This is our most comprehensive program. It is appropriate for not only the newcomer to TEMS but the experienced operator as well.

We believe in and use a method called "training-in-context." This means that we attempt to make the training ground resemble the battlefield as much as possible. Our operations and scenarios have been drawn from actual incidents and callouts which we have ourselves been involved in.

There are about 20 members in the training cadre and many more support personnel who share particular areas of expertise. These affiliate faculty members include tactical officers and team leaders, physicians and surgeons, veterinarians, fire and EMS personnel, explosive and ordnance specialists, psychologists, emergency management personnel and others. Our planning committee regularly meets and reviews the curriculum for potential modifications. The Essentials of Tactical EMS is approximately 40% classroom and 60% practical evolutions, and addresses the following topics:

A pair of tactical medics performs ALS interventions on a casualty in a difficult location without the benefit of their sight (blacked out masks).	TACTICAL CONCEPTS Team Composition Roles and Responsibilities Hostage Survival Team Movement Preplanning and Triage Cover and Concealment High Risk Warrants Use of Force Use of Specialty Munitions
MEDICAL CONCEPTS Remote Assessment Preplanning and Triage Environmental Concerns Nutrition and Hydration Rapid Treatment and Evac Trauma Tactical BTLS Issues Critical Medical Concerns Canine Aid	You will practice “medicine across the barricade” events where you may be a distance from the casualty or talking to a non-medical provider who is attempting to care for a critically injured victim.
This team evacuates a patient who has already received medical intervention.	PRACTICAL EXERCISES Small Team Movement Speedcuffing and Arrest Extrication and Rescue Defensive Tactics Tactical Operations Chemical Munitions Rapid Armored Rescue Lifts, Carries and Insertions Team Initiatives

Each morning begins at 0600 hours. We understand that training in this fashion may be out-of-the-ordinary for some people, but there is nothing ordinary about our business as tactical operators! We greet a new day of training and opportunity with injury prevention (stretching) and physical team initiatives. We have found that this is an impressive way to facilitate team building and cohesion. Physical training in the morning also creates an alert mind and it helps prepare us for the learning opportunities ahead. At 0700 hours we have breakfast together and classes begin at 0800 hours.