Post OIS/Critical Incident First Aid Considerations
Much of our career involves or should involve debriefing critical incidents, pre-planning, and mental rehearsals, to prepare ourselves for those low-frequency, high-stress events that visit us from time to time. The reality-based training and advanced officer skills training our officers receive is truly exceptional, especially considering most smaller agencies and even some major metropolitan departments have not yet adopted this mindset. I want to take a few minutes of your time to talk about and consider the applications of first aid in officer-involved shootings (OIS) and other dynamic events. Within the last year, we have seen several OIS where officers have rendered first aid to the suspect who had only moments earlier tried to kill either them or someone else.
This included applications of tourniquets, doing chest compressions, and applying wound dressing. Many times, we have arrived at critical incident scenes to find an officer(s) covered in the blood of the suspect after they had attempted life-saving measures. In at least three of these incidents, we were contacted by FIT, post-autopsy, and told the suspect was HIV positive. Imagine sitting at home the day after an OIS, still trying to wrap your mind around what you had just been through the day before, only to have one of us call you and tell you that the suspect you were doing chest compressions on, the suspect who bled all over your uniform, arms, hands, etc. was HIV positive.
Now imagine how it would feel when we ask you to report to UMC to undergo testing and preventative measures with the hope that you do not contract this life-altering disease. This scenario has played out several times within the last year.
The purpose of this article is not for me to tell you what to do in this scenario. The truth is your response to this scenario and your moral beliefs are between you and your god.
Understand this:
You are NOT compelled to apply a tourniquet or perform chest compressions on the suspect who just moments earlier tried to murder you or someone else. You ARE expected to and should summon medical personnel as soon as your scene is safe to introduce them. Firefighters, EMTs, and paramedics are trained P# 19873 and equipped to treat these types of injuries. Furthermore, they are equipped with the proper PPE to accomplish their mission while protecting themselves
from communicable diseases. Please take a few moments to think about this scenario. Pre-plan and mentally rehearse what you will do. Understand and recognize what you are compelled to do, and what you are NOT compelled to do. No law or department policy requires you to place yourself in the position of contracting a communicable disease from a savage who just tried to murder you or another innocent. Please take a moment to review the LVMPD Use of Force Policy 3.110 page 5 outlines an officer(s) responsibility.
Medical Attention
Whenever an officer applies a use of force option upon a subject that results in either observable signs or complaints of injury or any signs-of-life concerns (e.g.,difficulty breathing), the officer will continuously monitor the subject and immediately summon medical attention. Officers will be mindful that persons who are in a prolonged physical encounter with officers may be at an increased risk of medical distress. Incidents involving these persons should be considered behavioral or medical emergencies, prompting an expedited request of medical personnel. The following procedures are intended to help officers elicit the fastest medical response possible for a subject’s survival. Officers should inject humanity into every interaction and treat all subjects with dignity, rendering medical aid within the scope of their departmental training and skill level while awaiting the next level of medical care.
Procedure
For all subjects in LVMPD custody, officers/supervisors will:
1. Monitor for signs-of-life concerns (e.g., pulse, verbal statements of breathing complications, chest/head pain that compromises normal behavior, requests for water post-critical incident, or sudden inactivity of movement).
2. When requesting medical attention, provide the nature of the injury, the subject’s age and gender, and other circumstances that could be of potential medical risk to the subject (e.g., obesity, suspected drug use, extreme agitation,
profuse sweating, labored breathing, complaint of chest pain, excessive thirst, or involvement in a foot pursuit) (see LVMPD 3.400, Responding to Persons in Behavioral Emergency or with Special Needs).
3. If the subject’s condition worsens, update responding medical personnel via radio or the Police/Fire/Medical (PFM) channel if criteria are met (see LVMPD 7.235, Voice Radio Communications). The PFM radio channel, which allows for
direct communication between officers and fire department (FD) personnel, can be used to expedite response times of FD medical resources.
Communications Bureau personnel will:
1. Update the computer-aided dispatch (CAD) event with the status of the subject’s condition and whether the PFM channel was used.
Officers/supervisors will:
1. When available, assign an additional officer to continuously monitor the subject’s condition and provide appropriate updates via radio.
2. Be aware of the subject’s condition during adverse weather such as extreme heat.
a. When outside exposure to extreme heat occurs, officers will consider alternative locations (e.g., placement in the shade or air-conditioned police vehicle).
1) In an attempt to reduce body temperature, officers can consider applying a cold source, if available, to points of the body (i.e., neck, chest, head).
Use of the Recovery Position
Officers will avoid restraining subjects who are in custody and under control in a manner that compromises their ability to breathe.
1. Proned handcuffed subjects will be immediately placed in a recovery or seated position once safe to do so (i.e., the placement of a subject’s body in a manner that does not restrict breathing or obstruct the airway, such as on their side or upright).
2. While handcuffed subjects are seated, they will not be forcefully bent forward at the waist, and pressure will not be applied to their back, neck, or head. Thanks for the time and consideration. As always, stay safe.