Tactical Medicine
safe, BSI?” EMS providers got that whereas hospital staff did not. Now the TCCC methodology (Care under fire, tactical field care, and tactical evacua‐ tion) is the comparable mantra for the tactical medic.
Find programs that have proper med‐ ical AND operational oversight. Remember, what makes the tactical medic valuable is having the critical thinking skills to do the right thing, at the right time. “Good medicine is not necessarily good tactics…and…bad
how to insert a chest tube, when it isn’t applicable to your scope of practice, nor when it is practical for your opera‐ tional environment. For the Special Forces Medic, it is applicable because they might care for a pre‐hospital casu‐ alty for days whereas the civilian law enforcement medic will not (in most cases).
Take tactical medicine seriously as a discipline of EMS. Participate in contin‐ ual education opportunities as well as research opportunities. Attend various
Future Of Tactical Medicine
As an author of several tactical medi‐ cine programs since the 1990s, I have seen the continual development and change of practice in tactical medicine. The most insightful and innovative changes weren’t within medicine, but rather in the approach to the delivery of procedures. The premise of hemor‐ rhage control has been around for hun‐ dreds of years. It wasn’t until the late 1990s that the concept of controlling the operational environment took precedence as a medical interven‐ tion…” Mission failure can result in more casualties.”
Since the inception of the tenets of tactical combat casualty care (TCCC), there have been several updates, but most of those were focused at minor changes in medical procedures. The contextual lessons remain the same. As the worldwide operational environ‐ ment changes so will the operational environment of EMS and pre‐hospital providers. Training therefore should focus on the operational environment, rather than a specific list of core com‐ petencies. Wound epidemiology will differ based on the operational environ‐ ment, the weapons profiles, the dam‐ age potential, use of hazardous materi‐ als, use/non‐use of protective equip‐ ment, as well as intrinsic physical and psychological characteristics of the per‐ sonnel involved.
tactics can cause a mission to fail. Mission failure can lead to more casual‐ ties.” Having a progressive medical director who understands the tactical mission is critical, just as having good and experienced tactical personnel is paramount. The combination of these two ingredients is key in when selecting your program.
Training for your operational environ‐ ment includes training within your med‐ ical scope of practice and operational (legal) purview. Don’t bother learning
30 EMS PRO Magazine
tactical medicine programs to capitalize on experiences from many military and law enforcement veterans. Take what is useful from each of these programs and avoid the “one‐way” approach mindset. Just as you matured in the EMS profession, it was innovation and “street tricks” that have helped you as a provider to get where you are. Tactical medicine as a specialty is still in its infancy and is in a state of continual development. Take part in that devel‐ opment.
Twenty years ago, it was inconceiv‐ able to think that there would be ter‐ rorist attacks on US soil. Ten years ago, only Hollywood would produce movie plots of terrorist attacks on New York and Washington DC. Weapons of mass destruction were once something only considered by the military when prepar‐ ing for war overseas. Now, a nexus exists between the war on drugs and international terrorism. We’ve lived through the events of 9/11, yet smug‐ gling tactics used by drug cartels world‐ wide against the US are being adopted by international terrorists. Along with this changing environment comes a need to change our approach to the emergency response. These contextual changes require specialized training for the missions ahead. EMS
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