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Incidence of Fatal Airway Obstruction in Police Officers Feloniously Killed in the Line of Duty: A 10-Year Retrospective Analysis

Published online by Cambridge University Press:  27 June 2013

Laura A. Fisher ,
David W. Callaway  and
Matthew D. Sztajnkrycer
Laura A. Fisher
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota USA
David W. Callaway
Affiliation:
Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina USA
Matthew D. Sztajnkrycer*
Affiliation:
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota USA
*
Correspondence: Matthew D. Sztajnkrycer, MD, PhD Associate Professor of Emergency Medicine Mayo Clinic GE-GR-G410 200 1st Street SW Rochester, MN 55905 USA E-mail sztajnkrycer.matthew@mayo.edu
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Abstract

Background

According to US military data, airway obstruction is the third leading cause of possibly preventable death in combat. In the absence of law enforcement-specific medical training, military experience has been translated to the law enforcement sector. The purpose of this study was to determine whether airway obstruction represents a significant cause of possibly preventable death in police officers, and whether current military combat lifesaver training programs might have prevented these fatalities.

Methods

De-identified, open-source US Federal Bureau of Investigation (FBI) Uniform Crime Report Law Enforcement Officers Killed and Assaulted (LEOKA) data for the years 1998-2007 were reviewed. Cases were included if officers were on duty at the time of fatal injury and died within one hour from time of wounding from penetrating face or neck trauma. After case identification, letters requesting autopsy reports were sent to the departments of victim officers. Reports were abstracted into a Microsoft Excel database.

Results

During the study period, 42 of 533 victim officers met inclusion criteria. Departmental response rate was 85.7%. Autopsy reports were provided for 29 officers; 23 (54.8%) cases remained in the final analysis. All officers died from gunshot wounds. No coroner specifically identified airway obstruction as either a direct cause of death or contributing factor. Based upon autopsy findings, three of 341 officers possibly succumbed to airway trauma (0.9%; 95% CI, 0.0%-1.9%). Endotracheal intubation was the most common advanced airway management technique utilized during attempted resuscitation.

Conclusion

The limited LEOKA data suggests that acute airway obstruction secondary to penetrating trauma appears to be a rare cause of possibly preventable death in police officers. Based upon the nature of airway trauma, nasopharyngeal airways would not be expected to be an effective lifesaving intervention. This study highlights the requirement for a comprehensive mortality and “near miss” database for law enforcement officers.

FisherL, CallawayD, SztajnkrycerM. Incidence of Fatal Airway Obstruction in Police Officers Feloniously Killed in the Line of Duty: A 10-Year Retrospective Analysis. Prehosp Disaster Med.2013;28(5):1-5.

Keywords

airwaylaw enforcementTCCCtrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 5 , October 2013 , pp. 466 - 470
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

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References

1.Berg, RA, Hemphill, R, Abella, BS, et al. Part 5: adult basic life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 suppl 3):S685-S705.Google ScholarPubMed
2.Committee on Trauma; American College of Surgeons. Advanced Trauma Life Support (ATLS) for Doctors, 9th ed.Chicago, IL: American College of Surgeons; 2012.Google Scholar
3.Butler, FK Jr, Hagman, J, Butler, EG. Tactical combat casualty care in special operations. Mil Med. 1996;161(suppl 1):3-16.CrossRefGoogle ScholarPubMed
4.McSwain, NE, Frame, S, Salomone, JP, eds. National Association of Emergency Medical Technicians; Committee on Tactical Combat Casualty Care: Military Medicine. Prehospital Trauma Life Support, military ed, rev 5th ed, St. Louis, MO: Mosby. 2005:374-408.Google Scholar
5.Bellamy, RF. The causes of death in conventional land warfare: implications for combat casualty care research. Mil Med. 1984;149(2):55-62.CrossRefGoogle ScholarPubMed
6.US Dept of Justice. Law Enforcement Officers Killed and Assaulted 2011. http://www.fbi.gov/about-us/cjis/ucr/leoka/2011. Accessed December 12, 2012.Google Scholar
7.Callaway, DW, Smith, ER, Cain, J, et al. Tactical Emergency Casualty Care (TECC): guidelines for the provision of prehospital trauma care in high threat environments. J Spec Oper Med. 2011;11(3):104-122.CrossRefGoogle ScholarPubMed
8.Sztajnkrycer, MD. Tactical medical skill requirements for law enforcement officers: a 10-year analysis of line-of-duty deaths. Prehosp Disaster Med. 2010;25(4):346-352.CrossRefGoogle ScholarPubMed
9.Elam, JO, Brown, ES, Elder, JD Jr. Artificial respiration by mouth-to-mask method: a study of the respiratory gas exchange of paralyzed patients ventilated by operator's expired air. N Engl J Med. 1954;250(18):749-754.CrossRefGoogle Scholar
10. American Heart Association Web site. History of CPR. http://www.heart.org/HEARTORG/CPRAndECC/WhatisCPR/CPRFactsandStats/History-of-CPR_UCM_307549_Article.jsp. Accessed December 9, 2012.Google Scholar
11.Butler, FK Jr, Hagmann, J, Butler, EG. Tactical combat casualty care in special operations. Mil Med. 1996;161(suppl):3-16.CrossRefGoogle ScholarPubMed
12.Calkins, MD, Robinson, TD. Combat trauma airway management: endotracheal intubation versus laryngeal mask airway versus combitube use by Navy SEAL and Reconnaissance combat corpsmen. J Trauma. 1999;46(5):927-932.CrossRefGoogle ScholarPubMed
13.Butler, FK Jr, Holcomb, JB, Giebner, SD, McSwain, NE, Bagian, J. Tactical combat casualty care 2007: evolving concepts and battlefield experience. Mil Med. 2007;172(11 suppl):S1-S19.CrossRefGoogle ScholarPubMed
14.Cordts, PR, Brosch, LA, Holcomb, JB. Now and then: combat casualty care policies for Operation Iraqi Freedom and Operation Enduring Freedom compared with those of Vietnam. J Trauma. 2008;64(2 suppl):S14-S20.Google ScholarPubMed
15.Tien, HC, Jung, V, Rizoli, SB, Acharrya, SV, McDonald, JC. An evaluation of tactical combat casualty care interventions in a combat environment. J Am Coll Surg. 2008;207(2):174-178.CrossRefGoogle Scholar
16.Mabry, RL, Edens, JW, Pearse, L, Kelly, JF, Harke, H. Fatal airway injuries during Operation Enduring Freedom and Operation Iraqi Freedom. Prehosp Emerg Care. 2010;14(2):272-277.CrossRefGoogle ScholarPubMed
17.Adams, BD, Cuniowski, PA, Muck, A, De Lorenzo, RA. Registry of emergency airways arriving at combat hospitals. J Trauma. 2008;64(6):1548-1554.Google ScholarPubMed
18.Gerhardt, RT, Berry, JA, Blackbourne, LH. Analysis of life-saving interventions performed by out-of-hospital combat medical personnel. J Trauma. 2011;71(1 suppl):S109-S113.Google ScholarPubMed
19.Holcomb, JB, McMullin, NR, Pearse, L, et al. Causes of death in U.S. Special Operations Forces in the global war on terrorism: 2001-2004. Ann Surg. 2007;245(6):986-991.CrossRefGoogle ScholarPubMed
20.Mabry, RL, Frankfort, A. Advanced airway management in combat casualties by medics at the point of injury: a sub-group analysis of the reach study. J Spec Oper Med. 2011;11(2):16-19.CrossRefGoogle ScholarPubMed
21.Gallo, AC, Adams, BD. Emergency battlefield cricothyrotomy complicated by tube occlusion. J Emerg Trauma Shock. 2009;2(1):54-55.CrossRefGoogle ScholarPubMed
22.Larsen, MJ, Guyette, FX, Suyama, J. Comparison of three airway management techniques is a simulated tactical setting. Prehosp Emerg Care. 2010;14(4):510-514.CrossRefGoogle ScholarPubMed
23.Seamon, MJ, Fisher, CA, Gaughan, J, et al. Prehospital procedures before emergency department thoracotomy: “scoop and run” saves lives. J Trauma. 2007;63(1):113-120.Google ScholarPubMed
24.Metzger, JC, Eastman, AL, Benitez, FL, Pepe, PA. The lifesaving potential of specialized on-scene medical support for urban tactical operations. Prehosp Emerg Care. 2009;13(4):528-531.CrossRefGoogle ScholarPubMed