, two guard members were shot near the White House in what officials called an ambush; one of the victims later died. The episode is a grim reminder that mission design matters, showing how highly visible security roles in cities can expose service members to targeted violence.
A medical mission is different. Medics don’t detain or arrest people. They stop bleeding, stabilize patients and move them fast, striving to conserve precious minutes between injury and surgery.
Tapping the National Guard for medical surge support is not unprecedented. During a peak period of COVID-19 hospitalizations in early 2022, more than 15,600 guard members helped nationwide, including more than 6,000 who worked in hospitals and nursing homes.
But any guard-medic plan must face the biggest choke point in the EMS system — the hospital handoff. National data from 2017 to 2022 show ambulances regularly stuck at hospitals, waiting to transfer patients because beds are scarce, hallways are jammed and staff are stretched thin. In California, a study found the average handoff took about 43 minutes, with nearly half of EMS agencies reporting averages longer than the state’s 30-minute standard.
If such logjams persist, adding medics alone won’t win back those crucial minutes; the delay would simply shift from the street to the ER door. Given that, any program that engages the guard should add capacity in the field and include measures to speed up hospital handoffs.
So what would a responsible pilot look like?
For starters, strict guardrails are essential. This must be a medical-only mission under state authority and civilian medical direction, with clear written limits. Guard members selected for this endeavor should already be licensed EMTs or paramedics, or should be required to complete a short, state-approved certification bridge.
Guard teams should operate under the local EMS chain of command, not under law enforcement. They should be covered by state liability rules and dispatched through 911. Teams should enter only after scenes are cleared, and the mission should remain unmistakably medical through clearly marked uniforms and gear.
A guard-medic pilot should be a bridge, not a replacement, for civilian EMS staffing. EMT and paramedic shortages, made worse by staff burnout and the pandemic, won’t be solved by surge deployments alone. To boost effectiveness, a pilot should be paired with retention and pipeline investments, including paid training, retention bonuses, faster credentialing and more support for veterans entering EMS careers. Veteran-to-EMS programs like Atlanta’s Grady EMS Veterans Academy should be expanded so a short-term surge becomes long-term staffing.
Embracing this idea isn’t about downplaying crime prevention or dodging the gun debate. It’s about declaring that while we work to reduce shootings, survival shouldn’t depend on a ZIP code.
Thaddeus L. Johnson, a former police officer, is a senior fellow at the Council on Criminal Justice and teaches at Georgia State University. His wife, Natasha N. Johnson, is an assistant professor of educational studies and research at Augusta University.
Governing's opinion columns reflect the views of their authors and not necessarily those of Governing's editors or management.
