Force Science News #121:
One more piece of life-saving equipment you should carry + More
on naked subjects
In this issue:
I. What is 1 more piece of life-saving equipment you should be carrying?
Not that you need more stuff to hang on your duty belt, but here’s an addition you might consider: a pouch you can reach with either hand that contains a one-handed tourniquet. If you or another officer are wounded and bleeding badly, it could make the difference between life and death.
Although a number of hemostatic agents are being advertised to the law enforcement market to stanch bleeding while waiting for EMS, the tourniquet is gaining renewed respect for first-aid intervention.
“Before you buy hemostatic agents, be sure you understand proper wound management and packing,” advises an emergency room physician and instructor with Defense Training International, Inc., who uses the pseudonym “Doc Gunn” in law enforcement circles.
“Direct pressure is the first line treatment. The American College of Surgeons and the Pre-Hospital Trauma Life Support Guidelines no longer recommend elevation and pressure points for severe bleeding. There is no evidence that these techniques work and you may be wasting precious time. It is possible to bleed out from a femoral artery injury in as fast as 3 minutes.
“If direct pressure does not work, for extremity trauma go directly to a tourniquet. For bleeding that is not amenable by a tourniquet, such as a high femoral artery injury, go to hemostatic agents. Apply the agent and pack the wound with gauze and apply constant pressure for 2-3 minutes. Wrap with compression bandage to keep pressure on the wound. The most important step is to pack the wound and fill the void.”
(You can go to click here and click on Videos to view a proper wound-packing demonstration.)
Gunn’s recommendation was conveyed this month [4/09] via a popular listserv conducted by Chief Jeff Chudwin of Olympia Fields (IL) PD.
In an interview with Force Science News, Dr. Matthew Sztajnkrycer, a technical advisor to FSRC and chairman of the Division of Emergency Medicine Research at the Mayo Clinic, agreed that Gunn’s assessment is “very appropriate and accurate.” Sztajnkrycer himself reinforced the value of tourniquet use.
He serves as a SWAT team medic and equips every officer on his team with a SOFTT (SOFTM Tactical Tourniquet) and wound dressing. Chudwin issues a SOFTT and 2 wound bandages to each of his patrol officers. “If you pick one additional thing for your belt that has been shown to save lives, it would be a tourniquet,” Sztajnkrycer says. “And we should not think of them as just for tac teams. Patrol officers are the ones who tend to be under fire and subject to being wounded before SWAT even gets there.
“Hemostatic agents, while they can save lives in rare circumstances, have very limited facility. You have to think of them as last-ditch efforts when all else has failed. Tourniquets are clearly cheaper and they’ve been effective for hundreds of years. When you see a commercially made medical kit advertised with a hemostatic agent but no tourniquet, think twice before buying it.”
Gunn recommends either SOFTT or the C-A-T® (Combat Application Tourniquet), noting: “Both are approved for use by the military and both can be placed one-handed—and just plain work. The C-A-T is the current issue to U.S. Special Operations soldiers.”
Sztajnkrycer adds that the selected tourniquet should be equally easy to apply to both upper and lower extremities, and he wants to dispel the myth that all tourniquet application carries a risk of causing limb loss. “We have a lot of data now, from Israel, Afghanistan, and Iraq, indicating that a tourniquet can be left on for 4 to 6 hours with no significant risk. There would be few situations in law enforcement where it takes longer than that to reach professional medical treatment.”
Finally, he poses some questions with important training connotations: “If you are shot, can you reach your tourniquet? Can you apply the tourniquet with your non-dominant hand? Can you transition from your weapon to the tourniquet and back to your weapon?
“Just having a tourniquet available doesn’t mean anything by itself. If you don’t train with it, you won’t think about it when you need it.”
He cites the case of Albert Johnston, a leading Confederate general during the Civil War. At the Battle of Shiloh in 1892, he was shot in the knee and bled to death. He died with his issued tourniquet forgotten in his pocket.
II. The naked truth about naked subjects: 1 more reminder
Since 1981, Dr. Bill Lewinski, FSRC’s executive director, has been compiling accounts of officers killed and injured by naked subjects. This month [4/09] he added another attack to his data and issued a reminder to LEOs: Naked subjects are no laughing matter.
Lewinski described the recent assault as “a classic example of the danger these subjects can pose.” A 15-year veteran of a major police department in Kentucky responded to a domestic disturbance and was confronted by a nude, “zoned out,” 25-year-old man with a history of drug arrests who aggressively advanced on her. Before the encounter ended, she had shot him but the offender gained possession of her gun and shot her multiple times, then shot 2 other persons before being subdued by responding backup. The injuries, fortunately, were not fatal.
“It’s true that on some calls naked people can be humorous,” Lewinski says. “But in others, subjects who are nude in public have lost control and have no connection to reality. They can be some of the most dangerous people you’ll ever encounter. Don’t underestimate them. You need to be ready to respond quickly to the highest level of threat.”
For tactical suggestions for handling these subjects, see an interview with Lewinski carried by Force Science News in Transmission #16.
III. FSRC associates impacting policing
Associates of the Force Science Research Center are impacting law enforcement in a variety of venues these days.
National Advisory Board Member Dr. Alexis Artwohl has made 2 trips to the Middle East to train line officers and command staff at the Jordan International Police Training Center and the Royal Academy Command College in Amman, Jordan. Inspired by the information she conveyed, according to the colonel who heads the Center, officials are establishing a committee to develop a Behavioral Science Unit for the Jordanian Public Safety Directorate, the country’s 60,000-person national police force. First of it’s kind in Jordan, the Unit will continue the training in human performance factors in police operations that Artwohl introduced, as well as expand clinical services to officers and their families.
Technical Advisory Board member Chris Lawrence is serving as a program manager with the Canadian Police Research Centre, on loan from the Ontario Police College. The CPRC, recognized worldwide for its innovative approaches, supports R&D relevant to law enforcement, fire fighting, and EMS, particularly projects designed to increase first-responder safety, improve forensic techniques, and establish technology standards. Lawrence’s work focuses primarily on research into less-lethal weapons technology, sudden in-custody deaths, and body armor durability. He’s also working with FSRC on evaluating a proposed use-of-force training curriculum.
Force Science News editor Chuck Remsberg, whose best-selling books on survival tactics have been used to improve officer safety in more than 50 countries, has been named as one of 5 external advisors for a new Career and Leadership Development initiative currently underway at the Indianapolis Metropolitan PD. Earlier this year, the Supreme Court of Wisconsin cited one of Remsberg’s books, The Tactical Edge: Surviving High-Risk Patrol, in justifying its decision in a case that concerned police tactics on a DUI stop (Wisconsin v. Kramer, Jan. 29, 2009).
Written by Force Science Institute
April 24th, 2009 at 5:35 pm
© 2017 Force Science Institute Ltd.