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Training for Gunshot Wound Treatment

Written by Ed Nowicki

How much training should law enforcements receive in addition to basic police skills? In recent years, additional training in cultural diversity, anti-terrorism, responding to major terrorist attacks, and dealing with weapons of mass destruction have been added. But the question looms, just how much training is “enough?” How much training is “needed?”

Protecting lives is our top priority. Officers need to protect their lives, the lives of other officers, the lives of crime victims and the general public…and even the lives of assailants.

Most officers are not EMTs or paramedics, but they will probably reach the victims of gunshot wounds before an ambulance can arrive at the scene and treat any victims. So, it seems reasonable for officers to receive added basic emergency medical training in the treatment of gunshot wounds. This training would stabilize wounds until traditional EMS responders arrived on the scene.

Consider a July 1, 2008, shooting incident when Wichita, KS Police Officer Derek Purcell almost died after being shot once in each leg with a 9 mm round. Normally, a leg wound isn’t fatal, but this wasn’t a normal gunshot wound. Officer Purcell’s wound to the right leg hit his femoral artery, which caused profuse bleeding. Unless the bleeding stopped, Purcell would have bled out and died within minutes.

Luckily for Officer Purcell, Officer Brad Crouch quickly responded to Purcell’s radio call for help. Officer Crouch was a U.S. Army Special Forces medic for nine years, and after looking at Purcell’s wound, Crouch knew that immediate action was needed. He applied direct pressure to the wound while applying a tourniquet with Purcell’s pants belt. The tourniquet slowed the bleeding just enough until an EMS crew arrived in their ambulance. EMS staff replaced the makeshift tourniquet with a direct pressure bandage.

The use of a tourniquet has taken a bad rap in recent years, such as causing an unnecessary loss of an extremity. Chief Jeff Chudwin of the Olympia Fields, IL Police and president of the Illinois Tactical Officers Association said, “Tourniquets have been a source of mystery and fear. In our early days, we were told that the use of a tourniquet would mean the loss of the limb. While our docs caution that a ligature type made from a boot lace may indeed severely damage the limb, with current models that are an inch or more wide, they tell us such danger is greatly reduced or eliminated.

“The proper application of a tourniquet can and has saved many lives both overseas and at home. Further, they explain that a tourniquet can stay in place for several hours. The Wichita officer, saved by another officer, had but a few short minutes to live in the absence of the tourniquet. A small item that fits the pocket, the tourniquet is a must-have lifesaver.”

The use of the tourniquet may have save Purcell’s life. “I don’t think anybody else on scene, or very few in the whole department, would have had his knowledge and ability to assess it that quickly and start treatment,” Officer Travis Easter said of Crouch. “I mean, it was just seconds.”

Senior Police Officer Eric Dickinson of the Vinton, IA Police, a certified EMT-Intermediate, said, “Officers should be trained in the treatment of gunshot wounds. It only makes sense given the possibility of not only a felonious assault, but also in case of an unintended discharge or training accident. Sadly, it has been my experience that even many EMS providers are not up to speed on the treatment of gunshot wounds unless they have experience in regularly violent jurisdictions or in combat. The training needs to cover a wider variety of possible injuries, besides gunshots.”

Basic police recruit training programs train officers in a number of different EMS-focused programs that can include CPR, basic first aid, an expanded 40-hour “first responder” training program and recently in the operation of various portable defibrillators. Although initially trained and certified in these EMS different programs, some agencies fail to recertify the officers. The reasons range from “it’s too costly” to “EMTs don’t do police work, and we shouldn’t do EMT work.”

So, if an agency wants to include additional training in gunshot wound treatment, what should that training program contain? Dr. Fabrice Czarnecki said, “Bleeding control is the main issue of first aid. The other important elements are HOW (police car vs. EMS) and WHERE (any ER vs. trauma center) to transport casualties. All officers need that training. SWAT, warrant service and firearms instructors may need even more training. A 4- to 8-hour block of training would be fine for most officers. I think that this is up to each law enforcement agency or maybe a state’s POST commission to set the course content. There is no national standard.”

SWAT officers have a greater chance of losing their lives in training or by “friendly fire” than by being shot by an assailant, according to research conducted from 2004 to 2008 by a Maryland-based company, OpTac International. OpTac’s research shows that suspects killed a total of five officers during that five-year stretch, while accidents and “friendly fire” killed 12 officers. Perhaps improved safety equipment, relevant safety protocols and EMS training could have reduced both categories of deaths, but especially the non-assailant deaths.

The FBI understands the importance of having trained medical staff available in critical incidents. According to FBI information, “Our Emergency Medical Support Program, headed by Dr. William Fabbri, was launched in the wake of the 1998 U.S. Embassy bombings in East Africa.” Fabbri said, “After that investigation, we realized that our teams of people working in austere medical environments were at risk. And because operational deployments include a limited number of personnel—situations where even one minor injury or temporary illness could impact our mission—we began including FBI medics on our deployment teams.”

Today, more than 250 special agent medics around the country are fully qualified as emergency medical specialists. These FBI medics support crisis-response efforts, special operations, and terrorism and high-risk investigations in the United States and abroad. Their patients are not just FBI employees. FBI medics will render treatment to subjects and civilians involved in hostage situations where it’s not safe for local emergency workers to enter the scene.

Having specially trained law enforcement medics has some advantages. Trooper Mark Robbins of the Massachusetts State Police said, “In this newer violent world, officers are more apt to be forced to engage an opponent in gunfire or respond to a situation where rounds have been exchanged. With this in mind, EMS providers, unlike police officers, are not so willing to rush in to this violent encounter. This only leaves us to start the first aid to save our lives or the lives of our friends, colleagues and the victims.”

Chuck Soltys, DEA special agent, is a tactical emergency medical technician (EMT-T) who believes that officers should receive special training. Soltys said, “Training in the area of self-care and buddy care has long been overlooked in basic law enforcement academy curriculums, as well as in-service programs. If you or fellow officers are seriously injured during a hostile attack on the street, for an unspecified amount of time, you are on your own!

“Even the best intentioned EMTs and paramedics will likely not be permitted to come to your aid until the threat has been eliminated. That time lapse could be the difference between life and death. The steps that need to be taken to ensure your survival are simple. But you must have the training and equipment necessary to accomplish this available when something bad happens.”

Soltys said, “You must be mentally prepared to come out of a critical incident with a life worth living, not mere survival where your quality of life has been irreparably damaged. Training and preparing to prevail and not merely survive is a responsibility that falls squarely on each of us.” Clearly, proper medical treatment of gunshot wounds proves that, “The life you save may be your own!”

Ed Nowicki, a nationally recognized use-of-force expert, is a part-time officer for the Twin Lakes (WI) Police Department. He presents use-of-force instructor certification courses across the nation and is the executive director of ILEETA. He can be reached at ed@ileeta.org.

Published in Law and Order, Apr 2009

Rating : 9.7


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