Page 131 - Journal of Special Operations Medicine - Summer 2015

reporting biases. Although partially mitigated through on- States. The majority involve a single patient. Care is
going data edit checks, the 101.206 code for Activation- most frequently provided at the EMT level. Advanced
Tactical or SWAT Specialty Service/Response Team is a airway procedures are required in a minority of pa-
non-mandatory field. As such, it is likely that not all tac- tients. On-scene cardiac arrest is rare. Further study is
tical incident EMS activations were captured. Similarly, needed to identify and delineate medical interventions,
key TCCC/CTECC procedures, including tourni quet training, equipment, and policies needed by EMS per-
and hemostatic agent application and needle thoracos- sonnel charged with supporting law enforcement tacti-
tomy for presumed tension pneumothorax, may not cal incidents. Ideally, this would involve the creation of
have been recorded. However, fields for these proce- a national database specifically analyzing medical re-
dures do exist within the NEMSIS data set, and these sponse to law enforcement tactical incidents.
procedures were documented within the total NEMSIS
EMS activation data set. Acknowledgments

The NEMSIS Project identifies several specific limita- The NEMSIS dataset is supported by the Office of
tions in its own documentation, including convenience Emergency Services, National Highway Traffic Safety
sampling, use of event-based rather than patient-based Administration. We acknowledge the participating EMS
coding, selection and information bias, and missing providers, EMS agencies, and state EMS offices who
data. Of particular note, the NEMSIS data set is re- support and provided data for the NEMSIS Registry.
12
source-based rather than patient-based. A single patient
may be represented in more than one record for a vari- Disclosure
ety of reasons. Several agencies may respond to the same The authors have nothing to disclose.
event (i.e., one patient) and each submit a record to the
National EMS Database.
References
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