Hostname: page-component-848d4c4894-pjpqr Total loading time: 0 Render date: 2024-06-30T21:05:55.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Tactical Medical Skill Requirements for Law Enforcement Officers: A 10-Year Analysis of Line-of-Duty Deaths

Published online by Cambridge University Press:  28 June 2012

Matthew D. Sztajnkrycer
Matthew D. Sztajnkrycer*
Affiliation:
Associate Professor of Emergency Medicine, Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA Medical Director, Rochester Police Department, Rochester, Minnesota, USA Medical Director, RPD-OCSO Emergency Response Unit, Rochester, Minnesota, USA
*
Department of Emergency Medicine, Mayo Clinic, 200 First Street SW, E-mail: sztajnkrycer.mathew@mayo.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

In the absence of other data, military Tactical Combat Casualty Care (TCCC) precepts are increasingly being adapted to law enforcement needs. The purpose of this study is to better describe the nature of potentially preventable law enforcement Line-of-Duty Deaths (LODDs) occurring as a result of felonious assaults.

Methods:

A retrospective analysis was performed of open source data available through the US Federal Bureau of Investigation (FBI) Uniform Crime Reporting (UCR) Law Enforcement Officers Killed and Assaulted (LEOKA) program for the years 1998–2007 inclusive.

Results:

After applying exclusion criteria, 341 victim officers were included in the study. The most common cause of death was head trauma (n = 198), followed by chest trauma (n = 90). There were 123 victim officers that suffered potentially preventable deaths; the majority of these injuries involved the chest. Over the 10-year study period, only two officers (0.6%) died from isolated extremity hemorrhage.

Conclusions:

The current emphasis of TCCC on control of exsanguinating extremity hemorrhage may not meet the needs of law enforcement personnel in an environment with expedited access to well-developed trauma systems. Further study is needed to better examine the causes of preventable deaths in law enforcement officers, as well as the most appropriate law enforcement tactical medical skill set and treatment priorities.

Keywords

assaulthemorrhagelaw enforcementprehospitalpreventable deathTactical Combat Casualty Care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 4 , August 2010 , pp. 346 - 352
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Butler, FK Jr , Hagman, J, Butler, EG: Tactical combat casualty care in special operations. Mil Med 1996;161(1 Suppl):3–16.CrossRefGoogle ScholarPubMed
2.Butler, FK, Hagmann, JH: Tactical management of urban warfare casualties in special operations. Mil Med 2000;165(1 Suppl 1):1–48.CrossRefGoogle ScholarPubMed
3.Mabry, RL, Holcomb, JB, Baker, AM, Cloonan, CC, Uhorchak, JM, Perkins, DE, Canfield, AJ, Hagmann, JH: United States Army Rangers in Somalia: An analysis of combat casualties on an urban battlefield. J Trauma 2000;49(3):515–529.CrossRefGoogle Scholar
4.Butler, FK Jr : Tactical Medicine Training for SEAL Mission Commanders. Mil Med 2001;166(7):625–631.CrossRefGoogle ScholarPubMed
5.Committee on Tactical Combat Casualty Care: Military Medicine. In: McSwain, NE, Frame, S, Salomone, JP (eds), Prehospital Trauma Life Support, Military Edition. 5th ed. St. Louis: Mosby, 2005, pp 374–408.Google Scholar
6.Butler, FK Jr, Holcomb, JB, Giebner, SD, McSwain, NE, Baglan, J: Tactical combat casualty care 2007: Evolving concepts and battlefield experience. Mil Med 2007;172(11 Suppl):1–19.CrossRefGoogle ScholarPubMed
7.Chambers, LW, Rhee, P, Baker, BC, Perciballi, J, Cubano, M, Compeggie, M, Nace, M, Bohman, HR: Initial experience of US Marine Corps forward resuscitative surgical system during Operation Iraqi Freedom. Arch Surg 2005;140(1):26–32.Google Scholar
8.Navein, J, Coupland, R, Dunn, R: The tourniquet controversy. J Trauma 2003;54(5 Suppl):s219–s220.Google ScholarPubMed
9.Brethauer, SA, Chao, A, Chambers, LW, Green, DJ, Brown, C, Rhee, P, Bohman, HR: Invasion vs insurgency: US Navy/Marine Corps forward surgical care during Operation Iraqi Freedom. Arch Surg 2008;143(6):564–569.CrossRefGoogle ScholarPubMed
10.Chambers, LW, Green, DJ, Gillingham, BL, Sample, K, Rhee, P, Brown, C, Brethauer, S, Nelson, T, Narine, N, Baker, B, Bohman, HR: The experience of the US Marine Corps' Surgical Shock Trauma Platoon with 417 Operative Combat Casualties during a 12 month period of operation Iraqi Freedom. J Trauma 2006;60(6):1155–1164.CrossRefGoogle ScholarPubMed
11.Kragh, JF, Walters, TJ, Baer, DG, Fox, CJ, Wade, CE, Salinas, J, Holcomb, JB: Survival with emergency tourniquet use to stop bleeding in major limb trauma. Ann Surg 2009;249(1):1–7.Google Scholar
12.Kragh, JF, Walters, TJ, Baer, DG, Fox, CJ, Wade, CE, Salinas, J, Holcomb, JB. Practical use of emergency tourniquets to stop bleeding in major limb trauma. J Trauma 2008;64(2 Suppl):s38–s50.Google ScholarPubMed
13.Bellamy, RF: The causes of death in conventional land warfare: Implications for combat casualty care research. Mil Med 1984;149(2):55–62.CrossRefGoogle ScholarPubMed
14.Bellamy, RF: Death on the battlefield and the role of first aid. Mil Med 1987;152(12):634–635.CrossRefGoogle ScholarPubMed
15.Champion, HR, Bellamy, RF, Roberts, P, Leppaniemi, A: A Profile of combat injury. J Trauma 2003;54(5 Suppl):s13–s19.Google Scholar
16.Uniform Crime Reporting Program. Law Enforcement Officers Killed and Assaulted 2007. Federal Bureau of Investigation. US Department of Justice. October 2008.Google Scholar
17.Sztajnkrycer, MD, Callaway, DW, Baez, AA: Police officer response to the injured officer: A survey-based analysis of medical care decisions. Prehosp Disaster Med 2007;22(4):335–341.CrossRefGoogle Scholar
18.Walters, TJ, Mabry, RL: Issues related to the use of tourniquets on the battlefield. Mil Med 2005;170(9):770–775.Google Scholar
19.Lakstein, D, Blumenfeld, A, Sokolov, T, Lin, G, Bssorai, R, Lynn, M, and Ben-Abraham, R: Tourniquets for hemorrhage control on the battlefield: A 4-year accumulated experience. J Trauma 2003; 54(5 Suppl):s221–s225.Google Scholar
20.Cloonan, CC: Treating traumatic bleeding in a combat setting. Mil Med 2004;169(12 Suppl):s8–s10.Google Scholar
21.Calkins, MD: Evaluation of possible battlefield tourniquet systems for the far-forward setting. Mil Med 2000;165(5):379–384.CrossRefGoogle ScholarPubMed
22.Wenke, JC, Walters, TJ, Greydanus, DJ, Pusateri, AE, Convertino, VA: Physiological evaluation of the US Army one-handed tourniquet. Mil Med 2005;170(9):776–781.CrossRefGoogle ScholarPubMed
23.Walters, TJ, Wenke, JC, Kauvar, DS, McManus, JG, Holcomb, JB, Baer, DG: Effectiveness of self-applied tourniquets in human volunteers. Prehosp Emerg Care 2005;9(4):416–422.CrossRefGoogle ScholarPubMed
24.McPherson, JJ, Feigin, DS, Bellamy, RF: Prevalence of tension Pneumothorax in fatally wounded combat casualties. J Trauma 2006;60(3):573–578.CrossRefGoogle ScholarPubMed
25.Sztajnkrycer, MD: Needle thoracostomy by non-medical law enforcement personnel: Preliminary data on knowledge retention. Prehosp Disaster Med 2008;23(6):553–557.Google Scholar