Sgt (Ret) Charles Kean MA, EMT-P, IPSA TEMS & RTF Committee Member
In 2016, a cooperative training program was developed and introduced in Springfield, Illinois with the goal of providing basic life-saving skills and equipment to officers. This program was established because SPD officers received little, if any, medical training after they left the academy. While the initial concept was limited to the Springfield Police Department, it has since flourished far beyond that one agency.
SPD’s Emergency Response Team is essentially the same as other agencies’ SWAT teams. The ERT includes an active TEMS program, and as a sworn officer and paramedic, I was the TEMS leader and trainer. I was supplemented with eight emergency medical responders, who were also sworn officers. In addition, four emergency medicine physicians participated in training and supported SPD’s ERT.
Many officers on the ERT have a military background and several are combat veterans. A lot of officers were comfortable equipping themselves with tourniquets and other first aid equipment. However, there was no consistency in what they were acquiring, supply-wise, or the training they were getting.
In early 2016, I was introduced to Kari Jerge, MD (also a member of the IPSA’s TEMS Committee). Dr. Jerge was brought in as the Trauma Medical Director for HSHS St. John’s Hospital. She brought a wealth of trauma care knowledge including holding certification as a Tactical Combat Casualty Care instructor. I was fortunate to work with Dr. Jerge to design a comprehensive program using TCCC principles coupled with established law enforcement methods.
Training, costs, time and buy-in
Establishing the training program took nearly a year. In that time, every aspect of the training was analyzed. What became clear almost immediately was that this could not be a program built exclusively by the medical providers. As a police officer and paramedic, I could provide information related to what police are looking at and what EMS or medical personnel would see.
Financial considerations must be weighed. There are costs for instructors and equipment. Law enforcement, much like other public safety entities, is in a constant tug-of-war in the fiscal arena.
Another challenge we faced was time. SPD runs an in-house, in-service training program with five sessions annually. During that 40 hours per year, the Training Coordinator must squeeze in three shooting course and training required by the Illinois Training and Standards Board.
The third hurdle, and the most troublesome, was officer buy-in. Having been an officer for over 20 years and involved in department training for more than 10 years, I was aware that police officers are wary when ‘outsiders’ come into their training domain. Convincing officers that the program was paramount to their training, was challenging, on-going and necessary for it to be successful.
Tourniquets, wound packing and lifts/carries
To stay in line with recognized and proven training, SPD modified the training presented in the TCCC All Combatants (TCCC-AC) course. Acknowledging the many tenets in TCCC do not translate directly into civilian law enforcement and EMS care protocols, the decision was made to focus on the greatest pay-off for line officers. The training focused on the use of hemostatic agents, tourniquets and lifts/carries.
While recognizing the importance of bleeding control and the relative ease in training these skills, we needed something to drive the lessons home for the officers and the command staff. What evolved was a two-prong training approach.
The first portion of the training laid the groundwork for why they should care, both at the user level and why commanders and chiefs should care from a liability mitigation standpoint. The second part of the training was getting the students to apply the skills in practice.
Tourniquet use was demonstrated by the instructors applying the tourniquet to themselves and using a Doppler to demonstrate the occlusion of the distal arterial blood flow. Students were then evaluated on putting the tourniquet on themselves and then a putting a tourniquet on a partner with the instructors evaluating each application.
Wound packing was demonstrated using as near a live tissue model as possible. Bone-in pork shoulders were obtained and then were shot with duty ammunition of both the department issued Glock 17 9mm pistol and M-4 rifle. Students were use training Combat Gauze© to pack the wounds in the pork shoulder.
Lifts/carries were demonstrated and applied by the officers in the training. An important aspect to this is to make sure the officers are in body armor and duty belts to replicate the difficulties and issues that may be encountered by officers in the field.
Overcoming programmatic challenges
Costs were the first issue we addressed. HSHS Trauma Service approached the HSHS St. John’s Hospital Foundation and secured a grant to purchase equipment for SPD officers. The hospital further supports the program by resupplying officers when they used their equipment.
In addition, all the instructors involved in the initial training declined payment. This was a labor of love and collectively the instructors felt it was more important to get the information to responders than to be paid.
When I approached the Training Coordinator, I believed that I would be asking for time the upcoming year. As it were, there was a four-hour block of uncommitted time during the October 2016 in-service session. That provided the team with a target window for structuring the training for the officers. Since that initial training each successive group of new officers joining the SPD attend the 4-hour training and are then equipped.
Officer buy-in was initially my greatest concern. That turned out to be the least problematic issue. At the time of the training, SPD had approximately 240 officers from Chief to rookie patrol officers. As of today, 230 officers received the training. Usually the Criminal Investigations Division conducts a separate training program separate from patrol. In this instance, CID wanted to be involved in this training. In my mind that is a testament to the officers understanding the importance of the training.
The program’s future
Since SPD completed the training, the program has taken on a life of its own. Through the work of HSHS Trauma Service, the program has expanded beyond the officers of the SPD. Through the outreach of the HSHS Trauma Service combined with those who have attended the training, the program has grown much faster than anticipated.
A significant step forward was made when the team was invited in February 2017 to present the training to the Lincoln Land Chapter of the FBI National Academy Alumni Association. This organization is made up of command staff personnel of state, county, local and tribal law enforcement agencies. By presenting to the FBINAA, we gained another level of respectability. We have achieved that rare accolade of acceptance by line-level and command-level personnel.
As of October 2017, the team has trained 700+ responders. Agencies include the Sangamon County Sheriff’s Department, the Illinois Department of Conservation Police and numerous smaller agencies. The program was accepted by the Illinois Law Enforcement Training and Standards Board as a certified course for Illinois law enforcement officers.
To date officers and deputies trained and equipped through this program have been credited with saving at least three lives with tourniquet applications.
This training has progressed into the greater responder community. Numerous fire departments and EMS agencies, both paid and volunteer, have been trained. This was a welcome, yet unintended benefit, of the program. Since the skill sets translate across public safety disciplines and they often work together, it is intuitive to provide the training to them.
It’s important, regardless of the discipline we come from, that we do what is necessary to bridge those gaps and collaborate on solutions to common problems and situations. This program is a testament to cross-disciplinary training. It’s a program that started with a law enforcement agency collaborating with a healthcare provider to benefit both disciplines and, ultimately, those in need of emergent care in an unstable environment.
About the Author
Charles Kean is a member of the ISPA TEMS and RTF Committees and retired from the Springfield (IL) Police Department after 21 ½ years of service. He has been involved in EMS since 1984 getting his start in the US Army as a Medical Specialist. He established the SPD Emergency Response Team (ERT) TEMS program in 2005 and served as the leader and educator. He continues to serve the TEMS element with training and support. He is an instructor in the EMS Program at Lincoln Land Community College as well as a TCCC/TECC instructor. He holds a Master’s Degree in Crisis Management and Emergency Response.