Editor’s note: In light of the spate of attacks on officers, we reached out to long-time contributor and emergency medicine expert Eric Dickinson for some practical tips on tactical medicine and self-applied emergency first aid.
1. Effective bandaging and tourniquet practice can be effectively accomplished simply by having officers perform the skill a few times at the beginning of each shift (or roll call), once an initial familiarization class has been completed. This keeps the practice time short for scheduling (fewer in-service classes to schedule) but it will still give them 10–15 reps a week—around 500 reps per year. I bet that’s more reps than any officer gets with any DT technique in even the most-well-trained department.
2. I love the toys on the market—pressure dressings, tourniquets, clotting agents—but I still believe the emphasis on training should be giving officers the ability to perform the needed skills without those commercial products (what we call ditch medicine). Example: An off-duty officer injured in confrontation or responding to an active shooter may not have the various kits available and will have to improvise. This ability is also important when the number of victims is more than the amount of supplies you have available—you need to know how to make a TQ out of boot laces and a baton.
3. It’s very difficult to drag a body and still put effective fire on a target—tends to make shots less accurate and slow down your movement, resulting in more time exposed to fire. At times, it may be necessary, depending on the environment and number of officers. But if possible, avoid it. It’s much more effective to have one or more officers provide cover fire and a couple of officers dedicated to and focusing on moving the victim (and themselves) out of the line of fire as quickly as possible. (To see this done, visit www.tacmedsolutions.com.)
4. Departments must communicate with local EMS agencies and hospitals prior to this kind of incident. Mass casualty incident (MCI) kits probably already exist within your jurisdiction for such an event and may or may not be necessary for your agency (it depends on your needs, storage space, etc.). A law enforcement kit for MCIs should include stuff that’s compatible with local EMS capabilities so as to avoid an unnecessary delay in treatment. This is especially true if you’re including tags or tape for triage—won’t do the victim any good if local EMS doesn’t use the same triage system your department’s adopted.
5. Gear should be able to be used on multiple types of situations. Don’t go to the work of building and buying an “active shooter medical kit” and only allow it to be deployed during that type of event. Fortunately, most officers in the U.S. still have a greater chance of responding to a school bus crash or other MCI with 40–50 victims than they do of responding to a school shooting. A properly packed kit will aid emergency medical care in any situation with multiple trauma victims based on the low level of medical training possessed by most officers. Also: Consider saving some money by building your own kits.
