Tactical Emergency Medical Support and Urban Search and Rescue

Law enforcement agencies in the 21st century face an increase in terrorist threats and new challenges, including organized opposing forces, military-type weapons, direct fire, hostage and barricade situations, and potential toxic hazards. As these threats have increased, so has the recognition of the need for integrated medical support of tactical operations. Tactical emergency medical support (TEMS) is the specialty of emergency medical services (EMS) established to maintain safety, health, and welfare for combat medical units and special operations civilian law enforcement units, such as special weapons and tactics (SWAT) teams, hostage rescue teams, and special emergency rescue teams. These specially trained teams are composed of highly trained and specially equipped personnel who are tasked with mitigating and responding to many different high-risk situations. Events such as the World Trade Center bombings and hurricane Katrina have demonstrated the need for many nonhospital health care personnel to use some of these current military out-of-hospital medical strategies.