Resident Involvement in Tactical Medicine: 12 Years Later

Introduction:Interest in tactical medicine, the provision of medical support to law enforcement and military special operations teams, continues to grow. The majority of tactical physicians are emergency physicians with additional training and experience in tactical operations. A 2005 survey found that 18% of responding Emergency Medicine (EM) residencies offered their resident physicians structured exposure to tactical medicine at that time.Methods:This study sought to assess interval changes in tactical medicine exposure during EM residency and Emergency Medical Services (EMS) fellowship training. A secure online survey was distributed electronically to all 212 EM residency programs and 44 EMS fellowship programs in the United States.Results:Responses were received from 99 (46%) EM residency and 40 (91%) EMS fellowship programs. Results showed that 52 (53%) of the responding residencies offered physician trainees formal exposure to tactical medicine as part of their training (P < .0001 compared to 18% in 2005). In addition, 32 (72%) of the 40 responding EMS fellowships (newly established since the initial survey) offered this opportunity. Experiences ranged from observation to active participation during tactical training and call-outs. The EM residents and EMS fellows provide support to local, state, and federal law enforcement agencies. A small number of programs (six residencies and four fellowships) allowed a subset of qualified trainees to be armed during tactical operations.Conclusion:Overall, training opportunities in tactical medicine have grown significantly over the last decade from 18% to 53% of responding EM residencies. In addition, 72% of responding EMS fellowships incorporate tactical medicine in their training program.Petit NP, Stopyra JP, Padilla RA, Bozeman WP. Resident involvement in tactical medicine: 12 years later. Prehosp Disaster Med. 2019;34(2):217–219

Australian Tactical Medical Association and the Journal of High Threat & Austere Medicine: A joint initiative to progress a niche subspecialty of medicine

This year sees the launch of the official journal of the Australian Tactical Medical Association (ATMA), the Journal of High Threat and Austere Medicine (JHTAM). This initiative is a significant achievement in the progression of high threat medicine in Australia and builds upon the success of the past 18 months. Whilst ‘Tactical Medicine’ conjures in the minds of the uninformed ideas of black-clad specialists in body armour, JHTAM and ATMA actually encompass and represent a wide range of applications of first aid and medicine. The crossover between all these applications is significant, and collaboration will only allow for a larger evidence base to draw from, as well as opening communication channels and starting conversations that enable greater and more cohesive response capacity in wilderness, expedition, prehospital, tactical, military and austere applications.