CATO’s New Tactical Medicine Committee
TEMS Information, Training and Regulation for the State of California

By Rich Diliberti

The California Association of Tactical Officers (CATO) is in the process of assembling a series of subject matter expert committees, including the newly formed Tactical Medicine Committee. This committee will be made up of recognized subject matter experts such as emergency medical technicians (EMTs), paramedics and physicians. The goal of the committee is to act as a portal for information related to tactical casualty care in California. It will provide current information on tactical medicine, including training and regulations for tactical medics and non-medics on a SWAT team, as well as equipment and evolving trends.

Earlier this year, CATO sent a survey to agency SWAT teams throughout California, asking questions related to TEMS. The survey revealed the vast differences in programs across the state. One question that immediately caught the attention of the TEMS committee was, “How familiar is your department with local and state EMS regulations?” About 60% of the responses indicated “not familiar at all” or “somewhat familiar.” Based on that 60% response, we know we need to make sure everyone is completely clear on the current requirements regarding tactical medics in the state of California and provide information on where you can access that information.

There are many SWAT teams throughout the state that do not have tactical medics, nor are they required to have them. However, those agencies are still required to have a medical plan for their operations, per California POST SWAT Guidelines.

To summarize the existing regulations, there are three levels of medical providers recognized by the state:

  1. Tactical Medic/TEMS Specialist
  2. Tactical Life Saver/TEMS Technician
  3. Tactical First Aid/TEMS First Responder Operational (FRO)

Tactical Medic
The training and requirements needed to be a tactical medic in California are straightforward. Many agencies deploy medical personnel who have completed a “version” of the requirements, which do not fulfill the current requirements. This is likely due to a lack of knowledge on where to access the most current information and training. If your SWAT team wants to deploy tactical medics in the state of California, those medics MUST meet the following training and requirements:

1. Must be a current EMT or higher medical certification AND complete a CA POST Approved 80-hour Basic SWAT course AND a 40-hour Tactical Medicine for Special Operations course, such as LASD SEB course (open only to full-time law enforcement, fire or EMS).

OR

2. Must be a current EMT or higher medical certification AND complete the 80-hour Tactical Medicine for Special Operations course, such as International School of Tactical Medicine (open to anyone).

These are already established requirements as set forth by the California state Emergency Medical Services Authority (EMSA) and California POST. Further information is available on the following websites:

Tactical Life Saver

The Tactical Life Saver Technician/TEMS Technician course provides more advanced life support tactical medicine techniques and comprehensive instruction on the role of EMS in tactical response planning, response and inter-department operations when providing adjunct medical support to law enforcement personnel during active shooter and terrorism incidents. This requires a 40-hour EMSA approved course without the need for a SWAT basic course.

Tactical First Aid/TEMS FRO

Regardless of whether your agency deploys tactical medics or not, per California Code of Regulations, Title 22, all sworn officers on your department (not just your SWAT team) are required to have basic tactical casualty care training (tactical casualty care concepts, rescue techniques, tourniquets, hemostatics, chest seals, etc). These requirements can also be found on the above EMSA and POST websites. Additional information regarding Title 22 requirements can be found on the following website:

Basic Tactical Casualty Care is required to be taught in every CA POST academy in California, as part of the First Aid/CPR curriculum recruits receive (Learning Domain 34). If you have officers who were hired prior to this training becoming a requirement as of April 1, 2015 and agency compliance by April 1, 2017, it is the agency’s responsibility to ensure those officers receive the training, usually during their scheduled First Aid/CPR updates. Basic Tactical Casualty Care has become a standard of care and this recognition has prompted the updates to Title 22, which drive training requirements, standards and curriculum in California.

Although CATO is a tactical association with a SWAT team focus, it is understood that many of the SWAT teams in California are part-time and made up of patrol officers and detectives. Tactical casualty care, TEMS and tactical medicine are all interrelated concepts which must be addressed and looked at from across the spectrum – the non-medic patrol officer to the full-time SWAT team member/tactical medic.

The newly formed CATO Tactical Medicine Committee is in its infancy, but we have a vision moving forward, which is to provide information and best practices as they relate to tactical medicine. CATO does not wish to reinvent the wheel regarding tactical medicine. That foundation was laid by the combined efforts from the CA POST and EMSA TEMS Committees when the regulations were first established in 2010 and updated in 2017, and further updated by the CA POST SWAT Guideline Committee in 2019. CATO has many resources to deliver current, up-to-date training, references and direction regarding tactical medicine.

In conclusion, CATO hopes to create two-way dialogue with its membership. The development and direction of the Tactical Medicine Committee is as much your responsibility as it is CATO’s leadership. Look forward to future articles regarding tactical casualty care training, new equipment and the ever-evolving trends so your agency can be on the cutting edge of tactical medicine.

California is an enormous state with many law enforcement agencies of differing capabilities, and the CATO Tactical Medicine Committee would like subject matter experts from all parts of the state. If you are interested in being a part of the committee, please contact CATO.

Stay safe, Rich.

Rich Diliberti is a 29-year veteran of the Los Angeles County Sheriffs Department. He holds the rank of Deputy and has been assigned to Special Enforcement Bureau (SEB) for 14 years. He currently serves as a full-time Tactical Paramedic and has held that position for the last three of his 14 years. Prior to becoming a paramedic, he was assigned to one of the six full-time SWAT teams at SEB. He teaches several classes at SEB including the 40-hour Tactical Medical course. He has also created and taught several classes for CATO, including High-Risk Warrant Service and Manual Breaching. In addition, he has taught Hostage Rescue and Explosive Breaching at the annual NTOA conferences. He can be reached at rldilibe@lasd.org.

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