We’d like to start off with saying a special thanks to Casey Cassidy for his insight and dedication to this epidemic, and for helping with this podcast. If you ever get a chance to sit down and chat with Casey, it will be well worth your time.
This is not a fun situation to think about. If we were truly honest, I think this situation scares the living hell out of us. Nobody wants to uncover his/her friend from a mangled vehicle, or put a tourniquet on his buddy’s arm after they’ve been shot. If you pick up a newspaper, get on the internet, or watch t.v. for any amount of time, you will see that violence against public safety is on the rise; there is no question about it. Whether intentional attacks or unintentional threats from distracted drivers, this is an unfortunate reality we have to come to terms with. The only way we can hope these situations will go well is if we begin to train for them. Today, we will be focusing primarily on assisting the injured police officer. So let’s get to it…
ENTRY INTO THE SCENE
- Find a way to calm yourself down!
- Whether you think you will be able to handle it or not, this is a high stress situation.
- Tactical breathing
- Develop a primary plan with your partner before you get on scene. If you have an idea of what needs to be done, you are less likely to just be caught up in the chaos of the moment.
- There are hazards everywhere!
- Nothing majorly different than any other MVC scene
- Wires, fluids, etc.
- Remember that in this situation, while all of us are drawn first to the injured officer(s), there is the potential for other patients. Don’t get tunnel-visioned.
- This is a situation that might make you exceedingly unpopular, and you need to prepare yourself for maybe needing to be the bad guy… What if the officer isn’t the most critical patient? Are you going to transport them first anyway?
- Nothing majorly different than any other MVC scene
- Everyone is rubber necking to see what the commotion is.
- Scenes like this require immediate stabilization; everyone is emotional and not operating with full attention to detail of surrounding dangers; i.e. bystanders, fire, active shooter, news crews, etc. The more people you have on scene, the more risk you have for further injury.
- Get people out of the way
- People standing with hands in pockets are only complicating the scene; delegate
- Appoint specific people for crowd control
- Get off scene and don’t dick around. Seriously. If you can do it en route do it. There are several reasons for this.
- Trauma: It’s a surgical disease, and you starting an IV on scene isn’t worth the delay.
- Public/Responder perception: When people perceive that you aren’t moving quickly enough, they think you don’t understand the weight of the situation.
- This is a crime scene.
- Everything you took is evidence. While this shouldn’t affect your treatment that you render, you need to keep this in the back of your mind.
- If you can avoid it, try not to cut directly through a bullet hole, etc.
- Be careful where you place your equipment; i.e. don’t throw your first in bag on a murder weapon, etc.
- This is mostly common sense stuff, but you’d be surprised at the stupid stuff we do when we are under stress.
- If you aren’t in the habit of stripping down your trauma patients, we highly advocate you start. Trauma that might not show up initially can as time goes by. It’s good to have a before and after picture. It’s just good care.
- Duty belts and vests get in the way.
- Tourniquets/pelvic binders aren’t effective if a gun is in the way; vests inhibit in depth chest/abdomen assessment, EKG placement, listening to breath sounds, needle decompression, CPR… You get the point.
- Shootings to center mass; even if the officer is up walking around and the vest took the brunt of the damage, remember that blunt trauma can still cause internal abdominal hemorrhage, cardiac arrhythmias, pneumothoraces, etc.
- Don’t be afraid to pack a wound or use a tourniquet; they save lives.
- Securing the Weapon
- If you don’t know how to properly disarm a holster, don’t. Best rule of thumb, have an officer secure the weapon. It will be checked in as evidence, anyways. Don’t interfere with the process.
- Secondary Weapons
- Most officers carry a second weapon; check for ankle/armpit holster, knives, etc. It’s important to remember that you really should not deliver a patient to the ED with a weapon. Bad things just have a tendency to happen.
- The Unconscious Officer
- If the officer you are working on is unconscious, realize that if he/she wakes us, they will most likely still be in the throws of sympathetic surge and will probably want to fight because it is the last thing they remember.
- Basic Information
- Talk to your officers about wearing their basic demographics, med history, and blood type on the inside of their vests for more rapid treatment
- Everyone is amped up on these scenes; there are a few way that we can combat that stress.
- Train specifically; whether it’s mayday drills for fire, ambulance crashes for EMS, officer shootings for PD, we need to train specifically.
- When you are encountered with a new type of stress, you sink to the level of your training… Just imagine how bad it will be if you haven’t had any training at all.
- Plan for failure; not everyone has a happy ending. Officers, Medics, and FFs DIE on the job; fact of life. We need to be preparing that this could be a reality in our own departments. None of us are invincible.
- For these scenes to go as smoothly as possible, it is imperative for all departments to train together.
Sorry for the downer episode, but it is important to talk about. We’ll be talking about happier subjects (kind of) next go round.