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A Descriptive Analysis of Care Provided by Law Enforcement Prior to EMS Arrival in the United States

Published online by Cambridge University Press:  13 March 2018

Aaron B. Klassen Open the ORCID record for Aaron B. Klassen [Opens in a new window] ,
S. Brent Core ,
Christine M. Lohse  and
Matthew D. Sztajnkrycer
Aaron B. Klassen
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
S. Brent Core
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Christine M. Lohse
Affiliation:
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MinnesotaUSA
Matthew D. Sztajnkrycer*
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
*
Correspondence: Matthew D. Sztajnkrycer, MD, PhD Associate Professor of Emergency Medicine Mayo Clinic GE-GR-G410 200 1st Street SW Rochester, Minnesota 55905 USA E-mail: sztajnkrycer.matthew@mayo.edu
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Abstract

Study Objectives

Law enforcement is increasingly viewed as a key component in the out-of-hospital chain of survival, with expanded roles in cardiac arrest, narcotic overdose, and traumatic bleeding. Little is known about the nature of care provided by law enforcement prior to the arrival of Emergency Medical Services (EMS) assets. The purpose of the current study was to perform a descriptive analysis of events reported to a national EMS database.

Methods

This study was a descriptive analysis of the 2014 National Emergency Medical Services Information System (NEMSIS) public release research data set, containing EMS emergency response data from 41 states. Code E09_02 1200 specifically identifies care provided by law enforcement prior to EMS arrival.

Results

A total of 25,835,729 unique events were reported. Of events in which pre-arrival care was documented, 2.0% received prior aid by law enforcement. Patients receiving law enforcement care prior to EMS arrival were more likely to be younger (52.8 [SD=23.3] years versus 58.7 [SD=23.3] years), male (54.8% versus 46.7%), and white (80.3% versus 77.5%). Basic Life Support (BLS) EMS response was twice as likely in patients receiving prior aid by law enforcement. Multiple-casualty incidents were five times more likely with prior aid by law enforcement. Compared with prior aid by other services, law enforcement pre-arrival care was more likely with motor vehicle accidents, firearm assaults, knife assaults, blunt assaults, and drug overdoses, and less likely at falls and childbirths. Cardiac arrest was significantly more common in patients receiving prior aid by law enforcement (16.5% versus 2.6%). Tourniquet application and naloxone administration were more common in the law enforcement prior aid group.

Conclusion

Where noted, law enforcement pre-arrival care occurs in 2.0% of EMS patient encounters. The majority of cases involve cardiac arrest, motor vehicle accidents, and assaults. Better understanding of the nature of law enforcement care is required in order to identify potential barriers to care and to develop appropriate training and policy recommendations.

KlassenAB, CoreSB, LohseCM, SztajnkrycerMD. A Descriptive Analysis of Care Provided by Law Enforcement Prior to EMS Arrival in the United States. Prehosp Disaster Med. 2018;33(2):165–170.

Keywords

bleeding controlcardiac arrestEmergency Medical Serviceslaw enforcementmass-casualty incident
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 2 , April 2018 , pp. 165 - 170
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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Footnotes

Conflicts of interest: none

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