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In a harsh or remote environment, there may be times when access to the patient is not feasible.[1] Access can be limited for various reasons, such as an active shooter, barricaded subjects, distance, or any obstructions. These obstructions vary based on location and terrain. These limitations should not prevent a tactical medical provider from trying to provide the best medical care they can in these less-than-optimal conditions. These situations make a tactical medical provider's knowledge set unique because they may need to provide care in less than optimal circumstances and utilize the actual patient or partner to provide the care until the situation is safe. This is completely different from how EMS and medical care are provided in a "normal" environment, where one gets to interact immediately with the patient verbally and physically. The remote can range from verbal instructions to the patient to complete medically oriented tasks to change location for better access.[2][3][4]