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Tactical EMS/MCI pearls with Dr. Dan O’Donnell and Dr. Kevin Schultz

Tactical exposure and active shooter training is important for all EMS providers, working in tangent with law enforcement


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With the multiple recent active shooter related mass casualty incidents across the country, tactical EMS team development and continuing education have become hot topics across prehospital care.

In these episodes of the MCHD Podcast, we address EMS response to active shooter incidents. First, Dr. Dan O’Donnell, medical director for Indianapolis SWAT, joins Dr. Casey Patrick on episode No. 25.

Then, on episode No. 46, Assistant Medical Director for Houston Fire and Houston SWAT physician, Dr. Kevin Schulz, M.D., joins the podcast with MCHD TEMS Chief Patrick Langan EMT.

Robert Dickson, M.D.; Casey Patrick, M.D.; MCHD Chief Kevin Crocker; and Kevin Schulz, M.D. (Photo/courtesy MCHD)
Robert Dickson, M.D.; Casey Patrick, M.D.; MCHD Chief Kevin Crocker; and Kevin Schulz, M.D. (Photo/courtesy MCHD)

Structuring a Tactical EMS team

Both discussions begin with the basics of setup and structure of a tactical EMS team. This can obviously vary depending on the specific needs of the local area and a “one size fits all” answer is impractical. Tactical team members can be multiple variations of EMS, fire and law enforcement personnel, and the key is collaboration and communication between agencies.

Feedback is vital both to and from law enforcement to develop trust and to identify areas for team improvement. Tactical exposure and familiarity is also necessary for non-TEMS medics as they often will be the first to arrive on an MCI/active shooter scene.

Specific TEMS procedures include surgical and other advanced airway skills, needle decompression, finger thoracostomy, tourniquets and wound packing. Which are included in any specific system depends on availability and frequency of training.

Each episode closes with the issue of arming and/or deputizing the TEMS teams, addressed from both an offensive and defensive perspective. Whether you are a seasoned tactical operator or looking to start your team from scratch, these episodes will be valuable to all EMS personnel.  

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