NREMT EMT 5: Operations - Tactical Emergency Medical Support, TEMS, Law Enforcement and Fireground Operations

What This Is: Tactical Emergency Medical Support (TEMS)

Tactical Emergency Medical Support (TEMS) is a specialized medical response to high-risk situations, like active shooter incidents or hostage situations. Think of it like a SWAT team for medical emergencies. In these situations, EMTs and paramedics work closely with law enforcement and firefighters to provide medical care while keeping everyone safe.

Key Steps / Core Facts:

• Scene Safety: Assess the area for danger (e.g., gunfire, falling debris). Why it matters: You can't help anyone if you're hurt. Example: A building on fire is not a safe place to provide medical care.
• Law Enforcement Coordination: Work with police to secure the scene and ensure medical access. Why it matters: EMTs need a safe path to reach patients. Example: A police officer can block off a street to prevent more harm.
• Patient Assessment: Quickly evaluate patients for injuries and medical conditions. Why it matters: You need to know what you're treating. Example: A patient with a gunshot wound needs immediate attention.
• Tactical Patient Movement: Move patients safely to a secure location for treatment. Why it matters: Patients need to be protected from further harm. Example: A patient with a spinal injury needs to be moved on a backboard.
• Fireground Operations: Work with firefighters to access patients in burning buildings or other hazardous areas. Why it matters: Firefighters can provide access and ventilation. Example: A patient in a burning building needs oxygen and a safe way out.
• Communication: Use radios and other devices to stay in touch with law enforcement and other teams. Why it matters: Everyone needs to know what's happening. Example: A radio call can alert police to a patient's location.
• Resource Management: Coordinate with other teams to allocate resources (e.g., ambulances, medical supplies). Why it matters: You need the right tools to treat patients. Example: A team might need to share medical supplies.
• Debriefing: Review the incident to identify lessons learned and areas for improvement. Why it matters: You can improve response times and patient care. Example: A debriefing can highlight what went well and what didn't.
• TEMS Team Structure: EMTs, paramedics, law enforcement, and firefighters work together in a coordinated team. Why it matters: Everyone has a role to play. Example: A police officer can provide security while an EMT treats a patient.
• TEMS Training: EMTs and paramedics receive specialized training for high-risk situations. Why it matters: You need to know how to respond. Example: A training exercise can teach EMTs how to move patients in a burning building.
• TEMS Equipment: Specialized equipment, like tactical medical bags, is used in high-risk situations. Why it matters: You need the right tools to treat patients. Example: A tactical medical bag can contain essential medical supplies.
• TEMS Communication Protocols: Standardized communication protocols are used to coordinate with law enforcement and other teams. Why it matters: Everyone needs to know what's happening. Example: A radio call can alert police to a patient's location.

What Laypeople Can Do:

• Call 911: If you see someone injured or in distress, call 911 or your local emergency number. Why it matters: You need to alert authorities to the situation.
• Provide Basic Care: If you're trained, provide basic care like CPR or bleeding control. Why it matters: Every minute counts in an emergency. Example: CPR can help keep someone alive until help arrives.
• Stay Back: If you're not trained or it's not safe, stay back and let professionals handle the situation. Why it matters: You can get hurt or interfere with medical care. Example: A burning building is not a safe place to be.
• Follow Instructions: If you're told to evacuate or move to a safe location, do so immediately. Why it matters: Your safety is the top priority. Example: A police officer might tell you to move to a safe location.
• Provide Information: If you have information about the situation or the patient, share it with authorities. Why it matters: Every detail can help medical professionals provide better care. Example: Knowing the patient's medical history can help EMTs treat them more effectively.

Common Mistakes:

• Mistake: Not assessing the scene for danger before providing medical care.
• Fix: Always check for danger first. Why: You can't help anyone if you're hurt.
• Mistake: Not communicating with law enforcement or other teams.
• Fix: Use radios and other devices to stay in touch. Why: Everyone needs to know what's happening.
• Mistake: Not using specialized equipment or training in high-risk situations.
• Fix: Use the right tools and training to provide effective care. Why: You need to know how to respond in a high-risk situation.

Quick Practice Scenarios:

1. Scenario: You're at a concert when a fight breaks out and someone is stabbed. What should you do first?
2. Answer: Call 911 and provide basic care (if trained). Why: You need to alert authorities and provide immediate care.
3. Scenario: You're driving home from work when you see a car accident on the side of the road. What should you do first?
4. Answer: Call 911 and stay back unless you're trained to provide basic care. Why: You need to alert authorities and stay safe.
5. Scenario: You're at a sporting event when a player is injured and can't move. What should you do first?
6. Answer: Call 911 and provide basic care (if trained). Why: You need to alert authorities and provide immediate care.

Last-Minute Exam Cram:

• Normal Blood Pressure: 90-120/60-80 mmHg
• CPR Compression Depth: at least 2 inches (AVPU)
• TEMS Team Structure: EMTs, paramedics, law enforcement, and firefighters work together (OPQRSTI)
• Fireground Operations: Work with firefighters to access patients in burning buildings or other hazardous areas (SAMPLE)
• Debriefing: Review the incident to identify lessons learned and areas for improvement (OPQRSTI)
• TEMS Training: EMTs and paramedics receive specialized training for high-risk situations (AVPU)
• TEMS Equipment: Specialized equipment, like tactical medical bags, is used in high-risk situations (SAMPLE)
• TEMS Communication Protocols: Standardized communication protocols are used to coordinate with law enforcement and other teams (OPQRSTI)
• Agonal Breathing: NOT normal breathing – start CPR
• Spinal Injury: Move patient on a backboard to prevent further injury (AVPU)
• Tactical Patient Movement: Move patients safely to a secure location for treatment (SAMPLE)
• Scene Safety: Assess the area for danger before providing medical care (OPQRSTI)