Tactical Paramedic Jobs: Providing Critical Care in Hostile Environments

Tactical law enforcement teams, such as SWAT and SRT teams, regularly operate at the absolute edge of the safety envelope while carrying out their operations. These assignments might include hostage situations, mass casualty incidences (MCI), high-risk warrant service, or protection for domestic and international dignitaries. These high-risk, tactical assignments result in a much higher incidence of casualty to both civilians and public safety officers than nearly all other routine law enforcement activities. As such, over the last twenty years, law enforcement agencies have adopted protocols which were originally developed for combat situations and have adapted them for application in civilian emergency response environments. These evolutions have led to the inclusion of specially trained tactical paramedic responders who act as an integrated member of SWAT and SRT teams. In this article, we’ll take a brief look at the role of the tactical paramedic, the training required, and some of the agencies who employ these highly-skilled responders.

A Brief History of Tactical EMS

The first known assignment of certified emergency medical personnel to a civilian tactical response unit occurred in 1969 when the Los Angeles Sheriff Department transferred several full-time EMTs to their SWAT unit. Two decades later, in 1989 and 1990, a pair of physicians presenting at the National Tactical Officers Association conference, Dr. Rich Carmona and Dr. Dave Rassumof, introduced the idea of using existing emergency medical services response models to support tactically-trained law enforcement officers in high-risk assignments.

While combat medics have played an integral role in the US armed forces as a hybrid of medical support provider and operator since the formation of the current special operations system in the late 1950’s, tactical training for medics offering care in a civilian environment was non-existent. After these two conferences, the term Tactical Emergency Medical Services (TEMS) began to describe the intersection of pre-hospital emergency care and the special tactical training required to operate within hostile civilian environments. In 1990, the US Department of the Interior was tasked with the formation of the Counter Narcotics and Terrorism Operational Medical Support (CONTOMS) Program. This program developed a curriculum for EMS professionals to gain the necessary training to support tactical law enforcement operations, which resulted in a 56-hour, one-week continuing education module for currently certified EMTs known as the EMT-Tactical program (EMT-T). Several other providers (both privately and publicly operated) have developed their own curriculum for training EMS professionals in the unique demands of tactical operations executed by law enforcement agencies.

Tactical Paramedic Training Programs

Tactical Paramedic Jobs and TrainingThe unique juxtaposition of emergency medical care and tactical operations means that the core curriculum within these tactical medic training programs focuses largely on teaching medics how to operate harmoniously with law enforcement officials under established tactical protocols, as opposed to advancing skills in pre-hospital medical care. There are some special considerations covered in the training which relate to pre-hospital care unique to tactical environments, however, the majority of the tactical medic course modules will focus on topics such as:

  • Firearms training
  • Use of force
  • Basic hand-to-hand combat
  • Takedowns and handcuffing
  • Basic SWAT tactics
  • Navigation skills training
  • Forcible entry
  • Team movement
  • Biological and chemical threats
  • K9 operations
  • Sensory overload and sleep deprivation
  • Raid planning
  • Health and wellness of tactical team members
  • Hostage safety and survival
  • Medical record management in the tactical environment
  • Legal and ethical issues for tactical teams

Tactical EMT training courses can range from around 50 to over 300 hours in some cases, depending on the provider. They will nearly all require that you hold current certification as an EMT-Basic and as entrance into these programs tends to be highly competitive, many providers prefer certification as a paramedic prior to applying for enrollment. Costs for tactical medical training also vary by provider but may range from $800 to $2,000 on average.

At the current time, here are some of the top providers of tactical EMS training programs outside of local and state law enforcement agencies:

Cypress Creek EMS (Houston, TX)
International School of Tactical Medicine (Palm Springs, CA)
Tactical Element (Lady Lake, FL)
Consurgo (Dallas, TX)
TAC ONE Consulting (Golden, CO)

You may also check with local community colleges and law enforcement agencies in your area to determine if there are tactical EMS training programs in your state.

Tactical Paramedic Jobs

One of the leading providers of tactical medic jobs is law enforcement agencies. Depending on the size of the agency, some SWAT and SRT units staff medics on their response teams. Other law enforcement positions may include opportunities with highway patrol agencies or air commands. There are also opportunities for the tactical medic within the military contracting community. These are typically contract positions offered by companies who are hired by the Department of Defense to maintain security operations in foreign countries. Various private security forces which operate both domestically and internationally also staff tactical medics within their operational units. While tactical EMS jobs are not widespread, with the right combination of training and experience, a medic can position himself as an attractive candidate within the limited pool of opportunities.

6 Responses to “Tactical Paramedic Jobs: Providing Critical Care in Hostile Environments”

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  1. Christine Heins says:

    How do i do this? I love the sound of it.

    • JimEllis says:

      Hi Christine,

      Your first step is to gain your EMT-B certification, however, as EMT-T courses tend to be highly competitive in terms of entrance and acceptance rates (most limit to around 20 students), it's highly advisable to get certified as a medic and gain one or two years of field experience. You'll then be able to apply for a tactical EMS course with a provider in your area or elsewhere. Keep in mind that many programs require you to be sponsored by a tactical law enforcement agency, so you'll need to determine that prior to applying.

  2. katie says:

    I am a paramedic in Delaware and also opperate as a tactical medic on our county's swat team. I am interested in finding a full time position as a tactical medic who co-exists/operates with a team either stateside or over seas. Looking for info on how to start the search. thanks

    • Jim Ellis says:

      Hi Katie,

      Thanks for stopping by the site. To be honest, full-time tactical medic positions are few and far between. However, your best bet for starting your search domestically will be with law enforcement agencies, such as state highway patrol units. There are also international assignments, generally on a contract basis. These are often with security teams for companies with global operations. Many of these are currently located in the Middle East, however, I recently had a conversation with a EMT-T who was hired by an oil refinery on a contract basis in Central America. You might also want to take a look at https://conflictareamanagement.com/

      Hope that helps,
      Jim Ellis

    • M Payton says:

      Go to secure aspects.com website many positions most Oconus overseas

      • Jim Ellis says:

        Thanks for sharing that site! It looks to have several great resources for those interested in tactical work.

        Jim