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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
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
S. Brent Core
Department of Emergency Medicine, Mayo Clinic, Rochester, MinnesotaUSA
Christine M. Lohse
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MinnesotaUSA
Matthew D. Sztajnkrycer*
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:


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.


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.


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.


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):165170.

Original Research
© World Association for Disaster and Emergency Medicine 2018 

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Conflicts of interest: none


1. US Department of Commerce. US Census Bureau. US and World Population Clock. Accessed May 16, 2017.Google Scholar
2. Hawkins, SC, Shapiro, AH, Sever, AE, Delbridge, TR, Mosesso, VN. The role of law enforcement agencies in out-of-hospital emergency care. Resuscitation. 2007;72(3):386-393.CrossRefGoogle ScholarPubMed
3. Sztajnkrycer, MD, Callaway, DW, Baez, AA. Police officer response to the injured officer: a survey-based analysis of medical care decisions. Prehosp Disaster Med. 2007;22(4):335-342.CrossRefGoogle ScholarPubMed
4. Gratton, M, Garza, A, Salomone, JA 3rd, McElroy, J, Shearer, J. Ambulance staging for potentially dangerous scenes: another hidden component of response time. Prehosp Emerg Care. 2010;14(3):340-344.CrossRefGoogle ScholarPubMed
5. Myerburg, RJ, Fenster, J, Velez, M, et al. Impact of community-wide police car deployment of automated external defibrillators on survival from out-of-hospital cardiac arrest. Circulation. 2002;106(9):1058-1064.CrossRefGoogle ScholarPubMed
6. Bulger, EM, Snyder, D, Schoelles, K, et al. An Evidence-based prehospital guideline for external hemorrhage control: American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014;18(2):163-173.CrossRefGoogle ScholarPubMed
7. Meizoso, JP, Ray, JJ, Karcutskie, CA IV, et al. Effect of time to operation on mortality for hypotensive patients with gunshot wounds to the torso: the golden 10 minutes. J Trauma Acute Care Surg. 2016;81(4):685-691.CrossRefGoogle ScholarPubMed
8. Alonso-Serra, HM, Delbridge, TR, Auble, TE, Mosesso, VN, Davis, EA. Law enforcement agencies and out-of-hospital emergency care. Ann Emerg Med. 1997;29(4):497-503.CrossRefGoogle ScholarPubMed
9. White, RD, Hankins, DG, Bugliosi, TF. Seven years’ experience with early defibrillation by police and paramedics in an emergency medical services system. Resuscitation. 1998;39(3):145-151.CrossRefGoogle Scholar
10. Davis, EA, Mosesso, VN. Performance of police first responders in utilizing automated external defibrillators on victims of sudden cardiac arrest. Prehosp Emerg Care. 1998;2(2):101-107.CrossRefGoogle Scholar
11. Papson, K, Mosesso, VN Jr. Ten years of police defibrillation: program characteristics and personnel attitudes. Prehosp Emerg Care. 2005;9(2):186-190.CrossRefGoogle ScholarPubMed
12. Sumner, SA, Mercado-Crespo, MC, Spelke, MB, et al. Use of naloxone by Emergency Medical Services during opioid drug overdose resuscitation efforts. Prehosp Emerg Care. 2016;20(2):220-225.CrossRefGoogle ScholarPubMed
13. Kitch, BB, Portela, RC. Effective use of naloxone by law enforcement in response to multiple opioid overdoses. Prehosp Emerg Care. 2016;20(2):226-229.CrossRefGoogle ScholarPubMed
14. Fisher, R, O’Donnell, D, Ray, B, Rusyniak, D. Police officers can safely and effectively administer intranasal naloxone. Prehosp Emerg Care. 2016;20(6):675-680.CrossRefGoogle ScholarPubMed
15. National EMS Database NEMSIS Research Data Set v. 2.2.1. 2012. NEMSIS Technical Assistance Center. August 2013. documents/NEMSISRDS2212012UserManual.pdf. Accessed May 16, 2017.Google Scholar
16. Callaway, DW, Robertson, J, Sztajnkrycer, MD. Law enforcement-applied tourniquets: a case series of life-saving interventions. Prehosp Emerg Care. 2015;19(2):320-327.CrossRefGoogle ScholarPubMed
17. Stiles, CM, Cook, C, Sztajnkrycer, MD. A descriptive analysis of tactical casualty care interventions performed by law enforcement personnel in the state of Wisconsin, 2010-2015. Prehosp Disaster Med. 2017;32(3):284-288.CrossRefGoogle Scholar
18. Butler, FK. Two decades of saving lives on the battlefield: tactical combat casualty care turns 20. Mil Med. 2017;182(3):e1563-e1568.CrossRefGoogle ScholarPubMed
19. Jacobs, LM, Wade, DS, McSwain, NE, et al. The Hartford Consensus: THREAT, a medical disaster preparedness concept. J Am Coll Surg. 2013;217(5):947-953.CrossRefGoogle ScholarPubMed
20. Scerbp, MH, Mumm, JP, Gates, K, et al. Safety and appropriateness of tourniquets in 105 civilians. Prehosp Emerg Care. 2016;20(6):712-722.CrossRefGoogle Scholar
21. Aberle, SJ, Dennis, AJ, Landry, JM, Sztajnkrycer, MD. Hemorrhage control by law enforcement personnel: a survey of knowledge translation from the military combat experience. Mil Med. 2015;180(6):615-620.CrossRefGoogle ScholarPubMed
22. Landry, JM, Aberle, SJ, Dennis, AJ, Sztajnkrycer, MD. Emergency medical response in active-threat situations: training standards for law enforcement. FBI Law Enforcement Bulletin. Accessed May 16, 2017.Google Scholar
23. Callaway, DW. Translating tactical combat casualty care lessons learned to the high-threat civilian setting: tactical emergency casualty care and the Hartford Consensus. Wilderness Environ Med. 2017;28(2s):S140-S145.CrossRefGoogle ScholarPubMed