October 18, 2021

Letter from the Chair

Dr. John Wipfler, MD, FACEP
Chair, Tactical Emergency Medicine Section


Hello fellow Tactical EM Section members,

I hope this letter finds you and your family doing well. Our country is wrapping up an eventful summer: school starting back up; the COVID pandemic continuing to impact our lives; hurricanes, floods and fires; riots and demonstrations; and the upheaval in Afghanistan. We all have plenty of challenges upon awakening each day. Even with these stresses, when I stand side-by-side with the excellent providers in our ED, along with our community first responders and fellow citizens, I realize that I am part of a great team, in a great community and country.  When we stick together and support each other, we figure things out and do fine. I wish you and yours well as you face your individual and community challenges.

This newsletter contains a variety of information that we hope you find useful.  One very timely topic is ketamine, including the significant political and medical implications of recent legislation in the state of Colorado. Dr. Keegan Bradley will update you on the situation, including an unfortunate case where ketamine was implicated in the death of a patient, ending with criminal charges against the responding paramedics and police officers. 

Dr. Bradley will be discussing the role of ketamine and other medications in the management of the agitated and potentially violent patient in a webinar presentation on Tuesday, September 21, at 7 p.m. Central Time. CME credit will be given for participants. This is part of our continuing Tactical EM Section monthly webinar series, and each section member will be receiving further emails and Microsoft Teams invitations for this seminar. Please mark your calendar and plan to join in.

Special thanks to Dr. Jeff Ho, who was a special guest on this past month’s Tactical EM webinar focusing on LE status for tactical physicians, and also law enforcement training and firearms.  He was able to share his extensive experience and the discussions afterwards along with our Section leaders were very worthwhile. The written summary from this webinar, as well as the Introduction to Tactical Medicine webinar (July 2021) will be posted soon on our Section website.

We are fortunate to have Dr. Dominique Wong as Newsletter Editor, (along with Dr. Springer and Dr. Bradley with their excellent proof-reading and contributions) and she has assembled another great set of articles for you this quarter.  Topics include a case study on TXA, and a law enforcement officer line of duty death update that includes the impact of COVID. We have a continuing series of reports on training programs in tactical medicine, with another program being highlighted this issue. There is an article on Xylazine, an increasingly prevalent medication that is being used by drug addicts that impacts our patients in the prehospital setting as well as in the emergency department.

I have included an article on the increasing trend of using pistol-mounted optics/red dot sights. Over this past year, I have done a considerable amount of research, as well as utilized fellow police officers’ experience and have shot their pistols during training sessions. The bottom line is that I am very impressed with the improved accuracy and more rapid acquisition of the target through the use of pistol mounted optics.  Those of us who use pistols for self-defense or carry as part of our normal tactical medicine gear should investigate the advantages and disadvantages of these sights.

Finally, I would like to take a moment to thank you and all of our fellow section members for your contributions to the world of tactical medicine, emergency medicine, trauma, prehospital medicine, and for your support of our Public Safety Triad including EMS, Fire/Rescue, and Law Enforcement. With the recent hurricanes and tornadoes and fires and other disasters, a special hats-off to all the professionals who have responded to major events that strike our nation and our world. Each of us makes our contributions in our own unique way, and I wish each of you well in your endeavors. Please stay safe and let us continue to share our experiences and learn from each other, so we can do it safer and better the next time.

With highest regards,

E. John Wipfler, III, MD, FACEP, RDMS

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