In recent years, significant emphasis has been placed on collaboration between conventional fire departments, emergency medical services providers, and patrol officers or deputies to deliver warm zone care during active violence incidents. However, what contingencies exist when offender tactics, false reports of additional suspects, limited law enforcement availability, or other "curve balls" result in unreasonable delays in defining where hot zones end and warm zones begin? This presentation will explore contemporary strategies, tactics, and concepts - including the deployment of SWAT medics - to help bridge those gaps. The goal is to facilitate faster hemorrhage control, casualty extraction, and transportation to hospitals in dynamic and unpredictable environments.

Jim Etzin is the Emergency Medical Services Coordinator for the Farmington Hills (MI) Fire Department and Oakland County Tactical Training Consortium (OakTac), a mutual aid organization comprised of 40 law enforcement agencies serving approximately 1.3 million people. He is also the founder of the International Tactical EMS Association (ITEMS) and served as a United States Navy corpsman during combat operations in Operation Desert Storm and then as a full-time combat medicine instructor for the 1st Marine Division. After becoming the first Corpsman to ever attend the United States Marine Corps Military Police School and Los Angeles County Sheriff's Department's Special Weapons and Tactics (SWAT) School, he then served as both an operator and medic for the only full-time Marine Corps SWAT team at the time. In the immediate aftermath of the infamous North Hollywood Bank of America takeover robbery and shootout in 1997, two years prior to the incident at Columbine High School, Etzin was the first in the United States to conceptualize what's now known as the Rescue Task Force approach to casualty management within such environments. He has been studying, practicing, and teaching active assailant response and tactical medicine for 35 years and is consequently considered a subject matter expert on not only the history of these events but also how to best mitigate them tactically and medically.