Force Science News: Transmission 161

Wounded but alive? You can help with new effort to save cops' lives

When you or fellow officers survive a "near-miss" incident--one that could have been fatal--Dr. Matt Sztajnkrycer wants to hear from you. You can reach him through a unique website he has just launched: www.valorproject.org.

There, regardless of where you live in the world, you can contribute confidentially to an ambitious, ongoing research study designed to fill a gaping hole in law enforcement knowledge and, hopefully, result in better and faster medical care for wounded officers in the field.

Sztajnkrycer, a technical advisor to the Force Science Institute, is chairman of emergency medicine research for the Mayo Clinic, medical director/SWAT doc for 2 law enforcement agencies in Minnesota, and a faculty member for the certification course in Force Science Analysis.

The immediate goals in his latest effort to improve police medicine are to identify the kind of injuries officers sustain in non-fatal attacks and accidents on and off duty and, especially, to learn what emergency measures seem most successful in keeping wounded officers alive until they are handed off to definitive medical care.

"Through the LEOKA program, the FBI collects some medically useful information on officers who are killed, especially where on the body they were fatally wounded," Sztajnkrycer told Force Science News. "But an officer has to die to become a LEOKA data point.

"Except for occasional anecdotes we have no reliable data on officers who potentially might have died but were saved, including the nature of their injuries and the interventions the officers themselves or others made on their behalf before definitive medical care was available.

"A classic example is the recent letter to Force Science News about the officer whose life was saved by a tourniquet. The LEOKA program would never collect data on him because he lived.

"If we can establish a profile of typical officer injuries and identify what works or doesn't work in terms of on-site crisis care, then longer-term we should be able to come up with a protocol of best practices tailored specifically for law enforcement personnel."

Currently, Sztajnkrycer explains, there is no law enforcement-specific medical training. "Most training is based on generic first-responder guidelines," he says. "More recently, departments have started looking to the military Tactical Combat Casualty Care (TCCC) model for guidance for immediate emergency field care of wounded officers."

After studying a 10-year span of LEOKA reports and discovering that fatal wounds of police tend to be significantly different from mortal injuries sustained by soldiers, Sztajnkrycer began to wonder whether TCCC procedures might need to be altered to better serve law enforcement realities. [See FSN Transmission #158, 9/10/10, "Could more wounded cops be saved with police-specific combat care?" Click here to read it.]

"By learning more about life-threatening events and, particularly, the interventions that made them survivable, we'll have a more complete picture of what adaptations may be desirable in order to save more officers' lives," Sztajnkrycer says. "And we should be able to resolve some of the current controversies, such as how valuable tourniquets are for police use." He calls his pursuit of near-miss information and related studies the VALOR (Violence Against Law Officer Research) Project, an undertaking he's financing from his own pocket. At its core is the compilation of a Near-Miss Database, with input fed to it on an ongoing basis through the new website mentioned above.

At the site, you'll find an easy-to-complete, 29-point questionnaire, seeking details of any LEO wounding or injury that you may be familiar with, whether your own or another officer's.

First, in mostly a checklist format, you're asked to supply key demographic information, such as the country and state or province where the near-miss incident occurred, your role in the event, the assignment of the wounded/injured officer, the type of call involved, the nature and cause of the injury, the type of aid rendered by law enforcement and EMS personnel, how the affected officer was evacuated from the scene, and so on.

Then you're asked for 5 free-form narratives, core components related to the circumstances of the incident:

• Describe the event.

• What worked well?

• What could be improved? What are your suggestions to prevent a similar event? What actions can correct the situation?

• Is there any specific training you wish the officers had completed at the time of the incident? What training worked well? What did not work well? How would you improve it?

• What equipment do you wish the officers had available during the incident? What equipment worked well? What did not work well? How would you improve it?

There are no mandatory fields in the questionnaire. "People should feel comfortable giving as much information as they want," Sztajnkrycer says.

The narratives will be screened, he explains, and "any identifying department indicators, names, or other information that may identify officers or agencies will be removed" before they are analyzed. To assure privacy protection during transmission, "I am using REDCap, a secure medical research platform, rather than a commercial system like SurveyMonkey," he says. The narratives themselves will not be posted for public viewing on the website.

Your checklist and narrative responses will, however, be confidentially parsed by a review committee consisting of Sztajnkrycer and a volunteer cadre of "operational medicine" providers, experts in crisis care in unconventional and austere environments. "Anything we view as a patient-safety issue will be identified and discussed," Sztajnkrycer says.

On a quarterly basis, "general summary data and emerging trends from the submissions will be posted on the website for law enforcement personnel to use as a learning tool," Sztajnkrycer says. These findings will also be reported by Force Science News as they become available.

Sztajnkrycer has modeled his project after the National Firefighter Near-Miss Reporting System (www.firefighternearmiss.com), which has been in existence for years. "I just got tired of saying that this is something law enforcement needs, and decided to do something about it," he says. "I decided to fund it myself to keep the focus on helping officers, rather than rely on commercial entities.

"The point is to empower officers with knowledge that will help them improve their ability to survive, and to provide law enforcement executives and policy makers with the tools to make reasoned, educated practice decisions. Any guidelines or protocols provided will be based on the most current information available from officers real-world experiences."

To make the website immediately useful to officers, Sztajnkrycer has included links to:

• Current news accounts of officer-down incidents

• Published VALOR Project research studies

• Articles related to combat-care concerns, such as tourniquets, hemostatic agents, airway management, and chest trauma.

Besides completing the questionnaire when near-misses arise, there are 2 other ways the law enforcement community can help Sztajnkrycer advance his campaign to improve police medicine:

1. He is seeking videos of incidents in which officers are shot or otherwise wounded or killed so he can analyze them for clues as to the nature of injuries, the immediate law enforcement response, and opportunities for life-saving interventions. "All videos submitted will be stored in a secured area, and none will be disseminated," he promises.

Among other things, he hopes these videos will help him establish "solid facts" about the relative response times required for assistance from a buddy system and EMS when an officer is hurt. "That information will inform officers working alone about how much time they're likely to be solely dependent on themselves and their training and ingenuity," Sztajnkrycer says. "Preliminary data already suggest important training implications."

1. He is also looking for ideas for future research projects related to police medical emergencies, self-aid or buddy-air, and post-event care.

If you can help with any of this, contact Sztajnkrycer at: matt@valorproject.org for further discussion. You can also apply at that address to be part of a special email list that will receive direct notification of developments from Sztajnkrycer's research-and-review team as it progresses. Credentials of all applicants will be verified.

"Dr. Sztajnkrycer is to be commended for his ongoing personal commitment to improving medical protection for officers in crisis situations," says Dr. Bill Lewinski, executive director of the Force Science Institute. "His near-miss data, plus other of his unique research projects, are certain to save lives."

CLICK HERE to go to the VALOR Project site now.

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