Tactical Emergency Medical Support: A Position Statement from the MTOA

The Michigan Tactical Officers Association (MTOA) endorses the provision of Tactical Emergency Medical Support (TEMS) for law enforcement operations. Tactical Emergency Medical Support includes, but is not limited to:

1.  Treatment of injury and/or illness during civilian law enforcement operations, mass-gathering events, natural or man-made disasters for which medical support of law-enforcement is deemed necessary

2.  Medical threat assessment, contingency planning, and logistics for such operations

3.  Training, education, and quality assurance monitoring for tactical medical providers

4.  Institution and oversight of preventive health measures for the tactical athlete

The presence of a medical element within a tactical team minimizes the response time for medical support, and, as such, potentially reduces the risk of morbidity and mortality within operations for law enforcement officers and civilians. The result is increased safety in our communities, a positive impact on morale for law enforcement, and a reduction in line-of- duty injuries and their incurred cost.

Pursuant to this endorsement, the MTOA recommends the following:

Responsibilities of the Tactical Medical Provider

1. The tactical medical provider shall carry the minimum licensing/certification in the State of Michigan appropriate to his/her level of training as an EMS provider, nurse, physician assistant or physician and is responsible for regularly participating in clinical care activities and keeping such licensing/certification current.

2. The medical capabilities of a tactical medical provider should be tailored to the needs of the operational environment, which can include all levels of medical providers. While no single, best approach to providing medical care during law enforcement operations exists, there are core competencies known to reduce the risk of potentially preventable death and disability.  These require mastery by all tactical medical providers.

3. The tactical medical provider is responsible for understanding and adhering to the content of the medical protocol adopted by his/her TEMS Medical Director.

4. The tactical medical provider shall have successfully completed a training course in tactical emergency medicine as approved by the TEMS Medical Director and the Tactical Commander. Ideally, the course should emphasize core clinical and operational domains and consist of a minimum of 32 hours in length. He/she will be required to demonstrate clinical competency on a regular basis.

5. The tactical medical provider shall document every patient encounter and medical pre-planning assessment in accordance with the pre-approved method of documentation.

6. The tactical medical provider will participate in quality assurance exercises pertaining to training or live operations at the discretion of the Tactical Commander and TEMS Medical Director.

7. Tactical medical provider duties should include the training of all supported agency personnel in lifesaving medical techniques, technical advisor on appropriate medical equipment and its deployment and management of health and safety matters including confidential maintenance of individual health and immunization records.

8. During all deployments, the tactical medical provider will tend to acute injury and/or illness and ensure transfer to an appropriate level of care in a timely fashion.  When circumstances permit, the tactical medical provider should closely monitor environmental factors that may affect operational safety and performance, including sleep deprivation, hydration, and nutrition.

9. When circumstances permit, the tactical medical provider should serve as a consultant to law enforcement commanders on matters of team sustainment in the operational environment and function as a liaison between law enforcement, EMS, and other state or local health care services.

Responsibilities of the TEMS Medical Director

1. The TEMS Medical Director and his/her appointees shall carry an unrestricted Michigan medical license and have experience in on-line EMS medical direction. Ideally, he/she should be residency-trained in emergency medicine and be board-certified or board-eligible. Specialists in other fields of medicine may be considered if their scope of practice includes emergency and pre-hospital care.

2. Whenever possible, the TEMS Medical Director will be available for "real time" medical oversight by phone or in person for tactical operations.

3. The TEMS Medical Director will organize and participate in the continuing medical education of tactical medical providers. This may include but is not limited to, didactic sessions, field training, and medical simulation.

4. The TEMS Medical Director will approve the medical competency of each tactical medical provider prior to initiation of service in that role and will assess the competency and proficiency of tactical medical providers on a continuous basis.

5. The TEMS Medical Director will implement a quality assurance process, reviewing the application of TEMS protocols, medical care provided, and any concerns with regard to patient or provider safety.

6.  The TEMS Medical Director reserves the right to evaluate the status of any tactical medical provider based on competency, safety issues, adherence to protocol, or any other reason he/she deems appropriate. The TEMS Medical Director reserves the right to suspend any tactical medical provider from his/her oversight pending an investigation of the relevant circumstances. Such action will be taken in close collaboration with the Tactical Commander of the relevant law enforcement agency.

Responsibilities of the Supported Law Enforcement Agency

1. The determination of a tactical environment for which TEMS support is deemed necessary will be determined by the Tactical Commander of the law enforcement agency overseeing the tactical operation.

2. The supported law enforcement agency is responsible for providing all tactical training, education, and oversight to tactical medical providers and defining the role of those providers for tactical operations.

3. The supported law enforcement agency shall be responsible for providing any and all relevant tactical and personal protective equipment to tactical medical providers, as well as training in the use of such equipment.

4. The supported law enforcement agency shall work with the employer of the tactical medical provider to address liability and work-related injury concerns. TEMS medical direction and implementation of protocols will commence only after such concerns are reviewed and agreed upon by the employer of the tactical medical provider, the TEMS Medical Director, and the law enforcement agency involved.

5. The supported law enforcement agency will maintain a good working relationship and open communication with local EMS providers, pursuant to the utilization of tactical medical providers employed by those agencies and for public safety, in general.

[Revised May 2014]