Effects of Tactical Emergency Casualty Care Training for Law Enforcement Officers

Rothschild, Heidie R.; Mathieson, Kathleen

doi:10.1017/s1049023x18000730

Cited by 6 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While TQ training for LEOs might be applicable to the high-threat prehospital setting, it could also be useful to make them more confident in treating and stabilizing victims of everyday trauma, such as vehicle collisions. Our findings suggest that the TCCC or TECC concepts could outline a framework for these educational efforts 32,33 …”

Section: Resultsmentioning

confidence: 86%

“…Our findings suggest that the TCCC or TECC concepts could outline a framework for these educational efforts. 32,33 Limitations Articles included were mostly observational, retrospective reports with small study populations. Few studies reported a comparison with a non-TQ control group.…”

Section: Resultsmentioning

confidence: 99%

“…Both studies are limited by a small sample size and are strongly biased toward positive outcomes. In addition, Rothschild and Mathieson 33 evaluated the effects of TECC training by analyzing TECC After-Action Questionnaires and police reports on 46 patient encounters where TECC skills were used by LEOs in the prehospital setting. 100% of officers were successful in stabilizing the patient injuries, and 97% reported TECC training to be sufficient.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Is tactical combat casualty care in terrorist attacks suitable for civilian first responders?

Borgers¹,

Boxstael²,

Sabbé³

2021

J Trauma Acute Care Surg

View full text Add to dashboard Cite

Prehospital management of intentional mass casualty incidents is a unique challenge to Emergency Medical Services. Tactical Combat Casualty Care (TCCC) and the use of tourniquets for extremity hemorrhage have already proven to reduce mortality on the battlefield. This literature review aims to determine the place of these military concepts in a civilian high-threat prehospital setting. METHODS:The PubMed database was searched for articles published between January 1, 2000, and December 1, 2019, containing descriptions, discussions, or experiences of the application of tourniquets or other TCCC-based interventions in the civilian prehospital setting. Data extraction focused on identifying important common themes in the articles. RESULTS:Of the 286 identified articles, 30 were selected for inclusion. According to the Oxford Centre for Evidence-based Medicine Levels of Evidence, overall level of evidence was low. Most articles were observational, retrospective cohort studies without a nontourniquet control group. Outcome measures and variables were variably reported. Two articles specifically analyzed tourniquet use during high-threat situations, and three described their application by law enforcement personnel. Overall, tourniquets were found to be effective in stopping major limb bleeding. Reported mortality was low and related complications appeared to be infrequent. Only four articles mentioned the application of other TCCC-based maneuvers, such as airway and respiratory management. CONCLUSION:This literature review shows that tourniquets appear to be safe tools associated with few complications and might be effective in controlling major bleeding in civilian limb trauma. For example, during mass casualty incidents, their use could be justified. Training and equipping ambulance and police services to deal with massive bleeding could likewise improve interoperability and victim survival in a civilian high-threat prehospital setting. More qualitative research is needed to further evaluate the effects of hemorrhage control training for first responders on patient outcomes. Literature describing the application of other TCCC-based principles is limited, which makes it difficult to draw conclusions regarding their use in a civilian setting. (

show abstract

Section: Resultsmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Is tactical combat casualty care in terrorist attacks suitable for civilian first responders?

Borgers¹,

Boxstael²,

Sabbé³

2021

J Trauma Acute Care Surg

View full text Add to dashboard Cite

show abstract

“…There has been a push for police officers to be trained in tactical medicine, and in many cities, both police officers and EMSs personnel are trained to use and carry windlass tourniquets. 15 In a single city retrospective evaluation, EMSs arrived on average 4 minutes after the police applied a tourniquet, which could have a significant impact in the degree of blood loss and shock if medical care had to wait until EMSs arrival. 16 However, competence does not necessarily follow confidence, and such a mismatch has been reported for windlass application.…”

mentioning

confidence: 99%

“…A few retrospective studies have reported on tourniquet placement in the prehospital setting, 5,6,14 but no recent prospective evaluation of the efficacy of prehospital tourniquet placement has been published. There has been a push for police officers to be trained in tactical medicine, and in many cities, both police officers and EMSs personnel are trained to use and carry windlass tourniquets 15 . In a single city retrospective evaluation, EMSs arrived on average 4 minutes after the police applied a tourniquet, which could have a significant impact in the degree of blood loss and shock if medical care had to wait until EMSs arrival 16 .…”

mentioning

confidence: 99%

The tight rope act: A multicenter regional experience of tourniquets in acute trauma resuscitation

Tatebe

Schlanser

Hampton

et al. 2021

J Trauma Acute Care Surg

View full text Add to dashboard Cite

BACKGROUND:As tourniquets have become more prevalent, device use has been questioned. This study sought to characterize the incidence, indication, and efficacy of tourniquet placement in acute trauma resuscitation. METHODS:Nine regional level 1 trauma centers prospectively enrolled for 12 months adult patients (18 years or older) who had a tourniquet placed. Age, sex, mechanism, tourniquet type, indication, applying personnel, location placed, level of occlusion, and degree of hemostasis were collected. Major vascular injury, imaging and operations performed, and outcomes were assessed. Analyses were performed with significance at p < 0.05. RESULTS:A total of 216 tourniquet applications were reported on 209 patients. There were significantly more male patients (183 [88%]) and penetrating injuries (186 [89%]) with gunshots being most common (127 [61%]). Commercial tourniquets were most often used (205 [95%]). Ninety-two percent were placed in the prehospital setting (by fire/paramedics, 56%; police, 33%; bystanders, 2%).The most common indications were pooling (47%) and pulsatile (32%) hemorrhage. Only 2% were for amputation. The most frequent location was high proximal extremity (70%). Four percent were placed over the wound, and 0.5% were distal to the wound. Only 61% of applications were arterial occlusive. Median application time was 30 minutes (interquartile range, 20-40 minutes).Imaging was performed in 54% of patients. Overall, 36% had a named arterial injury. Tourniquet application failed to achieve hemostasis in 22% of patients with a named vascular injury. There was no difference in hemostasis between those with and without vascular injury ( p = 0.12) or between who placed the tourniquet ( p = 0.07). Seventy patients (34%) required vascular operations. Thirty-four percent of patients were discharged home without admission. CONCLUSION:Discerning which injuries require tourniquets over pressure dressings remains elusive. Trained responders had high rates of superfluous and inadequate deployments. As tourniquets continue to be disseminated, emphasis should be placed on improving education, device development, and quality control.

show abstract

Impact of time and distance on outcomes following tourniquet use in civilian and military settings: A scoping review

Joarder

Moussaoui

Das

et al. 2023

Injury

View full text Add to dashboard Cite

Effects of Tactical Emergency Casualty Care Training for Law Enforcement Officers

Cited by 6 publications

References 16 publications

Is tactical combat casualty care in terrorist attacks suitable for civilian first responders?

Is tactical combat casualty care in terrorist attacks suitable for civilian first responders?

The tight rope act: A multicenter regional experience of tourniquets in acute trauma resuscitation

Impact of time and distance on outcomes following tourniquet use in civilian and military settings: A scoping review

Contact Info

Product

Resources

About