Extrications Involving LEOs

Due to the inherent risks of operating on and around the roadway, law enforcement personnel are routinely involved in motor vehicle collisions (MVCs). In fact, more law enforcement personnel die in the line of duty from traffic-related incidents than any other cause.

A significant amount of information has been published about dealing with law enforcement vehicles from an extrication standpoint. Features such as transport enclosures, push bumpers, equipment and firearm storage, etc., may complicate the extrication process by limiting initial access, decreasing the ability to provide patient care, and complicating common disentanglement tactics. However, one component of law enforcement vehicle extrication that has not been given much consideration is the officer themselves–our first priority.

In this month’s column, we’ll address the special considerations associated with assessing and treating a law enforcement officer, and offer suggestions to ease the process.

At the basis of this discussion is the interaction with your local law enforcement agencies. Although the best scenario involves a formal policy or procedure that’s developed between all agencies involved, there should at least be conversation and informal procedures to ensure that the first time these issues come up is not on the scene.

The Duty Belt
Law enforcement officers value their possessions the same way we value ours. Just as we are trained to protect our hand tools during firefighting operations, law enforcement officers are trained to maintain contact with their devices–and for obvious reasons. This is perhaps most apparent with their firearm, which can be classified as part of the duty belt. The duty belt could also include additional ammunition, a Taser, chemical sprays, a radio, a flashlight, batons, restraint devices, etc. Considering the components of a duty belt, it’s easy to see why an officer would be more likely to turn it over to another officer before a firefighter. Further, many officers would also be more likely to turn over their duty belt to someone from their own agency before someone from a different law enforcement agency. With this in mind, if faced with the need to remove the duty belt prior to other officers arriving, approach the situations similar to EMS care. If the officer is unresponsive, assume implied consent to properly treat them and secure the belt until it can be transferred to another officer. If the officer is conscious and alert, obtain consent before attempting to remove it.

Prisoner Control
Although a completely separate issue, there are similarities between how an officer would handle a duty belt and a prisoner in their custody who requires medical treatment. The officer would likely turn over custody of a prisoner first to someone from their agency, then someone from an outside law enforcement agency and lastly, a firefighter.

Even if the collision is not significant, jail personnel typically require some form of medical evaluation prior to taking. The prisoner could be located in the front passenger seat, the rear seat or some type of cage in a special purpose transport vehicle. They may be intoxicated, agitated, under the influence of drugs, combative, etc., not to mention suffering from any injuries sustained during the collision. Your ability to provide emergency care may be compounded by handcuffs and/or other restraint devices.

Important: Ensure that other law enforcement personnel take control of the prisoner, accompany the prisoner to the medical facility if transported, and retain custody of them.

Patient Care
The ability to conduct patient care for law enforcement personnel can present many challenges. First and foremost is the need to assess the patient, mainly considering the initial assessment and the need to determine the quality of their airway and breathing. This may be difficult due to the presence of a bulletproof vest. Almost all law enforcement organizations have vest policies that require their use if officers could potentially be involved in hazardous situations. It is important that any disentanglement supervisor understand this and how it impacts the ability to conduct a standard or rapid removal.

Once the patient has been extricated, a bulletproof vest may complicate other common procedures, such as auscultation and palpation of the chest, treatment of blunt chest trauma, etc. The easiest way to remove the vest is by exposing the vest and cutting and/or disconnecting the carrier at the shoulder and waist level on both sides. This will allow the anterior portion to be removed; the posterior can be removed in the same fashion as needed. The vest should be maintained as potential evidence and/or for evaluation of mechanism of injury.

The movement of the patient to a long spinal board may be difficult due to the presence of a duty belt, with all the gadgets and gizmos necessary to catch the bad guys. Although it may be possible to pad the voids between the patient and the board, removing and securing the duty belt makes the process much easier.

What about the Dog?
An additional hazard may be a K-9 involved in an MVC They may be agitated from the collision and the presence of responders attempting to treat the officer. Regardless of whether they are separated from the front occupant area or free to roam around the vehicle, they can pose additional complications, for example, if responders try to access the interior of the vehicle. Seek the assistance of another K-9 handler or, in some cases, family members from the officer’s household. They likely have established a bond and trust with the K-9–and also know proper handling techniques.

High Stress on Scene
The psychological impact of responding to a law enforcement incident cannot be overstated. Yes, there may be a tradition of jokingly devaluing the importance of law enforcement–or our relationship with them–but they are a part of the emergency response community. As we respond to these incidents, our stress and anxiety automatically increase. And they can become   compounded by the response of additional law enforcement personnel–and even non-first responders.

Such incidents are similar to school bus incidents. We know that at the height of a school bus incident, we may be faced with dozens or hundreds of parents, community members, etc., responding to the scene. Similarly, at the scene of a law enforcement incident, a large number of additional officers will begin to appear on scene. At a minimum, this will result in stress and pressure to quickly extricate the victim, regardless of their injuries and overall condition. In more extreme cases, their attempts to communicate with the officer, secure possessions, etc., may cause interference in the hot zone. As such, it is important to establish lines of communication prior to and during the incident with attempts to provide specific guidelines for their involvement. It will most likely be impossible to restrict their involvement, so we should try to control it as much as possible.

In Sum
It’s not uncommon to respond to incidents involving law enforcement officers. Although we should not deviate from the standard extrication process, we should understand that there are inherent problems, both physically and mentally, that will complicate the process. As responding agencies, we should attempt to do everything we can to make this process easier by coordinating with law enforcement agencies ahead of time to develop policies and procedures, conduct joint training and closely adhere to the incident command structure.
 
A special thanks to the Charleston Police Department and the South Carolina Highway Patrol.