Clinical care in the warm zone: a responder's perspective upon clinical practice in support of UK tactical medical operations

The field of tactical medical operations (TMO) is a concept that is still in its infancy within the ambulance service, especially as the practice of medicine in tactical environments has often been unique to the military. Society is now in a new age of international terrorism and this requires a bold and diverse approach to clinical practice. This sphere of practice, however, still has a plethora of challenges to meet, as for the ambulance service as an organisation to continue to develop its TMO response framework, it must look to the international community to identify the key lessons learnt and apply them within its ever evolving standard operating procedures (SOPs).

To achieve this, international policy review, training and regular assessment of clinical governance frameworks will ensure that if this unique response is ever needed, both patients and clinicians can remain in the strongest position possible.

Remaining effective within the tactical environment requires clinicians to assess the effectiveness of their clinical practice, while continuously ensuring that their safety is not being compromised. Although deployment into active shooter incidents can never be guaranteed as absolutely safe, ‘safety’ nevertheless is a prioritising factor.