Few careers allow an effective professional to arrive at their workplace without allocating time to prepare themselves mentally. Some career professionals need to mentally and physically prepare, making equipment status checks and evaluating the immediate needs of the day crucial to their success.. Physicians, pilots, firefighters and law enforcement officers as well as many other professionals spend a portion of every work day going through surveys of equipment preparation, functionality and assessing any special requirements unique to the day's responsibilities.. Law enforcement officers start each day inspecting their uniform, duty belt, tools, and weapons for function and sign of wear. The patrol vehicle is next undergoing review for operation, wear and damage. Every officer has a unique routine and set of priorities for preparing for their shift. The amount of personal equipment loaded into the vehicle is often a function of an officer's current assignment and personal preferences. Of the many lessons learned from the North Hollywood Bank Robbery, being prepared to sustain long periods of action without logistical support at a crime scene or critical incident is vital. Tactical independence has become a major teaching point in all law enforcement training which requires police officers be mentally and physically prepared.
The term "Bailout" bag has become a popular term for the west coast law enforcement community. It refers to a collection of equipment readily available for use when immediate sustained action is required. It typically is loaded into a patrol vehicle at the start of a shift as part of the vehicle preparation. The bag commonly contains food, water, extra ammunition and a medical kit. Officers can create them individually with the mind set that it be accessible in a split second and it provide them the ability to be self sustaining for a minimum of several hours. In recent years, medical kits have become very popular additions to bailout bags. Though some officers choose to create their own kit, there are several commercial vendors selling pre-packaged kits at various cost. Commercial kits can cost between $25.00 to $100 dollars depending on the contents of the kit. Many vendors will customize kits to fit specific police department’s needs. Contents often vary depending on the officer's assignment. SWAT or special operation team needs are different then the needs of a patrol officer. Any first responder is potentially exposed to high risk injuries and the need for emergent medical attention, therefore, should always be required to carry, at minimum, a basic kit
Each member of our SWAT team carries a medical kit attached to their tactical vest. It typically contains a battle tourniquet, pressure bandage and scissors. Each operator is trained in individual care as well as buddy care. The team is supported by a police officer/ medic who carries a fully supplied trauma bag, AED (Automated External Defibrillator) and oxygen. The presence of the Bearcat tactical vehicle allows for immediate rescue and extraction. Unfortunately, patrol and non special operations officers are often not afforded the same immediate medical support as the tactical teams. When creating or purchasing a basic medical kit, assessing potential risk and determining the environment an individual will be operating in is important. The urban area of Los Angeles compared to the remote wilderness of Montana obviously have differences in evacuation complexity and transport time to an acute care hospital. Many medical items are perishable, expensive and in many cases never used. The size and weight of a kit and, again, the environment of the officer will dictate the content. Expectantly, the Bail-out bag must be a manageable size to be functional.
Recommendations for medical kit content varies. The majority of vendors selling kits attempt to parallel military needs with that of law enforcement. Military statistics indicate 56% of battlefield ballistic injuries are non survivable and 44% of battlefield ballistic injuries are initially survivable. Statistics that clearly do not reflect the environment of U.S. law enforcement. Of those who initially sustained a survivable wound and later died, 90% of those soldiers died before reaching a medical facility. The majority died from either bleeding to death or a chest wound. Unquestionably, the injury and death rate of the military in battle does not compare to the same statistics in law enforcement. Thousands of soldiers are injured or killed every year on the battlefield while felonious assaults leading to death have never reached such numbers in modern U.S. law enforcement. However, unlike the military, there is no detailed database of the type of injuries or exact causes of death of law enforcement officers. Thus, the mechanism of death associated with initially survivable injuries either on the battlefield or on the streets are arguably compared in light of the amount of military weaponry that has made it to the level of the street criminal. It would seem logical to assume acute bleeding and chest trauma would also be the most likely causes of death of a wounded law enforcement officer.
Consideration of the most probable mechanism of critical injury should guide a officer's decision on what to carry in a medical kit. Function, size and weight are factors. Delayed extraction and transport time are not, typically, considered in an urban environment. The combination use of a battle tourniquet and pressure bandage is the most effective way to prevent the number one cause of death from a survivable injury. Used in combination, almost all extremity bleeding either venous or arterial can be controlled long enough for rescue and transport to a medical facility. The use of clotting agents in civilian law enforcement does not have enough evidence to warrant recommendation. The incidence of survivable chest trauma in law enforcement deaths is not well documented. Typical law enforcement body armor protects against most handguns. Unlike the military battlefield, there is very little explosive shrapnel injuries in civilian law enforcement which is one of the main causes of the "sucking chest" wound along with small caliber ammunition. Stabbings can also be cause of critical chest trauma but, based on available information, the number of officer deaths by stabbing is very small. These facts make it difficult to suggest the need to carry chest seals in a medical kit. Automatic weapons and rifles cause such extensive chest trauma, there is virtually no piece of first aid equipment available that would be beneficial in this situation.
Consideration of the most probable mechanism of critical injury should guide a officer's decision on what to carry in a medical kit. Function, size and weight are factors. Delayed extraction and transport time are not, typically, considered in an urban environment. The combination use of a battle tourniquet and pressure bandage is the most effective way to prevent the number one cause of death from a survivable injury. Used in combination, almost all extremity bleeding either venous or arterial can be controlled long enough for rescue and transport to a medical facility. The use of clotting agents in civilian law enforcement does not have enough evidence to warrant recommendation. The incidence of survivable chest trauma in law enforcement deaths is not well documented. Typical law enforcement body armor protects against most handguns. Unlike the military battlefield, there is very little explosive shrapnel injuries in civilian law enforcement which is one of the main causes of the "sucking chest" wound along with small caliber ammunition. Stabbings can also be cause of critical chest trauma but, based on available information, the number of officer deaths by stabbing is very small. These facts make it difficult to suggest the need to carry chest seals in a medical kit. Automatic weapons and rifles cause such extensive chest trauma, there is virtually no piece of first aid equipment available that would be beneficial in this situation.
Allocating time each day to mentally prepare as well as assessing equipment needs and equipment functional status will prepare an officer for almost any encounter. However, standardizing a basic medical kit to include a battle tourniquet and a pressure bandage as part of a police officer’s equipment needs, such simple items readily available for immediate access, could make the difference of life and death in today’s world of law enforcement.
