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equipping their LEOs with hemorrhage control train- these LEOs to meet these challenges. For individuals
ing and equipment. This trend translates into more than who face these threats or have to respond to these in-
180,000 LEOs in our nation’s largest cities (or approxi- cidents, it is the ultimate community policing program.
mately one of every five U.S. LEOs) who are now ca-
pable of saving an injured civilian or one of their fellow
officers injured in an active shooter or other situation. References
These officers provide this protection to nearly 80 mil- 1. Niska RW. Hospital collaboration with public safety organiza-
lion Americans. tions on bioterrorism response. Prehosp Emerg Care. 2008;12
(1):7–12.
Additional agencies are coming on board each week, 2. Eastman AL, Metzger JC, Pepe PE, et al. Conductive electri-
moving their LEOs into the present by training and cal devices: A prospective, population-based study of the
equipping them with hemorrhage control equipment. medical safety of law enforcement use. J Trauma. 2008;64(6):
1567–1572.
Some novel and effective local partnerships exist, but 3. Metzger JC. Civil sector tactical EMS. J Trauma. 2007;62(suppl
our nation’s trauma centers must be engaged and en- 6):S17.
sure that every law enforcement agency has both the 4. Sathyavagiswaran L, Rogers C, Noguchi TT. Restraint as-
expertise and the resources to develop these lifesaving phyxia in in-custody deaths: Medical examiner’s role in pre-
vention of deaths. Leg Med. 2007;9(2);88–93.
capabilities. 5. Hawkins SC, Shapiro AH, Sever AE, Delbridge TR, Mosesso
VN. The role of law enforcement agencies in out-of-hospital
Conclusions emergency care. Resuscitation. 2007;72(3):386–393.
As threats continue to evolve, our nation’s LEOs will 6. Veliz C, Montgomery H, Kotwal R. Ranger first responder
continue to be our frontline responders to incidents in and the evolution of tactical combat casualty care. J Spec Oper
which citizens are injured. We must continue to train Med. 2010;10(3):90–91.

148 Journal of Special Operations Medicine Volume 15, Edition 4/Winter 2015