Exploring the role of police in out-of-hospital cardiac arrest response
Academic Emergency Medicine
Background: Despite improvements in patient- and systems-level processes to treat prehospital cardiac arrests, survival continues to be low with significant variation for the 356,000 annual prehospital cardiac arrests in communities in the United States. Although police are often arrive first to cardiac arrest incidents, the impact of police administered resuscitative efforts on outcomes is poorly understood. This study aims to evaluate the trends of police response to out-of- hospital arrest and perceptions of prehospital providers regarding how police can be leveraged to improve survival rates. Methods: The Michigan Cardiac Arrest Registry to Enhance Survival dataset spanning 2014-2017 were analyzed to assess temporal trends of police response to cardiac arrest. These data were supplemented with semi-structured qualitative interviews and focus groups conducted during site visits to three communities across Michigan where emergency medical services, police departments, fire departments, and dispatch centers were queried about the role of non-medical first responders—including police—in responding to out-of-hospital cardiac arrest. Results: Four years of Mi-CARES registry data which included a total of 21,122 registered cardiac arrests were analyzed. Over this time frame, AED application by police remained fairly stable from 4.0% to 4.5% of all cardiac arrests. Qualitative data suggest most interview respondents believe that the role of police in cardiac arrest response is critical, as police often patrol in close proximity to arrest locations, thereby reducing time to chest compression initiation. Further, respondents identify cross-training between departments (e.g., police, fire, EMS) as a way to improve quality of resuscitation by police and collaboration on the scene to optimize results. Still, some police respondents expressed concern about the inclusion of increasing medical responsibilities in their scope of practice. Conclusion: We found modest use of AED application by police over the studied years. Across response team stakeholders, we found broad recognition of police as critical members of the cardiac arrest response team. These findings suggest greater police engagement as a novel opportunity to improve cardiac arrest survival and reduce the persistent survival gap among communities in the United States.
Salhi R, Lehrich J, Brent C, Nelson CD, Fertters N, Guetterman TC, Mendel P, Swor R, et al. Exploring the role of police in out-of-hospital cardiac arrest response. Acad Emerg Med 2019; 26: S268.