Please help! New to EMS with questions regarding tactical medicine

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Austin Mostoller

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Hello, my name is Austin, 21, and I am a new EMS student from Virginia. I wanted to know if anybody had any advice or knowledge in the field of tactical medicine or the like? I had originally attended college in hopes of earning my degree in biology and joining the military afterwards. Unfortunately, I was disqualified because I have ulcerative colitis and it really struck me down. In search of a new career path I turned to nursing because I have a passion for caring for people. After one semester I did not see a future for me as a nurse. Although I excelled in clinicals, (I am aware my skills were limited) I felt out of place in that environment. I feel comfortable in a more physical environment, having played college baseball and wanting to join the military (I would've done anything to be a Marine CSO or Air Force PJ). I also enjoy the teamwork atmosphere and hierarchy system that is found in that environment. It wasn't until I heard about tactical medicine that I really felt reinvigorated about future possibilities. I have tried to look into it as much as I can and this is just one more resource I hope to gain knowledge from. I took the first step and I start EMS school next month on my journey to become a paramedic. Does anybody have advice for me on getting into tactical medicine, flight medicine, contract work, etc.? I realize that before I get there I need to focus on being the best EMT/medic that I can be and gain experience before I can take further steps. I am willing to work relentlessly toward my goal, but I will take any help I can get. Thank you.
 
Get paramedic, get hired by police department that has tactical element and utilizes tactical paramedics. Stay in shape and get on the team. Tactical medicine is generally something you do on the side or as a extra thing, very few
people are able to make a career out of it.
 
In my area, you do EMT school, do paramedic school, then you work as a paramedic for a few years. Take something like TCCC to make sure you want to/are cut out to do TEMS (mentally). Find a mentor and start working out for 1-2 years until you're in insanely good physical shape, like active duty military physical standards and maybe even a hair harder than that (with leg presses or a few other measured skills). Then, in my area, the county sheriff runs TEMS under the SWAT team. You have to get an agency within the county that you work for to sponsor you. Then there's a small selection process/tryout. Then you are on a volunteer team where you have a limited commission, and get paid for some of your training, but not all of it, and some of the work you do, but not all of it.

So, at that point you're in, and you usually have about 1 day a week of training (excluding many weekends or weeks you'll be sent to training elsewhere), and then after you've received enough training and can pass some pretty tough physical qualifications and some pretty easy shooting ones (but ones that are still harder than typical police quals), you are active on a team and get call outs all week long at any time you are needed. Some are scheduled raids for like 3am that you know of in advance, sometimes you have no knowledge in advance.

For other counties around here, you do EMT, do paramedic school, work five hard years in a top notch 911 system, join the police/sheriff's office, go to a Police Officer/Peace Officer Training Academy, then slowly work your way up into SWAT.

Either way, you have to keep your credentials in EMS valid and continue to work in EMS the whole time, which usually means two full time jobs, plus you get constant calls for all other times of the day/night and you have to put in the extra work outside of work to stay in peak physical condition and enhance your skill sets. Some skills will require you to take classes/train on your own time and dime if you want yourself and your team to stay alive and healthy.

Basically, you're looking at about a 10 year path to do something that will require you to never sleep, always stay vigilant and where you'll rarely be home. Your spouse will respect you at first, and then might resent you for being gone all of the time. After the ten years of training to get there (at least about 7 of those in EMS...EMT School, Paramedic Prep, Paramedic School, some work in between and about 5 years of hard work after P school, but before you even start Police) you might work 2-5 years in TEMS and then be over it. Or, you might not hold up physically or mentally much longer than that. You would if it is your "true calling", the one and only thing you love/need...but you won't know for sure until you're most of the way through the process.
 
Thanks for yalls help! I truly do appreciate it. I realize the hard work and dedication it must take. Physically I'm in better shape than I was when I played college baseball. I've gotten really into powerlifting and I compete in that now. Waking up early and working long hours is no problem. My day starts at 0430 and doesn't end until late at night. I love self improvement and striving to be better. That's what has led me to this. I am willing to put in the work, I just want to ensure I am applying my efforts appropriately. The hardest part is the family strain but I reckon that's just going to be a test of preservance.
 
Through my research I've also come across several YouTube videos about tactical medicine with several thousand views. Being that it isn't a highly visible field, I take that mostly those people have also intentionally searched for information. That's my competition and I want to become the most viable and qualified candidate. I made my intentions clear to my instructor before I even started the path I wanted to pursue in tactical medicine. I do not want to seem like I am trying to run before I walk or even crawl but I refuse to fail because I failed to plan. One day I may have somebody's loved one's life in my hands and they deserve the best care and and preparation. I also want to thank y'all for your service, dedication and strength to endure in times like these. It's this kind of community that attracts me since I was unable to serve in our military. You have my utmost respect. God bless.
 
When you consider how few full time SWAT teams exist in this country, it becomes clear how few tactical paramedics exist whose job is just to work in a tactical setting. Most "tactical paramedics" are street paramedics who are good at there jobs, in shape, and have an interest. And are willing to wait a long time to find a spot I'd imagine...
 
Tigger said:
When you consider how few full time SWAT teams exist in this country, it becomes clear how few tactical paramedics exist whose job is just to work in a tactical setting. Most "tactical paramedics" are street paramedics who are good at there jobs, in shape, and have an interest. And are willing to wait a long time to find a spot I'd imagine...
Click to expand...
And a lot of the full time SWAT teams don't even utilize EMS personnel as tac medics. They'll either have a physician dedicated to their team (Dallas and maybe Houston), or will send one (or several) of the SWAT team members through EMT.

And the vast majority of tac medics that are EMS-based and attached to SWAT will not be a part of the stack, and will only make entry once an officer is down or during an active shooter event.

Where I'm at, we train with SWAT and are expected to maintain similar fitness standards (though it's weakly enforced, as evidenced by a few of our teammates...). We go through SWAT school and a few other courses. But during raids, we park behind the Bear and watch SWAT play. During standoffs, we hang out with the team, then watch as they make their deliberate entry. I know of very, very few teams that operate the way many imagine it- as a part of the stack and an integrated part of the team.

If you want to do the high-speed tac medic stuff, your best bet is to finish EMT, then go become a police officer. Become a badass at that, get onto their SWAT team, and be the guy on the team with some medical knowledge. Like has already been said, the spots in EMS are very few, and of those very few, the vast majority of them will not operate in the way you're likely imagining.
 
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