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Tactical Emergency Medical Services

Tactical Casualty Care and Tactical Medicine

The EMS Authority, working closely with fire and law enforcement agencies, recognized these differences and identified two distinct categories of specialized tactical field medical response and training needs of first responders during active law enforcement incidents: 1) Tactical Casualty Care and 2) Tactical Medicine.

Tactical Casualty Care (TCC) is the delivery of specialized adjunct tactical emergency medical services to casualties of active shooter and terrorism events by first responders from an established EMS system to include, but not be limited to, public safety personnel, EMT’s, Advanced EMT’s, and paramedics as described by CCR Title 22, Division 9, Chapters 1.5 and Chapters 2-4.  Tactical Casualty Care EMS providers respond as a medical support service provider to law enforcement incidents and provide field tactical medical care to casualties usually in an area where there is minimal to no direct or immediate safety threat.  Medical direction and oversight of the tactical casualty care first responder is provided by the local EMS medical director in coordination with local law enforcement.

Alternatively, Tactical Medicine for Special Operations is the delivery of specialized tactical emergency medical services to casualties of any active law enforcement incident by law enforcement personnel assigned to a Special Weapons and Tactics (SWAT) operations team, as described by California Penal Code 13514.1.  Tactical Medicine for Special Operations first responders respond as an integral part of a SWAT operation team and may provide field tactical medical care to casualties in an area where there is a direct and immediate safety threat.  Medical direction and oversight of the Tactical Medicine for Special Operations first responder are provided by a licensed physician in coordination with the local EMS agency as part of an established EMS system.  POST is responsible for monitoring and approving Tactical Medicine for Special Operations training programs and courses with input from the EMS Authority.  Additional information on the POST Tactical Medicine for Special Operations training and operation program can be found on the POST website at https://www.post.ca.gov.

Tactical Casualty Care and Tactical Medical Training Framework:

Tactical Casualty Care and Tactical Medical Personnel Levels   [pdf]

California Tactical Casualty Care (TCC) Guidelines and Resources
  • TCC Tactical First Aid/Tactical Emergency Medical Support (TEMS) First Responder Operational (FRO) Training Standards Guidelines [pdf]

  • Tactical Casualty Care (TCC) Assessment and Treatment Model (2015) [word] [pdf]

  • Tactical Medical Planning and Threat Assessment Checklist (2015)  [word] [pdf]

  • EMS Integration with Law Enforcement during Active Shooter Events (2015)  [word] [pdf]

POST/EMSA Approved Training Programs
California State Tactical EMS Advisory Committee
Tactical Medicine

Since May 2010, Tactical Medicine guidelines provide baseline development and implementation standards for Tactical Medicine programs developed as required by the Peace Officers Training and Standards (POST) and described in the SWAT Guidelines approved in 2010.  The California Emergency Medical Services Authority (EMSA) is responsible for setting the statewide medical standards utilized by POST. As such, guidelines are intended to serve as a template for the development of operational programs that are developed by any public safety agency in California, and to serve as the minimum standard for initial tactical medicine training.

Tactical Medicine guidelines are also meant to serve as a companion document to the POST Operational Guidelines for SWAT (2005). It describes the critical role that tactical medical planning and threat assessment plays in the overall contingency planning as part of the SWAT operational plan. The public safety agency developing a tactical medicine operational program should conduct a needs assessment to determine the level of emergency care required by the SWAT team to support the mission and operations.

The operational program must consider the need for medical oversight and coordination with the local EMS agency, medical direction, use of Emergency Medical Technicians (EMTs), paramedics and other advanced life support personnel, and minimum training and equipment standards. The agency should develop policies and procedures for medical support during tactical operations.

Approved tactical medicine training programs, which provide initial and refresher or update tactical medicine training to personnel, shall adhere to the minimum training guidelines and standards outlined in the guidelines. The goal of the guidelines manual is to describe minimum core competencies and define the written and skills testing necessary to achieve the standards prescribed by POST and EMSA. The guidelines have been approved and are available on the POST website.

Tactical Equipment Vendors

The following is a list of recommended tactical equipment vendors:

For Further Information from EMSA

Please contact Daniel Smiley, Chief Deputy Director or Kim Lew, Tactical Casualty Care Program Analyst.

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