Responding to tragedy: Physician subspecializes in tactical medicine

On Dec. 2, minutes after a report of an active shooter incident in San Bernardino, California, was broadcast on police radio, emergency physician Michael M. Neeki, DO, MS, was headed to Inland Regional Center. He was the first tactical physician to respond to the mass shooting, where he helped hostages escape and later assisted a SWAT team in their pursuit of the attackers.

Tactical physicians train intensively with SWAT teams, police or military personnel on how to provide medical attention during or immediately after chaotic events such as shootings, hostage situations and armed confrontations.

When he’s not working with the Inland Valley SWAT team, Dr. Neeki is the director of clinical research and tactical medicine with the osteopathic emergency medicine residency program at Arrowhead Regional Medical Center in Colton, California. Dr. Neeki recently spoke with The DO about his background in tactical medicine.

What is tactical medicine and how did you get involved with it?

Tactical medicine focuses on training physicians to respond to traumatic events more quickly. In tactical medicine, we are trying to move on from talking about the golden hour of trauma to minutes of trauma. Golden minutes.

I had some exposure to tactical medicine and flight medicine in my residency. After I moved to California, I obtained peace officer certification and took tactical medicine courses. I train routinely with the Inland Valley SWAT team to make sure I understand how to be safe in the environment and how to use a weapon for self-defense.

What advice would you give to medical students or DOs who are interested in doing what you do?

Study field trauma. Get to know the equipment that you will be using on the field. Take any opportunity you get to start an IV on a patient. Make sure you are on top of common field medicine procedures such as applying a tourniquet. Learn about advanced airway procedures.

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After you develop your medical training, start on tactical training. Ask your local police department if they need help. You can also take classes. Look for certified courses that are well-established.

What has been your experience assisting the Inland Valley SWAT team?

Most of my interaction with the SWAT team entails making sure the team is OK. If the situation is super dangerous, they usually keep me in an armored vehicle. If they are short on medics, I may go with them into the building like I did at Inland Regional Center.

The SWAT team has taught me a lot, and I’ve taught them a few things, too. I’ve taught them critical anatomy, such as alternative shooting locations if an attacker has a ballistic vest.

I’ve also explained ways to subdue people without killing them. If they absolutely need to shoot someone, there are places they can aim, such as the leg, to stop the person without ending their life.