Organization Title


Tactical Medicine and Tactical Casualty Care

In California, two distinct categories exist for the medical support of law enforcement operations.  The first is Tactical Medicine, and the second is broadly considered tactical casualty care (which is not considered tactical medicine.)  Tactical casualty care can be further subdivided into tactical first aid and tactical lifesaver.

In addition, significant progress has been made in improving the medical care in the tactical environment in California since 2008.  As part of this process, EMSA and POST have standardized minimum curriculum and terminology to improve training consistency and public understanding

Three different levels of medical training in the tactical environment have been established:

  • Tactical Medicine (TM)
  • Tactical First Aid (TFA)
  • Tactical Lifesaver (TLS)

These three levels are summarized in this chart

Tactical Medicine In California

Since May 2010, Tactical Medicine guidelines provide baseline development and implementation standards for Tactical Medicine programs developed as required by POST and described in the SWAT Guidelines approved in 2005. 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 available at the POST website.

Visit the State Tactical EMS Advisory Committee webpage.

POST/EMSA Tactical Medicine Guidelines and Regulations

Tactical Medicine Guidelines and Regulations have been established to guide tactical medical care.


Useful training and reference materials

  • Tactical Emergency Casualty Care (TECC) Assessment and Treatment Model - Pocket Card size (2014) [word] [pdf]
  • Tactical Medical Planning and Threat Assessment Checklist - Pocket Card size (2012)  [word] [pdf]
  • EMS Integration with Law Enforcement during Active Shooter Events Quick Reference Guide - Pocket Card size (2014)  [word] [pdf]
  • State Tactical EMS Advisory Committee
  • Purchase of Ballistic Protective Equipment (BPE) for Fire and Emergency Medical Services (EMS) Personnel in Support of Active Shooter and Mass Casualty Incidents (AS/MCIs) [pdf]

EMS Personnel may print and use for own references:


Frequently Asked Questions

FAQs regarding Initial Training Programs, Refresher Courses, Tactical First Aid and Tactical LifeSaver courses (Non-Tactical Medicine Courses) and Law Enforcement agencies

  • FAQs   [pdf]
  • Tactical Medical and Casualty Care Training Framework   [pdf]
  • Tactical Medical and Casualty Care Personnel Levels   [pdf]
Tactical Equipment

These equipment suppliers have equipment that comes prepackaged to meet the POST/EMSA Tactical Medicine Guidelines as described in Chapter 4.0

For Further Information from EMSA

Please contact Daniel Smiley, Chief Deputy Director

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