Disturbing article.

[chbare]

Another question to ask is how many true tension pneumothoracies have you seen on a spontaneously breathing individual? I am not talking about a patient with thoracic trauma who complains of dyspnea or has a sucking chest wound, but an actual life threatening tension pneumothorax where the patient's condition rapidly improves following intervention. I have never seen one with a non-intubated patient. Therefore, one has to question the need to have pleural decompression equipment readily available. Particularly in a non-permissive environment where the role of invasive procedures is generally limited.

[Chief1C]

What with the war(s) and all, there has been a tremendous surge in "federal contractors". Some agencies specialize in these kits, some added tactical sections... and unlike regular EMS supplies, where as some are controlled. They'll sell these kits to anyone. I purchased some of the new combat dressings, like for abdominal wounds, stump dressings, etc; to keep in the ambulance and WEMT bag. Anyhoo, you can go right to websites like North American Rescue, Rescue Essentials, etc; and buy damn near anything you please from tactical medic kits to combat life saver bags, fully equipped. If you wanna pay an arm and a leg, that is.

[BillKaneEMT]

That is a procedure he learned from watching M*A*S*H when Fr Mulcahey did it with Radar being squeamish beside him.

Fr. Mulcahey learned it from that weird and extremely disturbing Alley Oop comic in that one evening paper when the editor got really hammered in 1949.

[Richard B the EMT]

As an EMT since 1974, I thought I'd look up what the NY State Certified First Responders need to know for their "certs". Looks like even the folks on the CFR-D (defibrillator) engine company get trained more than 2 days worth, per the link. Same page shows for EMT-B, and several levels to EMT-P

http://www.health.ny.gov/nysdoh/ems/educ.htm

[MikeEMT]

Hi, I have been lurking on this site for awhile, but decided to join to provide my insight on this topic.

As a former cop I understand where the author is coming from in writing this. First and foremost, the author does specify the need for the appropriate training. Last time I checked, chest decompression needles require MPD approval to even purchase yet alone use.

Events such as Columbine and 9/11 have scared us. Law enforcement has moved into a mindset of we can't rely on EMS anymore. No disrespect to EMS, but Scene Safety is important. We can't expect EMS to enter scenes that would endanger them, thereby making the situation worse.

Many Police Departments have encouraged officers to get advanced medical training. Usually First Responder or EMT, but sometimes even Paramedic - which is common on tactical teams. Departments which may have a lengthy response from EMS or a high crime rate would likely have more officers that are trained as medical providers.

The intent is to not replace EMS, but to provide immediate, life saving care in a high risk situation. Columbine was a learning experience for the entire country. It was very clear that the Teacher could have been saved had a SWAT Medic gone in. There was also speculation that some of the students might have been saved as well. However SWAT Medics were virtually unheard of at the time. Exception being NYPD's ESU and LAPD SWAT.

The author of the article is a cop and it was written for cops. Certain assumptions have likely been made about the viewership of the article. Most cops know what they are allowed to do and not do. Therefore, the need for ALS level training isn't stressed when mentioning Chest Decompression.

Many companies sell tactical medical kits for police officers. This is just one kit sold to tactical officers:http://www.galls.com/style-TK115-general_catalog-north-american-rescue-storm-operator-kit

Some SWAT schools even teach ALS skills now. Needle decompression is taught in the military and can be taught rather easily. Keep in mind, this isn't a medical need for decompression. Rather it is a trauma need, usually involving a GSW.

I have never personally gone through this level of training when I was a cop. I am a Basic now, having changed careers. I can tell you that here in WA State, police officers are allowed to obtain MPD permission providing they meet the training requirements. WSP is the only agency I can think of that would provide care above basic first aid / CPR.

I have never seen, nor heard of, any officer in this state carrying ALS level equipment. Even most SWAT Teams use a Doctor rather than a Medic.

Hope this clears it up.

[Richard B the EMT]

I would add to the list of dual duty LEO/EMS personnel, the Port Authority of New York and New Jersey Police Department. As they operate on both sides of the Hudson River, at Kennedy, LaGuardia, and Newark Liberty International airports, and the major river crossings, they maintain dual state reciprocity, at Paramedic level.

[Chief1C]

I've personally never had a LEO assist on a scene, unless I went out of my way to ask them. I've been offered use of their kits, but we're talking severely outdated kits here. I mean, like something you'd pull off of eBay, 16 unit boxes that probably expired thirty years ago. Not kidding. Even the new cars have the same kits. I wanted to do a fundraiser to buy them all Law Enforcement "PFAK" pouches, just locally anway. I mean, they're screwed unless we're right around the corner. And when police are involved before we respond, they make us stage and won't give a location. With only one car on duty at night and weekends, for 450sq. miles, that's a long wait for back up. I've seen 60 law enforcement vehicles flood in for one push of an emergency button on a radio. But it took nearly a half hour for the first of the 60 to show up. I always offer them some stuff from the ambulance to keep just in case, but with only having ARC "Emergency Responder", once, with only a two hour refresher now and then along with CPR, few of them accept. And they don't even have CPR masks.

[DFIB]

When I went through TEMS all of those advanced emergency procedures were in the manual but they told us not to worry about that part because we were EMT-B and they used the same manual for all levels of EMT's. The Tactical stuff was the same for everyone and different information for the different EMT levels, depending on if the class was EMT or Medic level.