POLICE Magazine

SEP 2018

Magazine for police and law enforcement

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SPECIAL REPORT H ACTIVE SHOOTER RESPONSE 11 POL05-1217.18 READ IT WHERE YOU NEED IT! PoliceMag.com/KeepingSchoolsSafe Read POLICE Magazine's special report on Keeping Schools Safe on your tablet, mobile or desktop today! EDITORIAL HIGHLIGHTS • Building Police-School Relationships • POLICE Survey: How Would You Make Schools Safer? • You Have to Go In • Crowd Control • Tactical Medical Response • Staging a School Shooting Response Drill Sponsored by Knightscope Inc., Hardwire LLC & Omnigo Software venous blood returning to the heart. is leads to circulatory collapse and eventually death if not treated. A simple procedure called needle thoracentesis is used to diagnose and treat a tension pneumothorax. e management of tension pneu- mothorax is emergent chest decom- pression with needle thoracostomy. A 14-gauge angiocath-type (cathe- ter over needle) needle is preferred. e standard approach is to in- sert the needle into the second in- tercostal space at the mid-clavicu- lar line. e needle is advanced and an immediate rush of air out of the chest indicates the presence of a tension pneumothorax. e maneu- ver essentially converts the tension pneumothorax into a simple pneu- mothorax, which is typically not a life-endangering situation. ere are many locations on the chest wall where a needle thoracos- tomy may be performed. If you have a 14-gauge needle that is less than 3.25 inches and your victim has very large chest muscles simply look for a thin area anywhere on the chest wall, especially laterally under the arms, and insert the needle here. Do not fixate only on the second inter- costal space as your only option for needle insertion. While simple interventions per- formed in the field can save lives after an active shooter attack, it's important to remember that trauma is a surgical disease and it is fixed in the operating room. Advanced medical care and immediate ex- traction and evacuation to a Level One Trauma Center is paramount. n Lawrence E. Heiskell, MD, FACEP, FAAFP is an emergency physician and reserve police officer with the Palm Springs (CA) Police Depart- ment. A member of the POLICE Mag- azine Advisory Board, Dr. Heiskell is the founder and director of the International School of Tactical Medicine. e school offers an 8-hour Law Enforcement Tactical Life Saver Course for patrol officers, an 80-hour (2-week) Tactical Medicine course, and an alternative 40-hour Tactical Medicine Course for tactical medics, all of which are approved by Califor- nia POST and the U.S. Department of Homeland Security. Many types of tourniquets are out there. Test them out to determine the ones best suited to your agency, and always have them on hand to use when needed.

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