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The police response to medical crime scenes.

While on duty, a shooting occurs in one of the more violent areas of your jurisdiction. As you and your backup respond, the fire department and ambulance are not en route. Or, if you live in a rural community, your dispatcher still is contacting the local volunteer rescue squad. You are the first to arrive on the scene, and you know that the first emergency medical technicians (EMTs) will arrive soon.

Law enforcement, fire, and emergency medical services (EMS) work closely together. And, although they have different roles and responsibilities, they respond to many of the same calls. Officers' responsibilities at a medical crime scene consist of securing the scene and investigating the criminal act that caused the injuries. They do not respond to provide direct emergency medical care.

MEDICAL CRIME SCENES

When EMS personnel are dispatched to a scene that has the possibility of violence, they usually request the presence of law enforcement officers as well. In most instances, paramedics will not even respond to the scene until officers have secured it. Securing the scene and protecting the safety of themselves, EMS personnel, and others involved constitute the most important functions of the police at a medical emergency. EMS members cannot properly provide quality medical care if they fear for their safety; they rely on the police to perform this vital function.

Even if officers have no medical training and do not directly care for patients, their actions can affect the outcome of an injured person. By quickly securing the scene and relaying vital information to responding medical units, such as the number of patients, types of injuries, and the cause of injury (e.g., vehicle collision), officers indirectly can start the process of quality patient care. In many instances, the law enforcement response takes the first step toward successfully resolving a medical emergency.

While protecting and serving their communities, police officers encounter a variety of circumstances. Not every criminal act the police come into contact with results from criminal intent. Individuals who become belligerent and physically abusive following a violent assault may react this way due to a head injury, which can increase pressure in their craniums and cause them to act irrationally. Officers should not transport individuals in this condition to jail for assaulting police and rescue personnel. Instead, respondents should take them to an emergency room where medical personnel can determine the type and extent of their injuries. Officers should attempt to calm the individuals and, if possible, convince them to restrict their movements so that they do not exacerbate any injuries.

People who appear disoriented or stumble around following a motor vehicle related crime may not be intoxicated. Instead, they may be experiencing a diabetic reaction called hypoglycemia. If these individuals do not receive medical care, their sugar levels will continue to fall and they will pass out, lapse into a coma, and eventually die. (1) To reverse this condition, responding personnel must give them glucose or an intravenous bolus of glucose. Untrained responders should not attempt these procedures. Officers should summon medical personnel and have them transport these individuals to the hospital. Many chronic alcoholics have numerous medical problems masked by the effects of alcohol. Officers should not assume that the person who appears intoxicated is simply intoxicated; medical problems may cause certain activities.

Hazardous Materials

Many medical crime scenes contain hazardous materials that most police officers may not be trained or equipped to handle. Because many police departments do not provide their officers with the specialized equipment carried by most fire and EMS personnel, officers must protect themselves and others from these dangers.

Law enforcement officers always should consider the possibility of the presence of hazardous materials and, although detection may be impossible, a few simple steps can help officers recognize them. Upon arrival, officers should take a few moments to appraise the situation, survey the scene prior to entering, look at the injuries, and attempt to determine their cause. Are smoke or other odors in the air? Are liquids or other materials at the scene hazardous? Are injured persons acting strangely considering the situation? Officers should assume that vehicles and buildings contain hazardous materials until ruled otherwise. Safely remains the priority.

If officers arrive on the scene prior to fire department or EMS personnel, they should move people from additional harm and injury, secure the perimeter, and not let anyone in or out until specialized units arrive. They should attempt to contain contaminated materials and individuals, establish an operational area upwind in an uncontaminated location some distance from the hazard zone, and direct incoming units where to set up. Law enforcement officers always should treat the area as a possible crime scene and consider the possibility of additional hazards. (2) Hazardous materials can complicate matters for even the most highly trained experts. Officer safety should remain paramount to any police officer arriving on the scene of this type of incident.

Blood-Borne Pathogens

Blood-borne pathogens, microorganisms present in human blood that can cause diseases, (3) pose a second possible hazard at a medical crime scene. Officers should treat every injured person as if they have a blood-borne disease and guard against unprotected contact with a person's body fluid, which can contain blood. People can only contract blood-borne diseases from a direct blood-to-blood transmission. For example, getting cut on the hand or becoming stuck by a contaminated needle can transmit diseases. Common blood-borne diseases include HIV and hepatitis. (4)

The possibility of coming into contact with a person's body fluid exists at every crime scene. But, by taking certain precautions, individuals virtually can eliminate the chance of contracting a blood-borne disease. Officers always should wear latex gloves or other protective clothing if necessary, avoid contact with another person's body fluid, and decontaminate any equipment that came into contact with the patient. By following these simple steps, police officers can safeguard themselves against many of the potential hazards present at a medical crime scene.

PSYCHOLOGICAL ISSUES

In their role as public servants, police officers often encounter the worst in society. Situations they must face oftentimes can prove stressful, causing acute reactions. Further, continued exposure to these incidents can lead to delayed stress reactions. Stress means a hardship, force, or strain. It is defined as a state of physical or psychological arousal. A stressor is any agent or situation that causes stress. An imbalance between the demands of the job and a person's ability to perform the job at hand can cause stress. (5) Violent crime scenes involving injured persons can be a stressor for even the most seasoned officer. Situations involving children oftentimes can be the worst.

Dealing with the stress caused by these situations proves challenging. Following these types of events, officers can take particular steps to relieve some of the stress. For example, they can discuss the situation with others involved or attend a structured critical incident stress debriefing, which may help everyone connected with the situation. Additionally, officers can confide in a trusted coworker about the event, which can assist them when dealing with stress as well. Officers should try to maintain a regular routine, exercise, adhere to a normal diet, get regular sleep, and keep busy with enjoyable activities. (6) They also should seek professional help through their departments.

CONCLUSION

While performing their duties, law enforcement officers deal with a variety of situations. At a medical crime scene, officers secure the area and investigate the criminal act. Further, by following certain steps, they can protect themselves from possible hazards at this type of incident.

Along with other first responders, officers must render assistance in a calm, professional manner. Situations that police officers face can cause physical and psychological imbalances for those involved. Responders must recognize these stressors and ensure that they treat them as needed.

Endnotes

(1.) Bryan E. Bledsoe, Robert S. Porter, and Bruce R. Shade, Paramedic Emergency Care, 3rd ed. (Upper Saddle River, NJ: Brady Prentice Hall, 1997), 733-735.

(2.) Commonwealth of Virginia, Department of Emergency Management, Public Safety Response to Terrorism: Tactical Considerations, Unit 3, 1-3.

(3.) American Safety and Health Institute, Blood-Borne Pathogens Instructor's Guide, Newport Richey, Florida, 11.

(4.) For additional information, see John Cooley, "HIV/AIDS in Law Enforcement: what-If Scenarios," FBI Law Enforcement Bulletin, February 2000, 1-6.

(5.) Supra note 1, 112-115.

(6.) Supra note 1, 119, 120.
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Author:Boswell, Richard T.
Publication:The FBI Law Enforcement Bulletin
Geographic Code:1USA
Date:Sep 1, 2002
Words:1384
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