TacMed For Patrol

Tactical Medical Training for Patrol

Many tactical medical training programs focus 70% on medical skills, 25% on drags and carries, and maybe 5% — if at all — on the command and control of the incident by law enforcement. While that might be appropriate for a single gunshot victim in, say, an attempted robbery, it is the wrong focus for an Active Shooter / Mass Casualty Incident.

The Definition of a Mass Casualty Incident

A true mass casualty incident is defined by casualties exceeding available medical resources — like a train derailment or large-scale disaster. But in an active shooter event, that definition is incomplete, because it fails to account for the ongoing threat.

If there is no active threat, the solution is straightforward: bring in Fire/EMS immediately — those with the training, equipment, and expertise to treat and transport.

But if there is an ongoing or unknown threat, the priorities shift entirely:

• →Law enforcement must stop the killing first.
• →Only after — or sometimes simultaneously with — that effort can we begin to stop the dying.

Who Does What, and When?

If sufficient law enforcement resources are present, roles may need to be divided:

• →Some officers continue to address the threat in the hot zone.
• →Others begin life-saving interventions and evacuation in the warm zone.

That decision is not made at a command post. It is made by officers on the interior of the crisis site, in real time, under pressure. That is command and control.

This dynamic allocation of resources — threat suppression, corridor creation, RTF integration, evacuation priorities — is entirely driven by interior command and control in the first minutes of the incident.

If these decisions determine whether victims live or die — if they shape the entire operational response — why isn't command and control the primary focus of law enforcement training for active shooter and mass casualty incidents?