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Taking a pulse on protection.

If you are responsible for protecting an executive, you should be concerned about that individual's possible injury or death from natural or accidental causes.

Do you know how to deal with emergency medical crises? Do you know how to communicate effectively with emergency medical technicians (EMTs) and doctors? These are questions executive protection professionals must be able to answer affirmatively if they are to ensure their clients get the best care possible.

Numerous war stories could be told about individuals who became permanently injured because they did not get proper care in an emergency situation. Indeed, handling an accident victim improperly can cause more damage than the accident itself.

With this in mind, executive protection professionals should have more then just basic first-aid training. They should know how to resuscitate an individual, how to prevent an individual from choking to death, how to treat general life-threatening injuries and illnesses and how to converse effectively with an emergency care provider or doctor about the injury.

CPR is the basis for any good emergency medical program. Every executive protection professional should be certified in CPR and renew his or her certification each year. Both the American Heart Association and the American Red Cross offer this training.

An executive protection professional should also know how to deal with problems associated with life threats of any type and how to recognize whether his or her client needs to go to a Level 1 trauma center(1) or a neighborhood hospital in case of an accident. An executive protection professional should also know how to treat life-threatening situations until advanced life-support technicians(2) arrive on the scene.

An executive protection professional should also be trained to perform a primary and secondary survey to determine the condition of the client and be able to communicate the client's condition to the EMTs when they arrive.

By determining the condition of the client quickly, an executive protection professional can give the dispatcher information that will help determine whether a basic life support ambulance or an advanced life support ambulance is needed. This could save valuable time in the client's treatment and increase his or her chances of surviving.

TRAUMA IS A PHYSICAL INJURY OR wound caused by external force or violence.(3) Each year in the United States, traumatic injuries are responsible for more than 120,000 deaths,(4) and they are the leading cause of death for persons under the age of 44.(5)

An executive protection professional should know the kinematics of trauma.(6) He or she should be able to look at the scene of an accident, the injured party's placement, and the extent of his or her obvious injuries, and know whether the victim should go to the hospital.

If the client doesn't feel injured, the executive protection professional must decide whether he or she should try to persuade the client to seek medical attention. The executive protection professional should also know the signs of a developing injury and be able to measure the client's consciousness level.

Executive protection professionals come in contact with many different environments because they travel often. Whenever possible, an executive protection professional should tailor his or her emergency medical training to the environment he or she is in.

If, for example, an individual travels extensively to resorts near the water, then he or she should know how to deal with water-related injuries such as dive emergencies or near-drowning episodes. If the job includes extensive travel in mountainous terrain, the individual should know how to deal with hypothermia, frostbite, and snakebites, among other injuries.

An executive protection professional should also know where the best medical facilities are located when traveling. If the job entails using different private vehicles, such as a yacht or airplane, a list should be kept of all emergency medical evacuation helicopters in the region as well as an inventory of medications and apparatus necessary for dealing with a land, sea, or air emergency.

Trauma is not the only type of injury an executive protection professional needs to be aware of. Medical problems can arise at any moment due to a number of factors - food poisoning, dehydration, heart attack, anaphylaxis shock, or diabetes, for example.

An executive protection professional must be able to recognize a problem so he or she can assist in treatment. For example, during the flu season, knowing how to prevent the client from becoming dehydrated can save lost time and productivity. The first few minutes of an illness or injury is some cases dictate the patient's chance of survival. The actions of the executive protection professional make a difference.

An executive protection professional should obtain the highest level of emergency medical training possible, especially if he or she works closely with the client and his or her family.

The makeup of the client's family also dictates some specialized training. If children are involved, an executive protection professional should receive pediatric emergency medical training.

Each state has its own guidelines for emergency medical training. Nearly every area of the United States has emergency medical training available that may range from a first responder course to paramedic training.

Numerous specialty courses can be taken after reaching a certain training level. In many areas of the country individuals can get the basics for much less and have the training tailored to an organization. Some specialized courses require emergency medical certification as a prerequisite.

Once certified, an executive protection professional must maintain certification. He or she should volunteer with a local rescue squad or periodically ride along to observe. An executive protection professional should continually strive to increase and upgrade the emergency medical training he or she has received.

If an executive protection professional travels frequently, he or she should undergo a training program to become nationally registered.(7) With this kind of training, an individual can be recognize based on standardized training throughout the United States, increasing his or her recognition and possibly limiting exposure to liability.

If the executive protection professional cannot participate in an emergency medical training program, he or she should at least be instructed in emergency medical procedures. The chart provides an example of basic emergency medical course topics.

IF THE INDIVIDUAL RECEIVES A HIGHER training level, he or she also has a responsibility for providing a higher level of care. Unless an individual is negligent in providing care, which includes providing less care than his or her level dictates or abandoning the patient, then usually he or she is covered by Good Samaritan laws.

Good Samaritan laws(8) protect laypersons and prehospital care providers from criminal action and, in some cases, civil action as long as they are operating within the guidelines given for the level of training they have obtained and are volunteering their services. Executive protection professionals should check with local laws before performing prehospital care; rules vary throughout the United States and abroad.

Once the executive protection professional is trained, he or she should have the equipment that relates to his or her training level. For example, a basic trauma box should contain bandages, splints, cold packs, adhesive bandages, antiseptic, blood-pressure cuff, stethoscope, scissors, tweezers, pen-sized flashlight, and any other equipment that may be necessary for the region in which an individual is traveling.

If permitted, he or she should carry common drugs, including intravenous solutions for trauma situations, Benadryl tablets, nitroglycerin tablets, dextrose, or any drugs the client may need on a daily basis.

If an executive protection professional and his or her client are traveling, they should prearrange emergency medical service that enables them to telephone for emergency medical advice 24 hours a day. These services can be arranged through hospitals.

It's best to use a hospital or doctor familiar with the client's medical history. If not, executive protection professionals should carry a set of the client's medical records with them when they travel.

The service's operation should be thoroughly screened and have the appropriate confidentiality forms completed before any agreement on services is made. The medical records should be obtained from all doctors that the client has seen and who he or she is seeing at the time.

An executive protection professional must be able to react. While all situations are different, knowing emergency medical procedures or having the equipment may make the difference between the life and death of the client.

Basic Emergency Medical Course Topics

I. Introduction

A. Overview of the emergency medical field

B. Tiered response (an emergency medical

system where basic life-support vehicles are

dispatched to all calls unless an advanced life-support

level of care is needed) II. Patient Assessment

A. Anatomy

-Basic organ positions

-Pressure and pulse points(*)

B. Signs and symptoms



-Blood pressure



-Skin color(*)


-Level of consciousness

Primary survey(*)

Secondary survey(*) III. CPR

A. American Heart Association Lifesaver Course

with certification

B. Choking emergencies(*) IV. Traumatic Injuries (recognition and treatment)

A. Water-related trauma

-Thoracic, abdominal, head, spine, or extremity


B. Other emergencies

-Heart attacks,(*) strokes,(*) seizures,(*) or diabetes(*)

-Respiratory problems(*) and asthma


C. Emergencies created due to environment

-Heat or cold

-Dive emergencies

-Shallow water drowning V. Medical Command

A. Assessing medical command

((*) Indicates taught in American Red Cross Standard First-Aid Course.)

(1) Designation given to major hospitals that meet certain criteria and can manage any type of trauma. (2) Level of training for emergency medical technicians that allows them to treat patients with certain drugs. This classification varies from state to state. (3) B. E. Bledsoe, R. S. Porter, and B. R. Shade, Paramedic Emergency Care (New York: Prentice Hall, 1990), p. 372. (4) A.M. Butman, Ed., Pre-Hospital Trauma Life Support, Second Edition (Akron, OH: Educational Direction Inc., 1990), p. 2. (5) Paramedic Emergency Care, p. 372. (6) Paramedic Emergency Care, p. 376. (7) Paramedic Emergency Care, p. 27. (8) Paramedic Emergency Care, p. 40.

David H. Zimmerman, CPP, has been involved in executive protection in the United States and Europe. He is a certified emergency medical technician-cardiac in Virginia and is a sergeant with the Charlottesville/Albemarle Rescue Squad. Zimmerman is a member of ASIS.
COPYRIGHT 1992 American Society for Industrial Security
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Title Annotation:emergency medicine
Author:Zimmerman, David H.
Publication:Security Management
Date:May 1, 1992
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