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Already tasked with many responsibilities, firefighter duties are expanding in a few cities to include more medical care. Unlike tactical medical teams, where EMTs are given tactical skills to use on the scene, this medical attention occurs after an individual has been discharged from the hospital.

A tactical medical team consists of first responders who are trained in special operations and basic EMT skills. Being trained in both areas allows tactical medics to attend to the wounded as quickly as possible, even when a scene is not secure. By outfitting a crisis response team with at least one of these multifunctional individuals, agencies can save precious time and, as a result, lives.

By aiding first responders in their efforts and providing care for disaster victims, medical centers play a vital role in the success of emergency response. All agencies, including medical institutions, must examine how they act before, during and after an emergency to improve their end-to-end disaster preparedness.

Firefighters and law-enforcement agencies in Riverside County are practicing or discussing new federal guidelines that, in order to save more lives, recommend sending armor-wearing medics into mass-casualty attacks before shooters or bombers are subdued. San Bernardino County sheriff's deputies and Rancho Cucamonga firefighters, meanwhile, are years ahead of the guidelines that the Federal Emergency Management Agency issued in September. The tactic is a departure from the common practice of making firefighters wait in safe areas for the all-clear from police before entering a scene to tend to the wounded. The impetus for change, said San Bernardino County sheriff's Lt. Danielle Boldt, began with the 1999 shootings at Columbine High School in Colorado that killed 13 people.

If State Police troopers want to do anything in their career, it's save a life. So when staff at Tufts Medical made the desperate call for troopers to escort Ryan Brooker's car into Boston, that his future depended on it, this became a story about State Police service, about doctors and nurses, and about a young man thankful to simply live his life again.

The Barnstable Police Department recently received a $126,121 grant from the state Executive Office of Public Safety and Security to train and update training for 82 telecommunicators, including dispatchers, and 10 new police officers in emergency medical dispatch. Everyone currently assigned to the communications desk has had the training, Sweeney said.

When disaster strikes, agencies spring into action to provide aid, rescue services, medical care and other forms of emergency response. More and more, first responders are looking for help from new technology to improve their ability to save lives. Unmanned aircraft systems (UAS)-commonly known as drones-could become an important innovation for disaster preparedness and relief.

Unmanned aircraft systems can be used in a variety of contexts. Hobbyists fly them for private use, as they might a model aircraft. E-commerce giant Amazon is exploring the use of drones for rapid product delivery. Drones are also used for humanitarian purposes, surveying damage caused by natural disasters. The versatility of drones entices state and local law enforcement agencies, as well. The U.S. Customs and Border Protection, for example, deployed UAS to help monitor areas that are difficult to traverse along the Mexican and Canadian borders. When drones detect movement in these places, the CBP is able to send human agents equipped to deliver medical assistance. For local law enforcement, however, drone use is often misunderstood. As quickly as police departments find ways to leverage the benefits of unmanned vehicles, public criticism of such operations can shut them down. Along with an investment in technology and crafting good policy, public perception is a critical factor that law enforcement needs to address.

Emergency medical technicians perform one of the most critical jobs, but they also face a high degree of risk. In addition to the physical and health dangers that accompany each call, EMTs can easily find themselves in the center of legal disputes. Alarmingly, cases against them are often based on verbal accusations alone. To ensure that EMTs can remain legally defensible, certain services are now requiring their employees to wear body cameras. These cameras can document interactions with the public and provide a tangible record to be used in court, if necessary. As with every new technology, however, video cameras present challenges when integrating into an EMT's daily routine.

Practical skill and medical expertise are fundamental requirements for first responders. Now, emergency experts are realizing the impact cultural competency can have on saving lives in a community. First responders are the cornerstone of the areas they serve. In the event of an emergency, firefighters, EMTs, law enforcement officers and other key players share the duty of not only saving lives, but working directly with local residents to create an overall safer environment. Cultural competency represents the idea that understanding the nuances of the different cultures and the backgrounds that make up a particular population better equips first responders to provide effective care.

In an emergency situation, the location of fire stations plays a large role in how quickly first responders can reach a scene. For victims, however, this distance determines how much delay must be endured before receiving care. The city of San Diego is exploring a way to reduce the distance first responders have to travel to reach victims.

In a crisis, the difference between life and death is often having knowledgeable people on the scene with quick access to accurate information. With smartphone penetration in the U.S. up to 56 percent, mobile technology is an increasingly effective pathway to these facts. Mobile applications are now making it easier to find and share essential information during emergencies.

Faced with new threats, first responders put their training to the test in 2014. Law enforcement agencies, disaster workers and even school teachers learned new practices and honed their instincts to better allow them to survive stressful situations while caring for others. As the year comes to an end, we look back on how comprehensive training strategies contributed to effective emergency responses