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Physician Roles in Tactical Emergency Medical Support: The First 20 Years

Published:September 30, 2013DOI:https://doi.org/10.1016/j.jemermed.2013.08.022

      Abstract

      Background

      The benefits of Tactical Emergency Medical Support (TEMS) elements are providing injury prevention, immediate care of injuries, and medical augmentation of the success of dangerous law enforcement operations. TEMS is recognized by civilian Special Weapons and Tactics (SWAT) and various other law enforcement agencies around the country as a vital addition to such SWAT teams. The integration of specially trained TEMS personnel has become a key component of law enforcement special operations.

      Objective

      Our aim was to review the published literature to identify if there is a role for physicians within TEMS elements with regard to its establishment and progression, and to characterize the level of physician-specific support provided in the tactical environment for civilian tactical law enforcement teams.

      Discussion

      Physician presence as part of TEMS elements is increasing in number and popularity as the realization of the benefits provided by such physicians has become more apparent. The inclusion of physicians as active and participating members of TEMS elements is a critical measure to be taken for tactical law enforcement units. Physicians provide an added level of medical expertise to TEMS elements in rural and urban settings compared with law enforcement personnel with medic training.

      Conclusions

      Physician involvement is an essential element of a successful TEMS program. There is a need for more physicians to become involved as TEMS personnel for specialized tactical teams to spread the time commitment and increase their availability to tactical units on a daily basis.

      Keywords

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      References

        • Rinnert K.J.
        • Hall 2nd, W.L.
        Tactical emergency medical support.
        Emerg Med Clin N Am. 2002; 20: 929-952
        • US Department of Justice
        Federal Bureau of Investigation: Uniform Crime Reporting, Law Enforcement Officers Killed and Assaulted.
        US Printing Office, Washington, DC2001
        • Jones J.S.
        • Reese K.
        • Kenepp G.
        • Krohmer J.
        Into the fray: integration of emergency medical services and special weapons and tactics (SWAT) teams.
        Prehosp Disaster Med. 1996; 11: 202-206
        • Lavery R.F.
        • Adis M.D.
        • Doran J.V.
        • Corrice M.A.
        • Tortella B.J.
        • Livingston D.H.
        Taking care of the "good guys:" a trauma center-based model of medical support for tactical law enforcement.
        J Trauma. 2000; 48: 125-129
        • Bozeman W.P.
        • Eastman E.R.
        Tactical EMS: an emerging opportunity in graduate medical education.
        Prehosp Emerg Care. 2002; 6: 322-324
        • Bozeman W.P.
        • Kleiner D.M.
        • Winslow J.E.
        • Manthey D.E.
        Potential utility of a miniature electrocardiographic device in the medical support of law enforcement tactical teams.
        Prehosp Emerg Care. 2005; 9: 361-364
        • Metzger J.C.
        • Eastman A.L.
        • Benitez F.L.
        • Pepe P.E.
        The lifesaving potential of specialized on-scene medical support for urban tactical operations.
        Prehosp Emerg Care. 2009; 13: 528-531
        • Gildea J.R.
        • Janssen A.R.
        Tactical emergency medical support: physician involvement and injury patterns in tactical teams.
        J Emerg Med. 2008; 35: 411-414
        • Heiskell L.E.
        • Carmona R.H.
        Tactical emergency medical services: an emerging subspecialty of emergency medicine.
        Ann Emerg Med. 1994; 23: 778-785
        • Ciccone T.J.
        • Anderson P.D.
        • Gann C.A.
        • et al.
        Successful development and implementation of' a tactical emergency medical technician training program for United States federal agents.
        Prehosp Disaster Med. 2005; 20: 36-39
        • Greenstone J.L.
        The role of tactical emergency medical support in hostage and crisis negotiations.
        Prehosp Disaster Med. 1998; 13: 55-57
        • Smith B.D.
        Tactical medics. Front-line medicine evolves as a specialty.
        JEMS. 1999; 24: 50-64
        • Sztajnkrycer M.D.
        Tactical medical skill requirements for law enforcement officers: a 10-year analysis of line-of-duty deaths.
        Prehosp Disaster Med. 2010; 25: 346-352
        • Sztajnkrycer M.D.
        • Callaway D.W.
        • Baez A.A.
        Police officer response to the injured officer: a survey-based analysis of medical care decisions.
        Prehosp Disaster Med. 2007; 22 (discussion 42): 335-341
        • Tang N.
        • Kelen G.D.
        Role of tactical EMS in support of public safety and the public health response to a hostile mass casualty incident.
        Disaster Med Public Health Prep. 2007; 1: S55-S56
        • Hamman B.L.
        • Cue J.I.
        • Miller F.B.
        • et al.
        Helicopter transport of trauma victims: does a physician make a difference?.
        J Trauma. 1991; 31: 490-494
        • Liebovich M.
        • Speer C.
        Physician involvement in police tactical teams.
        Tactical Edge. 1995; (Fall:48−50)
        • Butler Jr., F.K.
        • Hagmann J.
        • Butler E.G.
        Tactical combat casualty care in special operations.
        Mil Med. 1996; 161: 3-16