Tactical emergency medicine requires frequent assessments of the overall situation, considering not only a potential threat situation but also the operational requirements of the mission/ operation during which the emergency has occurred. This may even imply that medical care must be postponed for the sake of continuing the mission, or that even limits to the medical care for an individual patient must be accepted. Tactical emergency medicine aims at the best possible outcome
for the patient
for the mission, because the life and limb of other personnel can be put at risk if the mission cannot be continued.
In emergency medicine, standardisation and a team-oriented line of action according to established algorithms, and also the the resulting “common language” have been instrumental in improving patient care. It is appropriate that the principles and procedures are geared to the situation in the rescue service as well as to the anticipated patient population. This particularly applies to the duration of pre-hospital care and to evacation times, which are both usually short.
In military or other tactical operational situations, and whenever emergency care is provided under enemy threat, and hence the prevailing conditions are totally different. In extreme situations, for instance, even a proper implementation of the ATLS guidelines and of “civilian” algorithms and procedures may cause deterioration both of the casualty’s condition and of the rescuers’ situation.
This is why the “Tactical Combat Casualty Care” (TCCC) concept in the military and the “Tactical Emergency Medical Support” (TEMS) concept for police special units have been developed during the past 12 years.
This concept and training system reflects:
However, such conditions can also be found in civilian environments, for instance with regard to workers operating at sites to which access is difficult (height workers or industrial climbers, or personnel employed in off-shore missions), to personnel working in regions with an underdeveloped medical infrastructure, and to individuals engaging in risky sports and potentially requiring emergency medical care within the scope of “wilderness medicine”. .
This is the background for the establishment of the Tactical Rescue and Emergency Association (TREMA).
To promote the further development and advancement of emergency medicine –particularly of preclinical care and of specific rescue techniques in extreme and/or tactical environments, respectively.