Tactical Combat Casualty Care (TCCC) has become the standard for medical care within DOD. It is slowly being adopted by law enforcement throughout the USA as more departments are embracing the fact that the first line of medical care after a felonious assault rests with the officer. The transition in the mindset over the last 10 years is remarkable. Initially, most LEOs thought of medicine as the domain of EMS, whereas departments are currently attempting to integrate military TCCC into their protocols. For instance, use of tourniquets as a first option for extremity wounds has been accepted as a priority in civilian medicine. However, all of the lessons learned during GWOT regarding TCCC do not neatly transition to the the civilian sector. Although extremity bleeding is the most common cause of preventable death on the battlefield, chest injuries are the leading cause of preventable death for LEOs. So why do so many officers only focus on hemorrhage control when deciding what to carry in Individual First-Aid Kits (IFAKS)? It is due to the dearth of research in the field of LEO medicine and a full adoption of the research from the battlefield.
One of the first studies to address this issue was published in Prehospital and Disaster Medicine in 2009 titled “Tactical Medical Skills Requirements for Law Enforcement Officers: A 10-Year Analysis of Line-of-Duty Deaths” by Matthew D. Sztajnkrycer, MD. He concluded that “…current emphasis of TCCC on control of exsanguinating extremity hemorrhage may not meet the needs of law enforcement personnel in an environment with expedited access to -well developed trauma systems. Further study is needed to better examine the causes of preventable deaths in law enforcement officers, as well as the most appropriate tactical medical set and treatment priorities.”
It is clear that more work needs to be done, but we will explore the issue more in the following posts.