Ever since the 1999 tragedy at Columbine High School, law enforcement agencies throughout the United States and Canada have been training on the "contact team and extraction team" approach to threat and casualty management during active assailant incidents. This is mainly attributed to the historical reluctance of conventional fire service and/or emergency medical services personnel to enter the warm zones of such environments and Tactical Emergency Medical Support (TEMS) providers not always being readily available. However, given the growing acceptance and utilization of rescue task forces, many law enforcement agencies are now falling into a dangerous trap by deemphasizing the critical roles point of wounding care by law enforcement officers, extraction teams, and unconventional transportation will continue to play during future critical incidents. Given the 35 years the presenter has spent studying such events, visiting affected communities, and interviewing countless emergency responders and survivors who were involved, many past and recent examples of extraction teams contributing to casualty survival will be referenced. Information will also be provided that will arm command officers with reasonable expectations and help perimeter personnel, contact teams, extraction teams, rescue task forces, conventional fire service/emergency medical services personnel, SWAT officers, and hospital providers work together to simultaneously "stop the killing and dying."

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.