I talk to alot of fire/EMS folks who are always asking on recommendations for a tactical medic school and of course my natural response is Tangent Edge. With all bias being put aside, there are many tactical medic schools besides Tangent Edge that are quite remarkable. CONTOMS was developed many years ago and was one of the original Tactical Combat Casualty Care (TC3) programs headed by members of Special Forces. CONTOMS is currently NOT up and running due to funding. I expect they'll be up again soon. One of the gentlemen from CONTOMS who has left the organization is Dr. Hagman. For security purposes, I'll leave his course out of the current discussion because of the mission profile of his course and his target audience. Dave Hall and Rescue Training Inc. remains in the top spot for his consistent performance and having an excellent program. Through the years, Dave has grown and plays host to various level of instructors for his program. In this, his program, like all programs, continues to develop with the current methodology and trends in the tactical medic arena. Cypress Creek is another note worthy program in Texas although I must admit, I do not know how active they are now. It is has been stated by many other tactical medic schools to beware of overnight tactical medic schools and I find that amusing. Many of the schools now, developed out of a regional need for tactical medic capabilities. On the other side of the house, Col. Farr warns the special operations forces community of buyer beware of civilian tactical medic schools claiming to teach the tactical combat casualty care. The TC3 was developed for warfighters with very different end goals and application of good medicine is to gain fire superiority. Good medicine can be bad tactics and bad tactics can get everyone killed and I mean everyone. In the civilian SWAT setting, unless you are a mandated officer medic, the likelyhood of you carring a gun is almost neglible, let alone shoot. Some schools offer shooting various calibre weapons in the program and, while this is a good idea, those same students were not able to qualify given an assigned weapon on a bonafide SWAT course taught by law enforcement agencies. There are still other schools that claim strategic importance and play on national security with a breach coming in from students who were not even sponsored by an agency or even a medic. With that being said, who is the best? How do you determine this?

First, they are all great. They must abide by the community standard and the community standard is TC3, Tactical Emergency Medic Support and Tactical Medical Response Initiatives (see goarticles.com and type in tactical medic). Now the difference lies in the course administrators and what they determine to be the BEST teaching platform for their students. Some will emerse the students in team building exercises such as running, obstacle course and so forth. Another school might take components from the military and induct the students in a water exercise known by the military communinty as drown proofing, teach entry level SWAT tactics and powerpoint you to death. Yet, another school may choose to implement critical care technology from the stand point of aeroevacuation (fixed and rotor wing aircrafts) as the teaching premisis highlighting cadever labs and critical care support.

Now my next statment my raise the hackels of all my competitors but the core component remains. YOUR BUDGET is what should dictate your school of choice. You will have to do your homework because there are some goofy foot schools out there (but luckily not that many, like I stated, they must abide by the community standard or perish). It is not wise to travel from the east coast to the west coast (or vice versa) to attend a course that you could have attended at a fraction of the cost. What is prevalent technology in one region may not be prevalent in another. Case in point. Three neighboring states. One is allowed to do sternal IOs all day, everyday. The other state does not acknowledge that sternal IOs even exist. All three states do not approve the use of hemostatic agents (that is slowly changing). Local schools should be up on technology, methodology and compliant to the tactical community standards. Many of the schools can be approved for homeland security funding but this should not be how you decide. Just remember, these funds already come off the backs of the bruised, you the taxpayer.

Guidelines are simple. They must teach blood lost first. Use of tourniquets. Use of hemostatic agents-products must be on hand and students taught how to use them properly. Airway skills-combi-tube, intubation, surgical airways. Shock, Shock, Shock! High threat extraction. WEAPONS familiarization-if you are working with members who tote guns, they go down in a fight, you must secure that weapon, period. These are the core components. How they teach you this is up to them and how you prefer to be taught. If you want paramilitary, go find a paramilitary style school, if you want a public safety course-find a public safety style school. If you want military, join the military.

What about officially sanctioned governing bodies? There is not one. The tactical medic community falls short here. There are so many points of view on what is tactical that for the most part, everyone wants to argue. There are many organizations that are trying to work in that direction and if you do some research you will find some of them. However, none so far have made a profound impact to unite the entire community. The specical forces medics have gone away from the national registry because the National Registry does not acknowlede the advance tactical practioner and the National Association of EMTs (NAEMT) has produced a military PHTLS 6th edition with supporting information gained from current Global War On Terrorism. Once again, I am not trying to leave anyone out. This is a courageous field.

As you may have seen on firefighter nation, we boast of over 19,000 members and growing. Yet, there are only 27 tactical medics in the group. Homeland Security warns us of many dangers ahead and only 27 people claim the title of tactical medic. We do not have enough tactical medics and sorely need alot more. If just for more fire/EMS personnel to be familiar with the new biotechnology that is available to stop massive amount of blood loss and is approved by the FDA for use. I encourage everyone that wants to be apart of the tactical medic community to go out and get this training. It will be eye opening to say the least.