BORELLI CONSULTING: Recommended Reading

The Self-Aid Kit: Medical Gear Every Cop Should Carry
By: Mike Marcon, 23 March 2005

This article may seem to be more questions than solutions - but life saving solutions lie within the questions.

Let's imagine a worst-case scenario. Dispatch has sent a lone patrol officer to a domestic disturbance. Immediately, upon stepping out of his cruiser and moving around the front of it, he takes fire from the address of the reported disturbance. He is hit twice: once in the face - the jaw to be exact - and again in the thigh. He manages to take cover behind his unit and calls for help. He's oriented enough to realize that the bright red blood flowing copiously from his leg is an arterial bleed.

A second officer rolls up and manages to get to the wounded officer's side, who is now having difficulty breathing because his mouth is filled with blood, tissue and broken teeth. Rounds continue to come from the shooter's position spewing broken glass and shrapnel in various directions. EMS is on the way, but they will be staged until the scene is safe. Forget about SWAT for now; focus on the downed officer. He is either going to suffocate or bleed to death unless a few things happen very quickly.

First, there is the matter of his airway. Even if the assisting officer does "rescue breathing," mouth-to-mouth, will he be able to get air into the lungs of the downed officer past the debris and blood?

Next there is the matter of the arterial bleed at the thigh: it's the femoral artery, which is a big artery, and if the bleeding is not stopped NOW, the downed officer is going to bleed out and die right there.

What do you wish for as the rescuing officer?

First you need a way to secure that officer's airway; a way that will allow you the ability to push air into his lungs and for him to breath; a way that bypasses his injured mouth. Next, you need a fast way to stop that bleeding at the thigh. Pressure points won't do it because 1) you are under fire, and 2) you need your hands to do other things as such as do a head-tilt-chin-lift to try to open that officer's airway. Also, there's the business of returning fire.

So, let's talk about that airway first. Your first wish is granted if you know what a nasal airway is and how to use it. Next, you need a way to stop that bleeding. "Tourniquet!" you say. Right! But what kind? Are you going to use, the John Wayne, whip off your pants belt, and chinch it up kind that takes two hands to get off? You know, the one you have to get past your duty rig and so on. Or something cleaner, faster, easier to apply, that could even be applied one handed if necessary? I'll expound on this later.

Here is a way your wishes can be granted immediately. What if every officer in your department carried, in exactly the same place on his person (more or less), a pouch about the size of a pack of cigarettes that contained the following items?
· A PRE-MEASURED nasal airway to fit the officer wearing the pouch
· A self-applied pressure bandage
· A self applied ratcheting tourniquet
· A vital info card that contained information regarding blood type, immunizations, known allergies, next-of-kin info, organ donor information and whatever else you deem important in an emergency.

Now, about that "nasal airway." A nasal airway is a soft rubber tube that looks like a skinny trumpet on average about four and half inches long. They come in various sizes based on the individual they will be used on. That's why I emphasized PRE-MEASURED. To get the right airway, you measure from the tip of the nose to the ear lobe. The nasal airway works by inserting it the right nostril after lubricating it with K-Y jelly and it slides down the back of the throat by-passing the mouth and it's structures. You can then do mouth-to-nose rescue breathing through it. Your local EMS providers can help you size them for each officer's individual use. The K-Y jelly comes in a small packet about the size of a fast food ketchup package. It will fit easily in the officer's Self-Aid pouch.

The other items I've mentioned are:
· A self-applied pressure bandage. These bandages affix in such a way as they maintain pressure on the wound much like someone pressing down on the wound might. They can be easily applied with one hand.
· A self-applied ratcheting tourniquet. This tourniquet looks like a long strip of Velcro or latex with a D-ring or hook attached to one end. You simply slip one end of the tourniquet through the D-ring and pull until tight then squeeze the Velcro together to lock it in place. It's fast and easy. (A word of warning about using a tourniquet, in this case, or any other case, when a major artery is hit on an extremity: Once applied, it should stay in place and be tight enough to stop the bleeding. Do not release it. Let the ER Docs do that.)
· A Vital information card. Name, social security number, department name, blood type, known allergies, immunizations (i.e. tetanus, hepatitis, etc) and next-of-kin, as well as organ donor information are all standard questions you should be able to answer about yourself quickly. But can you answer them quickly for that downed officer or your partner? Do you want to waste time having the department track this info down? This card, which is attached to a string loop to be placed around the officer's neck eliminates the need to track down info and it stays with him so EMS and the hospital has a ready source of info. (Also, have you considered data basing this info with your central dispatch? Just food for thought.)

The Self-Aid Kit or pouch for law enforcement is a vital necessity that should be developed by every department. It should contain at least the items written about here and one of the keys to its success is standardized location placement on your officers. They don't need to waste precious time searching for it when the stuff hits the fan.

For nasal airways and other EMS supplies, you can call EMS*USA at 800/264-2401.

For the best range of pouches to contain your kits and that fit a wide variety of duty rigs, I recommend BlackHawk Products Group 800-694-5263.

Readers are welcome to e-mail me for further recommendations or consultations regarding Self-Aid Kits.

About the Author:
Based in Virginia, Mike Marcon is an experienced Emergency Medical Technician (Cardiac/Tactical. He sits on the Board of Directors of Peninsulas EMS Council. A former Airborne Military Policeman, Mike is also a Commercial Pilot, a Wilderness Survival Instructor and Sport Parachutist with over 1200 jumps.

I have a comment or question for Mike Marcon.

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