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Over the past two decades, there has been significant progress in the development of national and state tactical emergency medical response strategies and training standards to improve casualty outcomes of active shooter and terrorism incidents. Tactical Medics are a specialized unit within the SWAT team that exists to provide emergency medical care first to officers, then to suspects and citizens injured during high-risk events. The East Montgomery County Fire Department created the Tactical Medics Program in 2017 in partnership with the East Montgomery County Strategic Response Team which includes the Splendora PD, Patton Village PD, Roman Forest PD, and the Splendora ISD PD. Each Tactical Medic is certified in Tactical Casualty Combat Care (TCCC), is a Tactical EMT, certified in SWAT Operations, and has a mandatory (16) hours of specialized training monthly. Our tactical medics are an intracule part of the Strategic Response Team and make entry with the team to provide emergency medical care. Our department has a Tactical Medic on duty 24/7.