FBINAA Associate Q1 Magazine

CRITICAL MEDICAL RESPONSE TRAINING FOR LAW ENFORCEMENT

GARY J. GLEMBOSKI

Medical training for law enforcement personnel at police academies and in-service level training has changed very little since the late 1970s. A typical recruit generally takes only a CPR and basic first aid class. Often, recruits do not even receive a certification, as this is left up to their departments. However, on occasion, events can occur that tend to compel individuals to shift their thought processes. O n Christmas Eve in 1978, several months after I graduated from the academy, I was dispatched to a call for medical assistance. When I arrived, there was a middle-aged woman lying on the floor next to her Christmas tree. Her daughter was kneeling next to her and wiping her forehead with a wet rag. She thought the woman had fainted as it was uncomfortably hot in the house. When EMS arrived, they determined the mother had suffered a heart attack and died. A similar incident, two months later, caused me to consider getting further medical training. I subsequently enrolled in an EMT program and graduated in 1979. I eventually worked as a full-time EMT and received valuable experience, which ultimately led me to co-develop a nationally recognized Tactical Medic pro- gram, and obtain certification as a NREMT-I and EMS instructor. I maintained my certification for 27 years so I could be able to teach law enforcement officers and military personnel the skills necessary to perform life-saving interventions in critical situations. The military has been training their personnel at higher levels for some time. Many soldiers have received Combat Lifesaver and Tactical Combat Casualty Care (TCCC) training. Each tier offers more advanced skills and constantly reinforces

the basic phases of emergency care. This information is applicable to all law enforcement officers as well and may allow you to save lives. PHASES OF CARE “The hemorrhage that takes place when a main artery is divided is usually so rapid and so copious that the wounded man dies before help can reach him.” - Col. H.M. Gray, 1919

Col. Gray is correct. Research using data fromWorld War II until the present has reached the same conclusion – the overwhelming cause of preventable death on the battlefield was extremity hemorrhage. However, until recently, personnel were not adequately trained or equipped to control life-threatening hemorrhage. In 1990, Captain Frank Butler , former Navy SEAL and direc- tor of Biomedical Research for the Naval Special Warfare Com - mand, wrote a treatise for SEAL Mission Commanders addressing the need for enhanced medical training for Special Operations Forces (SOF) operators. The result was the Tactical Combat Casualty Care (TCCC) guidelines. These recommendations are now contained in the Pre-hospital Trauma Life Support Manual (Mosby), and they carry the endorsement of the American Col- lege of Surgeons Committee on Trauma and the National Associ- ation of EMTs. The TCCC guidelines are the only set of battlefield trauma guidelines ever to have received this dual endorsement. Using the TCCC guidelines, the military currently identifies three separate phases of casualty care: Due to the unique circumstances law enforcement officers often find themselves in, the need for a level of medical training above basic CPR/First Aid is necessary. Quite often, officers are the first to arrive at a critical incident scene involving serious trauma such as gunshot wounds. Traffic crashes are also a cause of serious injury and officers must be prepared to render ap - propriate aid when necessary. Using the TCCC guidelines shown, law enforcement officers should consider learning how to deliver care under fire as well.

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