Craig Hooper
Journal of Paramedic Practice, Vol. 8, Iss. 6, 03 Jun 2016, pp 282 - 288

Active shooter incidents both nationally and internationally have embedded
significant cultural reforms within emergency medical services response
frameworks. The deployment of specialist responders within specific preidentified
areas or 'zones' of an active shooter incident is unprecedented, and
reflects the level of public expectation now required of the ambulance service.

As seen within the recent 2015 Paris attacks, the delivery of effective clinical
practice in tactical medical operations (TMO) facilitates a range of unique
challenges for clinical responders. Conflicting priorities between operational
tactics and clinical priorities, especially within multiagency working, has
historically led to 'Good medicine becoming bad tactics, and bad tactics leading
to further casualties' (Butler, 2001: 625).

Although situational dynamics may make it impossible to ever achieve an
absolute equilibrium of safety and tactical efficiency within this sphere of
practice, this article intends to contribute toward achieving this ideal by
reviewing the Tactical Emergency Casualty Care (TECC) guidelines to establish
if this framework would be compatible for use within the UK's TMO response

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