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Presentation transcript:

Law Enforcement and Public Safety Medical Response to Trauma: The Hartford Consensus

This module uses information from: Improving Survival from Active Shooter Events: The Hartford Consensus Pre-Hospital Trauma Life Support (PHTLS) Tactical Casualty Care for Law Enforcement and First Responders (TCC-LEFR) Tactical Emergency Casualty Care (TECC) Tactical Combat Casualty Care (TCCC)

Objectives Describe the role of law enforcement in the management of life-threatening injuries during an active shooter or blast event. Discuss the key role of law enforcement as a bridge between the law enforcement phase of an incident and the integrated rescue response involving law enforcement, fire service, and EMS.

Columbine Shooting Police, fire, and EMS responded Used the standard approach for this type of incident at the time Patrol officers mass outside SWAT notification and response to deal with the situation First responders and EMS stage, awaiting declaration that scene is safe to enter The end result: Preventable death from the delayed medical response effort

Later Shootings Virginia Tech Fort Hood Tucson Aurora Theater Sandy Hook © Jessica Hill/AP Images

“Traditional” Response Segmented, sequential public safety operation Initial focus on law enforcement goals (i.e., stop the shooting) This is followed by the remainder of the incident response Victim extrication Emergency medical care

Tactical Combat Casualty Care (TCCC) 4/17/2017 Improving Survival from Active Shooter Events: The Hartford Consensus (1 of 2) Meeting of leaders from: Law enforcement—FBI, Major Cities Chiefs Assoc. EMS—Prehospital Trauma Life Support Fire/rescue—International Assoc. Fire Chiefs, EMS Section Medical community—American College of Surgeons, ACS Committee on Trauma, Committee on Tactical Combat Casualty Care DRAFT

Tactical Combat Casualty Care (TCCC) 4/17/2017 Improving Survival from Active Shooter Events: The Hartford Consensus (2 of 2) Discussed active shooter/blast events Problem: Long-standing practices for law enforcement, fire/rescue, and EMS responses are not optimal to maximize victim survival Goal: Develop recommendations and policies to enhance the survival of victims of these events DRAFT

Fundamental Concepts of Hartford Consensus (1 of 2) No one should die from uncontrolled bleeding.

Fundamental Concepts of Hartford Consensus (2 of 2) There must be a continuum of care that begins with the initial responders and continues to definitive care. Provide a seamless integration of bleeding control interventions General public Responding officer EMS/fire/rescue Definitive trauma care EMS/fire/rescue must be involved earlier in the care of the victims

T-H-R-E-A-T Threat suppression Hemorrhage control Rapid Extrication to safety Assessment by medical providers Transport to definitive care

Hartford Consensus (1 of 2) Optimal response to the active shooter: Identify and teach skill sets appropriate to each level of responder Law enforcement Fire/rescue EMS

Hartford Consensus (2 of 2) Care of the victims is a shared responsibility between law enforcement, fire/rescue, and EMS. Optimal outcome depends on communication between all public safety responders The response requires coordination between law enforcement and the medical/evacuation providers Such coordination includes jointly developed protocols for an integrated response to these events

Hartford Consensus Call to Action Include the citizen bystander-as-responder concept into training and planning Ensure that first-responding law enforcement officers have training and proficiency in bleeding control Integrate fire/rescue/EMS early into the response continuum

Educational Programs (1 of 2) Bleeding Control (B-Con) Two-hour course that teaches the fundamentals of how to control hemorrhage from all types of trauma Tactical Casualty Care for Law Enforcement and First Responders (TCC-LEFR) One-day course (lecture, skills, and scenarios) on how to provide initial medical care to self, partner, or a trauma victim

Educational Programs (2 of 2) Tactical Emergency Casualty Care (TECC) Two-day course (lecture, skills, and scenarios) for advanced life support providers on how to respond medically to civilian tactical and all-hazards trauma events Tactical Combat Casualty Care (TCCC) Two-day course (lecture, skills, and scenarios) for advanced life support providers on how to respond medically to tactical/combat situations

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