The Difference in Job Dynamics Among Emergency Medical Services, Firefighters, and Law Enforcement: Subsequent Differences in Stress

2011 ◽  
Author(s):  
Emmanuel J. Finney
Keyword(s):  
Law Enforcement ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical ◽  
The Difference ◽  
Job Dynamics

Emergency Medical Services Experience With Barb Removal After Taser Use By Law Enforcement: A Descriptive National Study

2018 ◽  
Vol 34 (1) ◽  
pp. 38-45
Author(s):  
Mazen El Sayed ◽  
Chady El Tawil ◽  
Hani Tamim ◽  
Aurelie Mailhac ◽  
N. Clay Mann
Keyword(s):  
Law Enforcement ◽  
Emergency Medical Services ◽  
Life Support ◽  
Salt Lake ◽  
Traumatic Injury ◽  
Medical Services ◽  
National Study ◽  
Publication Type ◽  
Excessive Heat ◽  
Emergency Medical

AbstractBackgroundConducted electrical weapons (CEWs), including Thomas A. Swift Electric Rifles (TASERs), are increasingly used by law enforcement officers (LEOs) in the US and world-wide. Little is known about the experience of Emergency Medical Service (EMS) providers with these incidents.ObjectivesThis study describes EMS encounters with documented TASER use and barb removal, characteristics of resulting injuries, and treatment provided.MethodsThis retrospective study used five combined, consecutive National Emergency Medical Services Information System (NEMSIS; Salt Lake City, Utah USA) public-release datasets (2011-2015). All EMS activations with documented TASER barb removal were included. Descriptive analyses were carried out.ResultsThe study included 648 EMS activations with documented TASER barb removal, yielding a prevalence rate of 4.55 per 1,000,000 EMS activations. Patients had a mean age of 35.9 years (SD=18.2). The majority were males (80.2%) and mainly white (71.3%). Included EMS activations were mostly in urban or suburban areas (78.3%). Over one-half received Advanced Life Support (ALS)-level of service (58.2%). The most common chief complaint reported by dispatch were burns (29.9%), followed by traumatic injury (16.1%). Patients had pain (45.6%) or wound (17.2%) as a primary symptom, with most having possible injury (77.8%). Reported causes of injury were mainly fire and flames (29.8%) or excessive heat (16.7%). The provider’s primary impressions were traumatic injury (66.3%) and behavioral/psychiatric disorder (16.8%). Only one cardiac arrest (0.2%) was reported. Over one-half of activations resulted in patient transports (56.3%), mainly to a hospital (91.2%). These encounters required routine EMS care (procedures and medications). An increase in the prevalence of EMS activations with documented TASER barb removal over the study period was not significant (P=.27).ConclusionAt present, EMS activations with documented TASER barb removal are rare. Routine care by EMS is expected, and life-threatening emergencies are not common. All EMS providers should be familiar with local policies and procedures related to TASER use and barb removal.El SayedM, El TawilC, TamimH, MailhacA, MannNC. Emergency Medical Services experience with barb removal after TASER use by law enforcement: a descriptive national study. Prehosp Disaster Med. 2019;34(1):38–45.

Emergency Medical Services Response to Active Shooter Incidents: Provider Comfort Level and Attitudes Before and After Participation in a Focused Response Training Program

2014 ◽  
Vol 29 (4) ◽  
pp. 350-357 ◽  
Author(s):  
Jerrilyn Jones ◽  
Ricky Kue ◽  
Patricia Mitchell ◽  
Sgt. Gary Eblan ◽  
K. Sophia Dyer
Keyword(s):  
Law Enforcement ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Training Program ◽  
Comfort Level ◽  
Medical Services ◽  
Active Shooter ◽  
Response Training ◽  
Emergency Medical ◽  
Before And After

AbstractIntroductionEmergency Medical Services (EMS) routinely stage in a secure area in response to active shooter incidents until the scene is declared safe by law enforcement. Due to the time-sensitive nature of injuries at these incidents, some EMS systems have adopted response tactics utilizing law enforcement protection to expedite life-saving medical care.ObjectiveDescribe EMS provider perceptions of preparedness, adequacy of training, and general attitudes toward active shooter incident response after completing a tactical awareness training program.MethodsAn unmatched, anonymous, closed-format survey utilizing a five-point Likert scale was distributed to participating EMS providers before and after a focused training session on joint EMS/police active shooter rescue team response. Descriptive statistics were used to compare survey results. Secondary analysis of responses based on prior military or tactical medicine training was performed using a chi-squared analysis.ResultsTwo hundred fifty-six providers participated with 88% (225/256) pretraining and 88% (224/256) post-training surveys completed. Post-training, provider agreement that they felt adequately prepared to respond to an active shooter incident changed from 41% (92/225) to 89% (199/224), while agreement they felt adequately trained to provide medical care during an active shooter incident changed from 36% (82/225) to 87% (194/224). Post-training provider agreement that they should never enter a building with an active shooter changed from 73% (165/225) to 61% (137/224). Among the pretraining surveys, significantly more providers without prior military or tactical experience agreed they should never enter a building with an active shooter until the scene was declared safe (78% vs 50%, P = .002), while significantly more providers with prior experience felt both adequately trained to provide medical care in an active shooter environment (56% vs 31%, P = .007) and comfortable working jointly with law enforcement within a building if a shooter were still inside (76% vs 56%, P = .014). There was no difference in response to these questions in the post-training survey.ConclusionsAttitudes and perceptions regarding EMS active shooter incident response appear to change among providers after participation in a focused active shooter response training program. Further studies are needed to determine if these changes are significant and whether early EMS response during an active shooter incident improves patient outcomes.JonesJ, KueR, MitchellP, EblanG, DyerKS. Emergency Medical Services response to active shooter incidents: provider comfort level and attitudes before and after participation in a focused response training program. Prehosp Disaster Med. 2014;29(4):1-7.

Health and Medical Preparedness and Response to the 2008 Republican National Convention

2009 ◽  
Vol 3 (4) ◽  
pp. 224-232 ◽  
Author(s):  
John L. Hick ◽  
Ralph J. Frascone ◽  
Katherine Grimm ◽  
Merle Hillman ◽  
Jayne Griffith ◽  
...  
Keyword(s):  
Law Enforcement ◽  
National Security ◽  
Emergency Medical Services ◽  
Metropolitan Area ◽  
The United States ◽  
Medical Services ◽  
Special Events ◽  
Emergency Medical ◽  
National Convention ◽  
Riot Control

ABSTRACTObjective: National security special events occur yearly in the United States. These events require comprehensive advance planning for health and medical contingencies in addition to law enforcement concerns. The planning for and impact of the Republican National Convention (RNC) on the City of St Paul and the Minneapolis–St Paul metropolitan area is described.Methods: Descriptive analysis of events was provided by the authors based on their planning and operational experiences. Daily data were gathered from area hospitals, emergency medical services agencies, the National Weather Service, federal medical teams, and the Minnesota Department of Health to capture the impact of the RNC on emergency department activity, nonemergency surgery, emergency medical services run volumes, patient visits to onsite and offsite medical clinics, and general hospital occupancy in the metropolitan area.Results: There were no epidemiological signal events. Weather was not extreme. Confrontations between protestors and law enforcement resulted in frequent use of riot-control agents. Protestors sought medical care from “street medics” and their affiliated free clinics in preference to usual medical facilities. Emergency departments close to the event venue reported decreased patient volumes. Hospitals close to the venue reported significantly decreased nonemergency surgical case volumes. Local hospitals implemented access controls and in 1 case, shut down ventilation systems due to riot-control agent deployment in the streets outside. Emergency medical services volumes were near average, with the exception of St Paul Fire Department on the day of a major protest march.Conclusions: Planning and operational response for the RNC consumed large amounts of time and resources. The RNC had minimal patient impact on the health care system and in fact caused significant volume decreases at hospitals proximate to the venue. Although contingencies available for a mass casualty event were not needed, they must continue to be available for all such events. Health and medical preparedness and funding is not adequately detailed in the planning framework for national security special events, and this should be a focus for future events. (Disaster Med Public Health Preparedness. 2009;3:224–232)

Mistaken Identity: The Effect of Badges on EMT Recognition

1995 ◽  
Vol 10 (3) ◽  
pp. 195-197 ◽  
Author(s):  
Lawrence H. Brown ◽  
Jeff Waldman ◽  
Terry W. Copeland ◽  
William E. Smithson ◽  
N. Heramba Prasad
Keyword(s):  
High School Students ◽  
Law Enforcement ◽  
Emergency Medical Services ◽  
Medical Services ◽  
School Students ◽  
Chi Square ◽  
Mistaken Identity ◽  
Emergency Medical ◽  
Law Enforcement Personnel ◽  
Chi Square Analysis

AbstractIntroduction:Many emergency medical services (EMS) providers wear badges with their uniforms. This study was undertaken to determine whether emergency medical technicians (EMTs) who wear badges with their uniforms are more likely to be mistaken for law enforcement personnel than are those who do not wear badges.Hypothesis:Emergency medical services providers who wear badges are more likely to be mistaken for law enforcement personnel than are those who do not wear badges.Methods:High school students, college students, civic organizations, and church groups were shown slides of different uniforms and badges/insignia and asked to identify the person portrayed. Responses were categorized as “EMS,” “law enforcement,” or “other.” Frequency of responses for each uniform and insignia were compared with chi-square analysis.Results:Fifty-nine percent of the uniforms with badges were identified as law enforcement personnel. Only 5.5% of the uniforms with badges were identified as “EMS,” compared with 74% of the uniforms with a Star of Life (p<0.001).Conclusion:Individuals wearing uniforms with badges are more likely to be identified as law enforcement personnel than are EMS personnel. Emergency medical services providers who do not wish to be mistaken for law enforcement personnel should wear the Star of Life, not a badge, with their uniform.

Trial to End Ambulance Diversion in Boston: Report from the Conference of the Boston Teaching Hospitals Consortium

2011 ◽  
Vol 26 (2) ◽  
pp. 122-126 ◽  
Author(s):  
Franklin D. Friedman ◽  
Niels K. Rathlev ◽  
Laura White ◽  
Stephen K. Epstein ◽  
Assaad Sayah ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Medical Services ◽  
Online Survey ◽  
Medical Services ◽  
Teaching Hospitals ◽  
Routine Practice ◽  
Ambulance Diversion ◽  
Emergency Medical ◽  
Significant Difference ◽  
The Difference

AbstractIntroduction: Annual ambulance diversion hours in Boston increased more than six-fold from 1997 to 2006. Although interventions and best practices were implemented, there was no reduction in the number of diversion hours.Objectives: A consortium of Boston teaching hospitals instituted a two-week moratorium on citywide diversion from 02 October 2006 to 15 October 2006. The hypothesis was that there would be no significant difference in measures of hospital and emergency medical services (EMS) efficiency compared with the two weeks immediately prior.Methods: A total of nine hospitals and the municipal emergency medical services in Boston submitted data for analysis. The following mean daily hospital measures were studied: (1) emergency department volume; (2) number of emergency department admissions; (3) length of stay (LOS) for all patients; and (4) number of elopements. Mean EMS at-hospital time by destination and the percent of all Boston EMS transports to each hospital destination were calculated. The median differences (MD) were calculated as “before” minus “during” the study period and were compared with paired, Wilcoxon, non-parametric tests. Additional mean EMS measures for all destinations included: (1) to hospital time; (2) number of responses with transport initiated per day; (3) incident entry to arrival; and (4) at-hospital time.Results: The LOS for admitted patients (MD = 0.30 hours; IQR 0.10,1.30; p = 0.03) and number of daily admissions (MD = -1.50 patients; IQR -1.50, -0.10; p = 0.04) were significantly different statistically. The results for LOS for all patients, LOS for discharged patients, ED volume, EMS time at hospital by destination, number of elopements, and percent of Boston EMS transports to each hospital revealed no statistically significant differences. The difference between the study and control periods for mean EMS to hospital time, at-hospital time, and incident entry to arrival was a maximum of 0.6 minutes. The vast majority of EMS respondents to an online survey believed that the “no diversion” policy should be made routine practice.Conclusions: The LOS for admitted patients decreased by 18 minutes, and the number of admissions increased by 1.5 patients per day during the study period. The “no diversion” policy resulted in minimal changes in EMS efficiency and operations. Diversion was temporarily eliminated in a major city without significant detrimental changes in ED, hospital, or EMS efficiency.

scholarly journals Trauma Ultrasound in Civilian Tactical Medicine

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Lori Whelan ◽  
William Justice ◽  
Jeffrey M. Goodloe ◽  
Jeff D. Dixon ◽  
Stephen H. Thomas
Keyword(s):  
Decision Making ◽  
Law Enforcement ◽  
Emergency Medical Services ◽  
Hospital Setting ◽  
Clinical Applications ◽  
Medical Services ◽  
Medical Support ◽  
Emergency Medical ◽  
Tactical Medicine ◽  
Potential Use

The term “tactical medicine” can be defined in more than one way, but in the nonmilitary setting the term tactical emergency medical services (TEMS) is often used to denote medical support operations for law enforcement. In supporting operations involving groups such as special weapons and tactics (SWAT) teams, TEMS entail executing triage, diagnosis, stabilization, and evacuation decision-making in challenging settings. Ultrasound, now well entrenched as a part of trauma evaluation in the hospital setting, has been investigated in the prehospital arena and may have utility in TEMS. This paper addresses potential use of US in the tactical environment, with emphasis on the lessons of recent years’ literature. Possible uses of US are discussed, in terms of both specific clinical applications and also with respect to informing triage and related decision making.

scholarly journals Accessibility Assessment of Prehospital Emergency Medical Services considering Supply-Demand Differences

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Zhaoqing Shen ◽  
Ge Gao ◽  
Zhen Wang
Keyword(s):  
Emergency Medical Services ◽  
Catchment Area ◽  
Emergency Services ◽  
Supply And Demand ◽  
Assessment Method ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Emergency Medical ◽  
Prehospital Emergency ◽  
The Difference

The reasonable accessibility assessment method is an important basis for the measurement of the level of prehospital emergency medical services. There is no general model for prehospital emergency care in traditional accessibility evaluation, and its supply-demand characteristics have also been ignored. Based on the three-step floating catchment area (3SFCA) model, the supply-demand three-step floating catchment area (SD3SFCA) model is proposed in this paper, which can express the difference between supply and demand of prehospital emergency medical services and accurately simulate unified dispatching of emergency centers. The unified dispatching behavior of emergency centers is simulated based on the potential service capacity of emergency stations with a supply-demand difference. The supply capacity of different emergency facilities is quantified from the perspective of infrastructure and technical quality. The needs of typical population densities are taken into account and adjusted by the weighting index. The validity of the model is verified, with the prehospital emergency medical service in the West Coast New District of Qingdao as an example. The results show that the model can effectively measure the accessibility level of prehospital emergency services and truly reflect the characteristics of supply and demand. Compared with previous models, the model has been significantly improved, which can provide an important reference for optimizing the allocation of prehospital emergency resources.

The Carle-Illinois (Urbana, Illinois USA) Treatment Protocol for Law Enforcement K9s: Guidelines for Emergency Medical Services

2019 ◽  
Vol 34 (04) ◽  
pp. 428-437
Author(s):  
Ashley E. Mitek ◽  
Maureen A. McMichael ◽  
William B. Weir ◽  
Michael J. Smith ◽  
Danielle C. Schneider
Keyword(s):  
Law Enforcement ◽  
Emergency Medical Services ◽  
Task Force ◽  
Treatment Protocol ◽  
Medical Services ◽  
Major Life ◽  
Emergency Medical ◽  
Joint Task ◽  
Joint Task Force ◽  
Life Threatening

AbstractThis document is a resource for Emergency Medical Services (EMS) treating an injured law enforcement K9 (LEK9) in the field and/or during transport by ambulance to a veterinary hospital. A Joint Task Force on Working Dog Care was created, which included veterinarians, EMS directors, EMS physicians, and canine handlers, who met to develop a treatment protocol for injured LEK9s. The protocol covers many major life-threatening injuries that LEK9s may sustain in the line of duty, and also discusses personnel safety and necessary equipment. This protocol may help train EMS providers to save the life of an injured LEK9.

A case study of the law enforcement/emergency medical services response to the Virginia Tech mass casualty incident on April 16, 2007

2007 ◽  
Vol 5 (5) ◽  
pp. 17
Author(s):  
Matthew Lloyd Collins, PhD
Keyword(s):  
Law Enforcement ◽  
Emergency Medical Services ◽  
Virginia Tech ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Medical Services ◽  
Law Enforcement Agencies ◽  
Emergency Medical ◽  
Management Literature

The April 16, 2007, shooting rampage on the Virginia Polytechnic Institute and State University (Virginia Tech) campus, carried out by Seung-Hui Cho, was the worst gun-related massacre in the history of the United States. The purpose of this article is twofold. First, it examines the emergency management literature on interagency communication, collaboration, and coordination as it relates to the Virginia Tech mass casualty incident (MCI). Second, the article presents a single instrumental case study that focuses on the bounded case of the Virginia Tech MCI. Through multiple sources of data collection to include observations, interviews, and document analysis, this study found that 14 law enforcement agencies and 13 emergency medical services agencies responded to the Virginia Tech MCI. With only two exceptions, the law enforcement agencies involved in the response to this MCI responded informally or self-deployed (arrived without being dispatched). However, all of the emergency medical services agencies that responded were formally dispatched. Lessons learned from the emergency management literature review and the case study will be discussed. In conclusion, policy recommendations, which will be generalizable to other rural university campuses and rural organizational settings, will be made.

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