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Tactical emergency medicine services (TEMS) has emerged as a specialized niche within the field of emergency medicine. With increasing demand for physician participation in civilian tactical teams, there will be efforts by residents to become involved at earlier points in their clinical training. Interest in prehospital care research continues to grow within emergency medicine (EM), and the operational boundaries of its providers are continually being pushed further outward. Indeed, for many of us in the field, potential involvement in this earliest phase of care—with television images of lifesaving in-field cardiac defibrillations, racing ambulances, and medical helicopter evacuations in our minds—was one of the most alluring calls to join the ranks of emergency physicians, with the goal that we too would practice the best medicine "anywhere, anytime."
Tactical Emergency Medical Services (TEMS) is out-of-hospital care given in hostile situations by specially trained practitioners. It is distinct from the care given by medics in war zones, as TEMS generally refers to care rendered by civilians. Tactical Medics are Emergency medical technicians (EMT), paramedics, nurses, and physicians who are trained to provide life-saving care and, sometimes, transport in situations such as tactical police operations, active shooters, bombings, and natural disasters (though rarely the latter).
As the number of training programs in emergency medicine has grown, so too has the number of subspecialty areas within the field. One such niche is tactical emergency medicine services (TEMS), herein defined as the provision of emergency medical support to civilian law Special Weapons and Tactics (SWAT) and military special operations units. Importantly, this care encompasses not only that provided while under active fire, but also includes the preventive and primary care that takes place before combat ever begins.
Traditionally, the involvement of physicians in this area of medicine, and especially in the training for such participation, has come at the fellow or attending level. Currently, some emergency medical services (EMS) and occupational medicine fellowships include involvement with a TEMS team as an option for those interested.
But, as former tactical medic and Surgeon General Richard Carmona pointed out, tactical medicine is a field that is likely to grow over the next few decades, and as that expansion occurs, it is likely that residents will try to become increasingly involved at earlier points in their postgraduate training. It is neither a clinical study nor a structured literature review, but rather an opinion piece intended to help emergency medicine residents and emergency physicians better understand the difference between conventional prehospital and inpatient emergency medicine and that of tactical emergency medicine. Tactical emergency medicine is a specialty that utilizes the full array of the emergency physician's skill set. It is also a field that is ripe for continued expansion, but the resident looking to become involved with a team should be aware of the requirements necessary to do so and the obstacles likely to be encountered along the way.
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1) Global Summit on Emergence Medicine & Medicare Expo, October 05-07, 2015 Dubai, UAE
2) 11th Annual New York Symposium for International Emergency Medicine, August 6, 2014, Lennox Hill Hospital, New York City, New York, United States
3) 3rd International Emergency Care Symposium, Melbourne, September 4-5, 2014, Melbourne, Australia
4) Developing EM 2014, September 8-12, 2014, Salvador, Brazil
5) 8th Annual Symposium on Advanced Emergency Electrocardiology, September 14-21, 2014, Sailing from Barcelona, Spain
6) 8th European Congress on Emergency Medicine, September 28- October 1, 2014, Amsterdam, Netherlands
7) 4th Eurasian Congress on Emergency Medicine, November 12-16, 2014, Antalya, Turkey
8) Asian Conference for Emergency Medicine 2015 (ACEM 2015),November 7-10, 2015
9) 16th International Conference on Emergency Medicine (ICEM 2016), April 18-21, 2016, Cape Town, South Africa
10) 17th International Conference on Emergency Medicine, June 2018, Mexico City
1. National Tactical Officers Association
2. National Association of Tactical Medics
3. Special Operations Medical Association
4. Tactical Medics International (TMI)
5. International School of Tactical Medicine
6. OUTHERN NEVADA WILDERNESS MEDICAL SOCIETY
3rd International Conference on Nursing & Healthcare October 05-07, 2015 San Francisco, USA
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This page was last updated on 23rd Apr, 2015
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