Addressing The COVID 19 Pandemic

I have no doubt that all of us have heard WAY more than we would like to about the COVID 19 Pandemic.  However, since so many officers have become infected, and sadly a couple of law enforcement officers have died because of COVID 19, I would feel remiss if I didn’t address this topic as the SCT medical representative.  In this medical Monday we will attempt to provide some preventative measures, some decontamination procedures, and address some misinformation that may be floating around.  I have two disclaimers before we get started. This is not intended to replace your specific department’s plans or protocols.  Information on how to best combat COVID-19 is literally changing by the hour.  (While working at the hospital on 04/03/2020 we had two policy changes within one hour.)

Allow me to begin by discussing preventative measures.  In a previous Medical Monday post talking about medical gloves (Pre COVID-19 days) I stressed the importance of proper hand washing.  This is not a new concept.  In 1846 a physician working in a labor and delivery ward in Vienna began an investigation as to why so many women were developing fevers and dying in the hospital as opposed to women that opted to have home births.  He discovered that doctors at the hospital were performing autopsies and then going directly to the labor and delivery floor to assist with the delivery of the newborn.  Women who delivered their newborns at home with the assistance of midwives on the other hand did not receive as much of an exposure to disease because the midwives were not performing autopsies.  Dr. Semmelweis implemented a new regulation that the physicians at the hospital begin washing their hands between procedures.  Doctors in 1846 and modern-day law enforcement have a lot in common because at the time, the physicians thought that this change was essentially a bunch of bullshit (the way LE reacts to change in general).  Long story short, eventually over time it was found that handwashing is the number one way to reduce catching and spreading disease.  This statement is true to this day.  With that being said, YOU HAVE TO WASH YOUR HANDS CORRECTLY!  This means wash them with soap and with water.  Let me further break this down:

Step 1.  Get your hands wet.

Step 2.  Put soap on your hands

Step 3.  Rub the soap over the entirety of the hands to include the fingernail areas and at least three inches above your wrists

Step 4.  SCRUB for TWENTY (20) seconds  

Step 5.  Rinse off the soap under running water 

Step 6.  Dry your hands

You need to wash your hands before and after eating, after coughing or sneezing, after handling garbage, after you use the bathroom, after handling a suspect, and any other time that you even remotely think that you may need to wash your hands.  Many of you may have the mindset that you will just use the hand sanitizer in your patrol vehicle.  That is fine as a temporary measure (if you can even find some), but you still need to wash your hands as soon as you are able to locate running water and soap.  Additionally, make sure that the hand sanitizer that you are using is at least 60% alcohol.   

The next preventative measure is…DON’T TOUCH YOUR FACE WITH YOUR HANDS!  Germs get onto your hands and as soon as you touch your face those germs or the virus is much closer to your airway where it can grow and cause infection.  

WIPE EVERYTHING DOWN WITH A DISINFECTANT WIPE!  If you do not have access to disinfectant wipes, you can make your own cleaning solution by placing 4 teaspoons of bleach in a quart of water, or 1/3 cup of bleach in a gallon of water.  When you go on duty, ensure that you spray and wipe down all surfaces.  Wipe down the steering wheel, seatbelt and buckle, headrest, and any other surfaces that you come into contact with.  As far as radios go, Motorola released guidance advising to apply rubbing alcohol with at least a 70% concentration to a cloth, and then use the cloth to clean the radio.  Do not forget about the radio and mic in your patrol car as well.  Make sure that you wipe down your duty gear.  

In our basic law enforcement training academy, we were taught that DISTANCE IS OUR FRIEND.  It seems as if that advice is more than applicable in this day and age.  I have seen many different policies that different departments have implemented to protect their officers.  Regardless of your specific department has implemented, try to stay SIX feet away from people on or off duty.  This obviously doesn’t apply when you are at your home although some healthcare professionals have gone to some extraordinary lengths separating themselves from their family through this crisis.  

Moving on to masks…This is where information becomes tricky.  According to the National Institute of Safety and Health, the N95 mask that you have been hearing so much about in the news is the minimum standard for contact with known COVID-19 patients.  It is named N95 because it filters out 95% of particles in the air that are 0.3 microns in size.  There are a couple of issues.  I strongly suspect that hardly any agencies are requiring an N95 fit test upon hiring of new officers.  To wear the N95 respirator, it needs to be fit tested to ensure that the mask will work correctly.  As I am also sure that you have seen in the news, N95 masks are difficult to come by.  

The CDC is now recommending that people wear a cloth mask when out in public.  The theory is that the cloth mask will reduce the chance of you passing COVID-19 to others in public.  It is possible to be infected with COVID-19 and only exhibit minor symptoms, or even no symptoms at all.  The issue that I have with the cloth mask is that there has not been nearly enough research done to see exactly how many particles that these masks will filter out.  There are varying types of fabric.  Some cloth masks have slots made for coffee filters, or other home-made options.  The surgical masks and or cloth masks are ok for filtering out the large airborne particles, or good for blocking the fingers touching a large area of the face.  Again, information is changing on a continual basis.  When it comes to wearing masks, follow your department’s guidelines.  

Decontamination is absolutely essential when you get off shift and go home.  I recommend that you think of all of the areas outside of your home as the hot zone (direct threat).  Think of your garage or if you don’t have a garage, your entry way in your home as the warm zone (indirect threat).  The interior of your home is the cold zone.   

 The first step to decontamination is that when you get off duty, you again wipe down all of your duty belt equipment.  Change into civilian clothes (I have been changing into sweats and a t-shirt).  If you have a washing machine and dryer at your department, I highly suggest washing it at work. If not, place your uniform into a plastic bag.  Place your uniform into the trunk of your personal vehicle, or if you have a take home car, place it in the trunk as well.  When you arrive home, place your uniform as well as your clothes that you wore home into the washing machine and start it.  Go directly to your bathroom and shower.  I suggest leaving your footwear in your garage or entry way.  Make sure to wash your boots (especially the soles with hot soap and water).  The last thing that you want to do is risk bringing any type of sickness into your home or to your family.   All of these steps are merely a suggestion.  If you have a more efficient option, I would love to hear about it in the comments.

The last topic I will address in relation to COVID-19 is mental health.  Mental health could be discussed in multiple Medical Mondays, but for now make sure that you are taking care of yourself.  While off duty, try to focus on something that is not law enforcement related.  Read a new book.  Watch a new show on Netflix.  Play a board game with your family.  Whatever you do, don’t go home and become vapor locked on the news.  By giving yourself a break, you will be more focused and present while you are on duty.  Try to exercise patience, understanding, and kindness not only to the public that we serve, but also to your colleagues and family.  

This may not have been the most earth-shattering post, but if it helps even a single officer, the time to put it together is well worth it.  I promise a much sexier Medical Monday post in the near future.  Please watch out for each other.  Please take care of yourselves and your families.  If you have any questions or comments, please reach out, or put them in the comments section below.  Stay safe, take care of each other, and WASH YOUR HANDS! 

Be a Mentor

As proactive officers today in law enforcement, there are more obstacles to overcome daily in our efforts to interdict the criminal element than there have ever been.

Many of these obstacles are from outside influences. However, some of them, sadly enough, come from inside the walls of our department. Sometimes they come from our teammates around us. Unfortunately, those officers will always be speaking negatively about proactive police work. For a new officer who is excited about the job and yearning to go out and have fun doing the job they signed up for, those types of negative interactions with fellow officers can and will have a significant impact on the kind of officer they decide to become.  

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A VERY Brief Summary of the Recent SCOTUS Second Amendment Case

In New York State Rifle & Pistol Association v. Bruen, decided late last week, the Supreme Court held that the Second Amendment protects an individual’s right to carry a handgun outside the home for self-defense. Prior to Bruen, it wasn’t certain that the Second Amendment did protect such a right. As with most rights protected by the federal constitution, the right to keep and bear arms is not absolute. The government can, and does, enact reasonable legislation that limits the right.

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Shock and Some Important First Aid Care

It is practically guaranteed that when you become a law enforcement officer, you will undoubtedly witness some shocking events (pun intended) throughout your career.  Many of those events will involve some sort of medical element to it.  In this week’s Medical Monday, we will be breaking down the different types of shock, and some critically important first aid care that you can provide as an officer.  

The simplest definition of shock that I can come up with is that some type of event has happened to the body, and the body’s needs are not being met.  Initially in most cases the body will compensate or attempt to compensate.  Eventually if shock is not treated, the body will no longer be able to compensate, and the patient will die.   

To understand compensation and decompensation when discussing shock, I like to use the example of a city.  Imagine a large city such as Los Angeles.  The city government provides multiple services such as police, fire, ems.  They also provide electrical services, waste services, water services, etc.  In order for the city to run efficiently, each service must pull their fair share of the weight and perform their duties well.  For our example, imagine that the waste service workers go on strike and refuse to perform trash pick-up.  The first couple of weeks may not be too terrible, and the city would be able to compensate.  However, if the strike were to go on for months on end imagine the impact on the city that would have.  Fire departments would be running more fire calls, police would be running more calls, hospitals would be overcome with sick patients due to disease from the buildup of the trash.  The economy of the city would be negatively impacted.  If this crisis continued, the city would for all intents and purposes die off if no aid was given.  

The human body has a vast array of different systems, organs, and cells that need to work together toward the goal of living and being healthy.  If one system is affected significantly, all other systems become affected as well.  If not corrected, the body will eventually go into shock.  

There are four main categories of shock.  Each category breaks down into subcategories.  For our purposes today, we will focus on the four main types. They are as follows:

  • Hypovolemic Shock – This is the type of shock that most officers will be the most familiar with.  This type of shock most commonly is the result from significant blood loss due to trauma to the body.  As many of us have learned, it is critically important to treat this type of shock by stopping the bleeding and covering the patient with a blanket.  We will discuss this point further into the article.  
  • Distributive Shock – This is the most common type of shock.  This is the type of shock that a person who is severely allergic to bee stings or other allergens that produce a life-threatening reaction will experience.  A massive fluid shift occurs in response to the invading substance (such as a bee sting) that causes significant swelling to the airway.  Because the airway is being closed off, it obviously makes it a critical medical event. 

 The treatment for this type of emergency is administration of an EpiPen.  Most police departments do not have a policy in place nor provide an EpiPen for officers to administer.  For this type of shock, it is important to remove the substance causing the reaction.  In the case of the patient that has a stinger, it is important to remove the stinger using a scraping motion with a credit card or ID card.  Do NOT use tweezers as it could inject more venom into the patient causing a worse reaction.  Expedite EMS and allow the patient to position themselves to where it is easiest for them to breathe.     

This type of shock is also seen in very sick patients who become septic.  Sepsis is a subcategory of this type of shock.  

The last subcategory of this type of shock is neurogenic shock.  This could be observed in patients with a significant head, neck, or spinal cord injury.  The important treatment for a patient experiencing this type of shock is rapid transport to a hospital.

  • Cardiogenic Shock – As the name implies, this type of shock occurs due to an issue within the cardiac system.  Quite simply, the heart is nothing more than a pump that circulates the blood throughout the body.  When the pump is not operating optimally, problems begin to develop.  For these patients, it is important to loosen restrictive clothing such as neck ties, shoes, belts, etc.  It is also important to allow them to get into a position of comfort.  Expedite EMS, and again, cover the patient with a blanket.  
  • Obstructive Shock – This type of shock occurs when pressure is being exerted upon the greater vessels or upon the heart.  The most common example that law enforcement officers may have heard of before is tension pneumothorax.  If a hole has been made in the lung tissue, air will escape into the chest cavity causing a buildup of pressure.  This type of pressure could also be caused by a hemothorax which is blood that is collapsing the lung and placing pressure onto the greater vessels and heart.  If there is an open wound, it is absolutely vital to cover that wound with a chest seal.  Be sure to check for an exit wound as well.  Any hole found from the neck to the waist all around the body should be covered with a non-occlusive dressing.  

Another medical condition that obstructive shock falls under is pericardial tamponade.  The heart sits within a protective sac.  When the chest has been struck with a lot of force, that sac can fill with fluid and obstruct the heart from beating efficiently.  

With all of that being said, here are the main pearls of wisdom that officers can apply when treating patients prior to EMS arrival.  

  1. Shock is way easier to prevent than to treat.
  2. The two main indicators that a patient is experiencing shock are: altered mental status, and absent OR abnormal radial pulses.  
  3. If the patient is another law enforcement officer and they are experiencing an altered mental status, you MUST disarm the officer!
  4. PLACE A BLANKET ON THE PATIENT TO KEEP THEM WARM!!!!!  I cannot stress this enough.  I will do a future Medical Monday covering the Lethal Triad.  One of the elements of the lethal triad is hypothermia.  When a person goes into shock, the body loses the ability to conduct temperature regulation.  The outside ambient temperature could be 110 degrees, and the patient that is experiencing shock will become hypothermic if it is not treated.  If the patient becomes hypothermic, their blood will lose the ability to clot along with a host of other negative impacts.  Bottom line….COVER THE PATIENT WITH A BLANKET.  
  5. It is immensely helpful to the EMS providers if you can keep them updated while they are responding to the scene.  The number of patients, what is generally wrong with the patients, and any scene hazards are a few great pieces of information to begin with.  

One last note before we conclude this Medical Monday.  It had been taught for many years to elevate the legs of patients in shock.  After many medical studies it was found that elevating the legs not only provided no benefit to the patient, in some cases it caused a medical complication called pulmonary edema.  

As always, I hope that you enjoyed this installment of Medical Monday.  If you have any questions or if you would like to provide further discussion, comment below.  

The Rural Beat

Let me lead by saying that Mayberry has never existed before and does not exist now. However, that does not mean that aspects of that fictional world do not manifest themselves. We have talked about rural policing before. It gets brought up occasionally, but it’s never given much afterthought. I know it’s called “Street Cop Training,” so the programs are geared towards urban policing. However, rural cops are still a thing that exists. As a rural cop, I wanted to take a moment and wax poetic about what it’s like to “walk” the rural beat in 2022. 

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Walk a mile in my shoes…

All too often, opportunities to advertise the genuine moving parts of policing are missed. When figureheads of any relative law enforcement agency attempt to answer questions posed, I tend to cringe as I can almost guarantee the essential elements of the forthcoming response; “I’m sorry…We failed to…. We take the allegations seriously…etc.” The most basic requisite functions of our mission (protecting & serving) often require the “pretty” to meet the “ugly” in terms of what society has to offer, yet we stand steadfast to consume the bitter-tasting meal. How can a profession maintain dignity or commitment from cast when the voices of our executives instinctively bow down instead of standing tall?

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Increase In Crime? Solution: Cut Funding to Law Enforcement 

At this point, nothing should shock me anymore. Yet I cannot help but feign a little surprise at the actions of the West Hollywood City Council. Los Angeles is seeing an increase in crime at an alarming rate. The more agencies are defunded and told to fight crime with one arm tied around their backs. The more crime will continue to ascend into the smoggy atmosphere. It is almost as if these actions have consequences, and anyone with a functional brain stem could see this coming. 

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48-hour Shifts: Michigan Police Try Something New

 A small police department in Jonesville, Michigan, is trying something new. A recent job posting by the Jonesville Police Department on the city’s website sought to hire two full-time police officers who would work 48-hour shifts with 96 hours off, as the type of shifts seen at fire departments and emergency medical services around the country.

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