An officer has been shot in the upper thigh while responding to a bank robbery. Now the officer is pinned down behind cover, calling for help over his radio in a weakened voice and bleeding profusely as he attempts to improvise a tourniquet to his own leg. The heavily armed bank robbers are continuing to engage targets of opportunity, but the officer may die if he’s not able to receive medical treatment very soon.
A victim of a school shooting is bleeding profusely from multiple gunshot wounds in a second-story classroom while officers search a large school building for an unknown number of shooters. Attempts by bystanders to control the victim’s bleeding have been unsuccessful, and his condition is rapidly deteriorating. If the patient is going to survive, he must immediately be moved through the building, down the stairs and across several hundred yards of open ground to the closest EMS triage area.
The sooner these patients are rescued, the sooner they can receive medical treatment and transport to a hospital. How do you extract them rapidly and in the safest manner possible? Much like rifles, ballistic helmets and aggressive response tactics to active shooters, rescue of downed officers and civilians was previously thought of as a topic reserved for SWAT officers.
Recently, this topic has been finding its way into basic and in-service training for street officers, where it will likely do the most good. Victims often don’t have the luxury of waiting for SWAT to arrive. Ad hoc teams of patrol officers, detectives and supervisors from multiple agencies may be forced to act with limited equipment and personnel.
The purpose of emergency rescue operations is to save lives, not to unnecessarily risk lives to recover the body of a victim who is obviously dead. Dr. Matt Sztajnkrycer, “SWAT Doc” with the Rochester/Olmsted County (Minn.) Emergency Response Unit, has explained that military scenarios differ from law enforcement scenarios in that the latter won’t likely result in desecration of bodies temporarily left behind. Additionally, officers will usually have the opportunity to recover bodies at the conclusion of the incident. Investigators, medical examiners or coroners will want bodies left where they are, if possible, during the post-incident investigation.
This article is by no means intended to be all-inclusive. Rather, it’s intended to focus on a few simple, fast and effective techniques that will help street officers to move victims out of the hot zone.
In a perfect world, rescues would always be conducted using armored vehicles and personnel fully clad in Kevlar moving behind armor shields—a scene reminiscent of a Roman tortoise formation. In reality, we know that the majority of situations that arise won’t include the rapid availability of those resources. However, there are a few pieces of gear easily carried by officers on patrol that may significantly enhance survivability. Officers armed with patrol rifles can provide more effective cover for the rescuers over longer distances. Ballistic helmets and hard armor plate carriers will provide extra protection for rescuers. Helmets will also protect rescuers’ heads from accidental blunt impacts as they move rapidly in, out and around rescue vehicles.
Compact binoculars or a monocular will aid officers in conducting a remote assessment of potential victims prior to a rescue attempt. Observing the victim’s chest rise and fall or visible breath in cold weather indicates the victim is still breathing. Active bleeding indicates the victim still has a pulse. Remote assessment may also help determine the type and location of injuries, potential threats, cover, and avenues of ingress and egress for rescuers. By determining if a victim is a viable patient and whether the patient will benefit from a timely rescue, officers can avoid committing personnel to a dangerous and unnecessary rescue attempt.
Numerous products can be fashioned or purchased that will increase rescue capabilities and options. Ropes, tubular webbing or various types of patient carrying devices may enable rescuers to avoid unnecessarily exposing themselves or the victim to additional threats or make it easier to move the victim to safety.
According to Paul Howe, retired Special Forces operator and police trainer, “body armor can either help us or hinder us in accomplishing this task.” Protection and gear must be balanced with the need for speed and maneuverability. Overloading with gear takes time when time is scarce. Moreover, it’s heavy. The only tools that are required to complete many rescues are knowledge, communication and an ability to think fast and improvise.
Shields, armored vehicles and specialized extraction tools are great if they’re available. But for most officers, access is either not possible or far away. Often, those patrol officers who have specialized tools available don’t get the necessary training time to be proficient with them. Shields can also be bulky, awkward and slow for officers who aren’t used to operating with them. Their usefulness is limited by the fact that portable shields don’t stop rifle ammunition, and shield rescue tactics may require more personnel and shields than small agencies have available. In reality, street officers are more likely to be able to make a difference using patrol cars than shields and armored vehicles.
Because most officers don’t have specialty rescue equipment readily at their disposal, they will most likely drag or carry the victims. Don’t forget to determine whether a victim can walk under their own power or with assistance prior to attempting a drag or carry. Any technique that permits a rescuer to shoot if necessary is nice, but speed is more important if your goal is to get the victim out of the hot zone and to medical attention. Also, accuracy may be severely hampered if you’re trying to shoot one-handed while dragging or carrying another person, regardless of the method or equipment you are using. Utilize cover officers whenever possible instead of trying to provide your own cover during a rescue attempt.
Dragging is easier and faster with unresponsive victims over short distances or when a low profile must be maintained. One of the most recognizable drags is a single rescuer lift/drag. It’s commonly used by the fire service and is seen during the yearly Firefighter Combat Challenge competition. It’s performed by a single rescuer who sits the victim up, positions himself behind, reaches under the victim’s arms, grabs the victim’s wrists and then stands dragging the victim backwards. Lift with your legs instead of your back to help avoid injury. This common drag prevents the victim from sustaining additional head or torso injuries from dragging along the ground. However, it may be slow and hard to perform if the rescuer isn’t significantly larger than the victim. Although brute strength is a great asset for moving victims, it shouldn’t be required.
Drags can be performed over very short distances by simply grabbing the victim’s wrists or feet and pulling them. Be aware that the patient’s head is uncontrolled and may possibly sustain injury contacting the ground. Use wrists and feet only when absolutely necessary to get the victim out of the line of fire.
Dragging the victim by their collar or gear may also be effective but be aware that the victim’s airway may be compromised by their position during the drag. Don’t drag a victim face down when the victim’s face will be in contact with the ground. Also, several tactical medics I’ve met reported that so-called “drag handles” on body armor or equipment vests are often not strong enough to drag the entire weight of a fully equipped officer. Medics have reported drag handle failures during training on various models from well-known equipment manufacturers. Instead, grab the shoulder straps of an external vest or carrier instead of a drag strap. If available, an inexpensive 20–25 feet of tubular webbing sewn in a loop can greatly aid one or two officers in moving a victim by fashioning an improvised harness. A 5–6 foot length of heavy duty rope or webbing with carabiners at each end attached to the victim and rescuing officers’ gear can allow the rescuer to drag the victim while keeping hands free for other tasks.
Carries may be preferable to drag techniques when victims must be moved over uneven terrain or for long distances and if a low profile isn’t required. Although the classic fireman’s carry evokes a common rescue image, some fire departments have reportedly stopped using it due to injuries sustained by rescuers. It can be difficult for many rescuers to get an unresponsive victim onto their shoulders without assistance. Likewise, the one-person pack strap carry can also be difficult for a lone rescuer to establish with an unresponsive victim. For this technique, a victim’s arms are placed over the rescuer’s shoulders and the rescuer grasps the victim’s wrists. Squat and bend forward slightly keeping the victim’s weight over your hips. Both of these carries can be very effective for a lone rescuer if another officer or bystander can assist getting the victim into position. They may be your best option.
The options greatly increase if two rescuers are available in addition to any cover officers. One of the best two-rescuer carries is a two-person extremity carry. The first rescuer sits the victim up, positions himself behind the victim, reaches under the victim’s arms and grasps the victim’s wrists just like the single rescuer lift or drag. The second rescuer positions himself between the victim’s legs, facing the victim’s feet and grasping the victim’s legs. Both rescuers stand at the same time. This technique doesn’t allow either rescuer to engage targets, but the rescuers can move very rapidly and over uneven terrain. Have other officers provide cover while using this technique.
When a victim is down outdoors and good cover isn’t available, patrol officers may have to use vehicles to perform a rescue. Patrol cars are readily available and provide limited cover and concealment along with a rapid means of ingress and egress from the hot zone. By reducing rescuers’ time on target, and providing limited but highly mobile cover, we can increase the odds of a successful rescue.
Ideally, three or four officers would perform a patrol car rescue. One officer acts as driver, one as cover officer and two as rescuers. If only three officers are available, either the driver or one of the rescuers may have to provide a lesser level of protective cover while the car is stopped and most vulnerable.
The rescue team speeds across the open ground in the patrol car and stops as close as possible to the victim while the driver remotely opens the trunk lid. The rescuers exit the car, grab the victim and all three fall into the open trunk of the car. If available, the cover officer may exit the car also but remain close enough to rapidly re-enter the car when the rescuers are ready for egress. When all officers and the victim are in the car, the driver gets the team out of the danger area as fast as possible. Remember: The rescuers and victim in the open trunk may have little to hang on to. Officers should try to use as much of the patrol car as cover and concealment as possible throughout the rescue.
Other vehicles around your community may also be available to provide limited ballistic cover during a rescue. Images of officers utilizing fire trucks during the Columbine massacre and private armored trucks during the North Hollywood shootout are ingrained in our memories. Additionally, sanitation trucks and dump trucks may provide enough cover to safely extract a victim.
Note: Most civilian armored transport company trucks aren’t designed to stop rifle caliber ammunition. Try to keep the unprotected cab of a fire truck, sanitation or public works truck faced away from the threat in order to provide the driver with the most protection. Some of these large vehicles may even be equipped with rear-facing back-up cameras that may aid in approaching the victim in the hot zone.
Officers don’t have much time to formulate new ideas or debate options for rescue while victims bleed to death. Our first objective during a violent incident is to save lives. We must act quickly during rescues, but that must be balanced with the need to avoid unnecessary risks to personnel by trying to recover an obviously dead body. Law enforcement operations in most jurisdictions involve very limited initial manpower, weapons and support. Officers must not fall victim to emotions and realize that a failed rescue attempt may result in would-be rescuers who are now injured or dead, further complicating the situation.
Practicing remote assessment will help prevent rescuers from blindly rushing into a hot zone. Practicing simple drags and carries will enable responding officers to get victims and themselves out of the hot zone more quickly, which increases the odd of survival for both parties.
Agency trainers have a responsibility to integrate rescues into other departmental training. After providing officers with the basic skills, rescue scenarios should be unexpected and sudden for maximum benefit. “Downed” subjects may be randomly chosen during scenarios at the moment of injury. Dependable personnel may also be assigned as undercover “victims” who are given private instructions prior to training regarding when and where they should simulate an injury requiring rescue.
Check with your local fire department or technical rescue team for advice on the use of rope and tubular webbing to move victims. Be aware of the resources and tools that may be available if a rescue must be attempted before the arrival of specialized teams and tools. Instead of wasting time wishing for tools you don’t have, spend your time practicing with the tools you’ve got.
Thanks to the following for their assistance with this article:
Winnebago Co. (Iowa) Sheriff’s Office, Lake Mills (Iowa) Police Department, Scarville (Iowa) Fire Department, Romeoville (Ill.) Fire Academy, Dr. Andrew Dennis, Cook Co. Trauma Unit (Chicago, Ill.), Cook Co. Sheriff’s Police HBT, Des Plaines (Ill.) Police Department, and NIPAS EST.