According to the National Tactical Officers Association (NTOA); TEMS is now a standard of care for law enforcement special operations.
Tactical medicine is now definable as the preventative care and medical treatment rendered during mission driven, high-risk, large-scale, and extended law enforcement operations. Tactical Emergency Medical Support or TEMS is a comprehensive approach to emergency care and operational medical support in the tactical environment. It is focused on the broad range of knowledge and skills required for crisis management medical response including: care under fire; Weapons of Mass Destruction (WMD); medical counter-terrorism; counter-narcotics; protective operations; hostage rescue; explosive ordnance disposal; maritime operations; civil disorder; and major national security events. TEMS operators come from varied backgrounds and play varied roles within the tactical environment. Normally the role of Emergency Medical Services is to stand by several blocks away, in case of an injury. This creates one of two problems if an injury should occur. The tactical team extracts the injured person and, if possible, takes them to the waiting ambulance, or the EMS crew is escorted through the inner perimeter and close to the ongoing danger. Neither solution is optimal. The first necessitates emergency medical treatment and the second increases liability by exposing EMS personnel to unfamiliar dangers. Further more, both solutions take tactical members away from their primary duties, placing the rest of their team at risk. The opportunity for successful intervention in the management of casualties is greatest in the first few minutes after wounding. Any plan that delays arrival of the medical provider at the patient’s side, such as having conventional EMS on standby, will have a deleterious effect on outcome and should be avoided whenever possible.