Tactical emergency medical services

Tactical Emergency medical services (TEMS) is out-of-hospital care given in hostile situations by specially trained practitioners. Tactical support provided through TEMS can be applied in either the civilian world, generally with special law enforcement teams such as SWAT and SERT, as well as with military special operations teams.^[1] Tactical EMS providers are 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.^[1] Tactical medical providers (TMPs) provide care in high risk situations where there is an increased likelihood for law enforcement, civilian, or suspect casualties. TEMS units are also deployed in situations where traditional EMS or firefighters cannot respond. TMPs are specially trained and authorized to perform live-saving medical procedures in austere and often times unconventional environments. TMPs are also expected to be competent in weapons safety and marksmanship, small unit tactics, waterborne operations, urban search and rescue, and HAZMAT.^[1] TMPs also serve to train their respective teams in complex medical procedures that may be performed in their absence. TEMS providers are sometimes sworn police officers cross trained as paramedics, paramedics that are operators trained and integrated into the SWAT Team, or medical providers trained in tactical EMS who are then integrated into law enforcement or military units.^[2]