Natural and man-made disasters continue to be a major cause of morbidity and mortality. Natural disasters include earthquakes, storms such as hurricanes, floods, fires, drought. Man-made disasters include fires, explosions, chemical and radioactive releases, major transportation accidents, terrorism, and war. The effects of disaster include injury, death, damage to infrastructure, environmental exposure, population movement, and increased incidence of communicable diseases.

The emphasis of training for paramedics that function in the civilian sector in the United States has focused on the management of blunt trauma. The personal risks they face generally are the result of accidents or public health threats. The management of penetrating trauma under the threat of intentional personal harm is a different matter.

Law enforcement agencies have responded to the threat of apprehending heavily armed felons by forming special units highly trained in military-style, small-unit tactics. To provide care in this special environment, and support a special weapons and tactics (SWAT) team in fulfilling its mission, there is a requirment for a unique body of knowledge and special skills. (Prehospital care providers with at least emergency medical technician [EMT] skills and SWAT training will be referred to as tactical medics.)