The mission of the Division of Tactical Emergency Medicine (DTEM) is to provide the highest quality preventive and interventional care to law enforcement agencies (LEAs) in both clinical and tactical settings; create educational opportunities for law enforcement officers, current and future tactical medical providers and other medical personnel; and lead the nation in determining and disseminating best evidence and practices for tactical medical education and clinical care. Established in 2009, DTEM is now part of the Center for Prehospital and Operational Medicine.
Public safety organizations often work in dangerous environments with the possibility of injury a constant threat to their members - those who are protecting people in the communities they serve. One method of decreasing member risk and potential liability for interactions with others is to provide medical resources capable of operating in those same environments. Tactical emergency medical support (TEMS) is the ability to safely provide medical care in high-threat situations where conventional emergency medical services (EMS) personnel are not equipped or qualified to respond. This is particularly true for law enforcement special operations: aviation, bomb disposal and special weapons and tactics (SWAT) teams.
Tactical emergency medical support is based on three pillars:
- Achieving and maintaining team health through preventive medicine, human performance and sports medicine;
- Education and training programs for all team members (including commanders, operators and medics) on tactical casualty care; and
- Provision of medical expertise in the forms of advice for decision-making and direct care during all training activities and operational missions.
Over the last century, a systematic approach to the management and evacuation of battlefield casualties has been developed. Rapid, efficient and effective trauma management by medical personnel embedded in operational units has uniformly been accepted as the standard of care in the military tactical environment. Advances in military medicine have been applied in the civilian realm when medical personnel returned from conflicts and applied their skills back home. The fundamental concepts of medical support for LEA special operations evolved from these military roots. Although there are important distinctions between the two environments, military medicine and law enforcement TEMS each embody special knowledge, skills and abilities that define them as intertwined medical disciplines.
The Division of Tactical Emergency Medicine supports medical care of LEA special operations through qualified faculty serving as tactical medical providers. They are responsible for care of tactical team members during fitness, training and operational activities. In this capacity, they act as medical advisor and liaison to the team commander, provide lifesaving measures in the tactical environment and initiate other medical care as necessary. Supervised resident participation is strictly voluntary.
The Division supports preventive medicine and enhanced performance through cooperation with community medical providers. Activities include departmental physical examinations, pre-participation screening, fitness training, nutritional counseling, tactical performance enhancement training and injury clinics.
Education and Training
Education and training is provided to law enforcement officers, tactical medical providers, conventional out-of-hospital providers and other interested healthcare personnel. Example topics include self-care and buddy-care, concepts and practice of tactical emergency medical support and medical support of the tactical athlete.
In association with the Ohio Attorney General’s Office and the Ohio Peace Officers Training Academy, the DTEM conducts courses on Self-Aid/Buddy Aid for the Law Enforcement Officer, in which patrol officers and tactical operators learn the basics of tactical emergency casualty care, training them to recognize immediately life threatening injuries and intervene quickly and effectively before the arrival of conventional EMS personnel. This training served as the model for the Critical Injury First Aid module that is now part of Ohio’s Basic Peace Officer curriculum.
Educational opportunities are provided for the emergency medicine resident physicians and other graduate level physicians. These consist of classroom lectures, small-group discussions, skill labs and field exercises. Content is drawn from the current peer-reviewed TEMS literature. Delivery is overseen by Division faculty. Interested residents may teach as well, and will be mentored by a qualified attending physician. The DTEM directly supports the Tactical Resident Interest Group (TRIG).
Division members provide medical standby care and participate in SWAT training sessions and real-world missions. Care is provided to all law enforcement personnel, bystanders and suspects under the principles of humanity and impartiality.