Trending Topics

Significant Medical Behavior: Tactical Response to Medical Emergencies

In my last tactical tip, I discussed how to recognize the signs and symptoms of Significant Medical Behavior, a term used to describe a broad category of life-threatening medical conditions from Positional Asphyxia and Cocaine Psychosis to Excited Delirium.

You can read it here: Significant Medical Behavior: Sign & symptoms of impending disaster

In this tip, I am going to discuss how to respond to Significant Medical Behavior.

Above all else, the key to a safe and efficient response to Significant Medical Behavior is early recognition.

For example, you should view a naked person walking down the street - sweating and talking incoherently with eyes bulging out of their head - not as a laughing matter but instead as a warning sign. You could be dealing with a dangerous situation here, both because the person could become violent and because they could be exhibiting signs of a life threatening medical condition.

Check out this video and see how many signs and symptoms of Significant Medical Behavior you can see in the naked subject:


BLUtube is powered by PoliceOne.com

I have developed a set of guidelines to act as a general template for managing Significant Medical Behavior. Its components are:

1. Early recognition
2. Notification / Planning
3. ALS Notification / Staging
4. Area Stabilization
5. Subject Stabilization
6. Medical Stabilization
7. Medical Transportation
8. Follow Through

Let’s look at each of them one at a time:

1. Early recognition: We recognize the signs and symptoms of Significant Medical Behavior and begin to mobilize our resources. Trust your gut: If it looks, sounds, and smells like a duck then it’s probably a duck. Don’t delay, get your backup responding.

2. Notification / Planning: We need to notify our dispatcher and begin planning our response. This includes getting both security and medical units responding. You need to train your dispatchers to recognize the signs & symptoms of Significant Medical Behavior so they will forward you important information and get appropriate security and medical backup coming.

3. ALS Notification / Staging: Request an Advanced Life Support (ALS) response to your location, not a Basic Life Support (BLS). This call may require more than a BLS unit can deliver (most likely the subject will need to be sedated). The request for an ALS unit should be part of a prearranged medical protocol: As soon as the officer explains the signs and symptoms they are seeing, the proper unit should be on its way. Again through prearranged protocols, the ALS unit should stage in a safe location until the subject is stabilized. They then will be ready to make a quick entry on to the scene.

4. Area Stabilization: The initial officer(s) on the scene should attempt to contain the subject in one area until enough back-up arrives to safely and efficiently stabilize the subject physically. Moving in too soon is dangerous for both the officers and the subject. Further, it could cause a subject to flee. Instead, stay in sight and wait for other units to arrive and assist you.

5. Subject Stabilization: Rapid subject stabilization is in the best interest of all parties involved. The TASER is a great tool for assisting in the stabilization of a subject experiencing Significant Medical Behavior, if it is used in association with efficient team tactics in order to minimize the amount and duration of force used. Check out the following Corrections1 Video Tactical Tips that instruct officers in team tactics:

Prone Stabilization: Controlling the Legs

Prone Stabilization: Controlling the Head

Prone Stabilization: Controlling the Arms

6. Medical Stabilization – Once the subject is stabilized the ALS unit should immediately begin to provide medical stabilization for the subject.

7. Medical Transport – This initial medical stabilization needs to be followed immediately by medical transportation to a medical facility for continued supervision. Remember that medical transportation is the only correct mode of transportation for a subject experiencing a possible life threatening medical emergency.

8. Follow Through – Finally, the officers will need to follow through. Persons who experience Significant Medical Behavior will need to go somewhere after the emergency room. This may include remaining in the hospital, being transferred to jail, being transferred to a mental health facility or released to go home if no criminal charges are pending. The bottom line is, the one place you don’t want the subject to go is the morgue for an autopsy. Early recognition and proper response are key to maximizing the subject’s chance of survival and minimizing your potential liability.

Remember, how you respond to a situation will determine how safe you can keep both yourself and the subject. Early recognition is critical. Having a plan in place will do much to improve both the speed and quality of your response while best maintaining the safety of everyone involved.

Gary has been involved for over fifteen years in the development of both training & duty trauma protective equipment. He is currently employed by Police1.com as a Use-of-Force subject matter expert, researcher, program developer, and training specialist where he continues to provide tactical communication skills and defensive tactics training. His collaboration with the Force Science Research Center, Team One Network, Northeast Wisconsin Technical College, Verbal Judo Institute, and Purposeful Development Associates allows him to bring the most current tactical and instructional insights into his training programs. He is the lead instructor for Verbal Judo’s Tactical Communication for the Correctional Professional training program.
RECOMMENDED FOR YOU