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Your ED can become an integral part of law enforcement response teams. Health care providers and law enforcement personnel must have special training. Preventive medicine is a critical component of Tactical Emergency Medicine Support (TEMS). TEMS can be a valued community service and improve the public's perception of your facility.
OBJECTIVE: To assess the knowledge and attitudes of law enforcement officers regarding treating out-of-hospital cardiac arrest (OHCA) and using automated external defibrillators (AEDs). METHODS: This was a survey conducted among officers serving Marion County, Indiana. RESULTS: Of 1,130 surveys distributed, 929 (82.2%) were returned. Among these officers, 603 (66.4%) were certified in cardiopulmonary resuscitation (CPR) and 103 (11.3%) had received AED training. Most officers had limited knowledge regarding OHCA. A 100-point knowledge score (mean +/- SD: 31.9 +/- 14.3) was higher in officers who had performed CPR while on duty [35.0, 95% confidence interval (95% CI) = 32.9 to 37.2, p = 0.005] and who were AED-trained (40.8, 95% CI = 38.0 to 43.6, p < 0.001). Of the respondents, 367 (40.1%) believed that AED usage by local law enforcement was needed, and 323 (35.6%) stated that they would feel comfortable using an AED if trained. A 100-point attitude score (mean +/- SD: 32.1 +/- 21.0) was higher in officers who had CPR certification (38.2, 95% CI = 35.6 to 40.8), who had performed CPR while on duty (40.6, 95% CI = 37.7 to 43.5), who were AED-trained (39.5, 95% CI = 35.6 to 43.4), and who had improved OHCA knowledge (+3.8 per 10 points knowledge score, 95% CI = 3.0 to 4.7), p < 0.001, all significant factors. CONCLUSIONS: Limited knowledge and negative attitudes of law enforcement officers regarding their involvement in treating OHCA and using AEDs are commonly present. These factors could result in barriers that negatively impact law enforcement AED programs.
This study of tobacco possession law enforcement was conducted in four selected counties in Florida, the first state to report statistically significant annual declines in youth tobacco use during the 1990s. The primary objective of this study was to assess the impact of possession enforcement on youth attitudes, perceptions, and behaviors by comparing results of a survey administered in high-enforcement counties with results from low-enforcement counties and by examining the survey results for relationships of tobacco use to perceptions and awareness of laws and enforcement activity. The survey was administered to a sample of 2,088 randomly selected youth, in conjunction with a qualitative study of law enforcement officials reported elsewhere. Findings indicate that possession enforcement, as a component of comprehensive tobacco control, appears to help reduce youth tobacco use and may be a critical component of the most successful youth tobacco prevention program, documented in the previous decade.
In the closed society of a law enforcement agency, factors such as the conspiracy of silence, authoritarian supervision, and police discretion contribute to corruption. This article describes various types of corrupt behavior by police officers, reports the incidence of corruption in law enforcement agencies, discusses psychiatric conditions that may arise from corruption and also contribute to further corruption, and reviews proposed remedies for corruption. It also suggests that an understanding of corruption in law enforcement might be helpful in understanding, correcting, and preventing corruption in other professions, including medicine.
Aside from calls involving human exposures to potentially toxic substances, poison control centers handle other types of calls such as drug identifications (drug IDs). A portion of drug ID requests originates from law enforcement. The objective of this study was to describe such drug ID requests from law enforcement received by Texas poison control centers during 2002-2004. These calls were examined with respect to year of call, location of caller, and type of drug. There were in total 26,752 drug ID calls (involving 27,800 individual drug ID requests) from law enforcement, representing 3% of total calls and 16% of all drug ID calls received. The number of drug ID calls received from law enforcement and the proportion of total calls and all drug ID calls these represented increased from 2002 to 2004. A disproportionate number of the drug ID requests originated from eastern-central Texas. The most frequently involved drugs were analgesics (particularly acetaminophen and hydrocodone), sedatives and related drugs (particularly alprazolam), and muscle relaxants (particularly carisoprodol).
To assess consumer needs for and attitudes toward mental health services within law enforcement agencies, a questionnaire composed of a comprehensive list of mental health services potentially available to police departments was administered to populations of police officers and mental health workers. Respondents rated the services according to perceived utility of the service for law enforcement needs. Generally, police officers seemed receptive to several kinds of mental health service, although they were less enthusiastic about the value of the services than professionals. The implication of these data for the community mental health worker are discussed in terms of establishing and maintaining effective, mutually satisfying relationships with law enforcement agencies.
AIMS: To test the hypothesis that drug law enforcement encourages entry into methadone maintenance treatment. DESIGN: Survey conducted as face-to-face interviews in methadone clinics, at needle exchange centres and on the street, in areas of widespread heroin dealing and use. SETTING: Sydney, Australia. PARTICIPANTS: Heroin users. MEASUREMENTS: Self-reported data on personal characteristics, and experience of drug law enforcement and methadone maintenance treatment. FINDINGS: Although keeping their relationship/family together emerged as the most important reason given by respondents for entering treatment, avoiding more trouble with police/courts was also rated by the majority of respondents as an important or very important reason for entering treatment. The results of logistic regression analysis show that, after controlling for other factors, heroin users who have had a friend or family member imprisoned are more likely to have tried methadone maintenance treatment. A heroin user's own experience of arrest and imprisonment was also found to increase the likelihood of having tried treatment but only when age and length of time as a regular user (which were related to the user's experience of arrest and imprisonment) were excluded from the set of control variables. Despite having extensive histories of contact with the police and criminal justice system, however, Asian, Middle Eastern and Aboriginal respondents showed less proclivity to enter treatment than Caucasian respondents. CONCLUSION: Drug law enforcement may have a role to play in heroin demand reduction but its effects are not evident for all ethnic groups and the separate effects of contact with police, age and time spent in the heroin market remain unclear.
Law-enforcement officers tend to look at traditional mental health services as being of little help to them in dealing with persons they encounter experiencing emotional emergencies. They are frequently skeptical that emergency mental health programs offer more than they deliver. Because of their traditional base as the primary, and frequently only, available emergency "field" service in a community, a mental health emergency program must have a cooperative working relationship with law enforcement to serve a community successfully. This paper describes the development and maintenance of such a relationship, designed to increase the police case-finding potential.
The literature on the prevalence of health hazards faced by law enforcement officers indicates that they are at high risk for several morbid diseases and conditions, particularly cardiovascular disease and cancer. To mitigate these risks, quitting smoking is of the utmost importance. This article focuses on reducing tobacco consumption by law enforcement officers in New York.
The authors examine the prevalence of acute traumatic dissociative responses in a group of 115 law enforcement officers involved in critical incidents. Law enforcement officers were retrospectively surveyed for the presence of dissociative symptoms at the time of the critical incident, as well as for the presence of acute stress symptoms and posttraumatic stress symptoms. Results show that 90% of the officers reported experiencing a dissociative response during the critical incident. Thirty percent meet the Dissociative Criterion B of acute stress disorder under the DSM-IV. The mean number of dissociative symptoms in this group was two and one-half. In addition, 19% of the law enforcement officers reported varying forms of memory impairment for details of the incident. There were no reports of amnesia for the entire event. The clinical, forensic, and legal implications of these preliminary findings are discussed in this paper.
This article reviews the results of a survey of California law enforcement agencies, designed to assess the experience of these agencies with mentally ill offenders (MIOs) and the training of their officers to interact with this population. The results suggest that most law enforcement officers are given insufficient training to identify, manage, and appropriately refer the MIOs they are increasingly likely to encounter. The data indicate that, in contrast to their training and expectations, peace officers are as likely to be called to a mental illness crisis as to a robbery. The MIO is likely to be arrested for nonviolent misdemeanors and to be screened by officers with little of the training or knowledge needed to divert them to appropriate mental health treatment. Respondents report that increased communication and cooperation between law enforcement and mental health professionals is the single greatest improvement needed for handling mental illness crises.
A survey on AIDS was administered within a large, southern California jurisdiction to law enforcement officers and first responders (paramedics, firefighters). Respondents had accurate knowledge about AIDS but several incorrect perceptions about HIV transmission; a substantial proportion believed that HIV could be contracted from casual contact. AIDS training was not frequent. Self-assessment of HIV risk was medium to high risk in one-third of respondents, and was largely attributable to fear of occupational exposure. Appropriate precautionary professional practices were adopted at low frequencies, with respondents adopting preventive measures less than 50% of the time on 7 of 10 measures. Seventeen percent reportedly received requests for HIV/AIDS education from members of the public, which is incongruous with law enforcement officers' and first responders' demonstrated level of knowledge about HIV transmission. It was concluded that improved educational programs on HIV/AIDS are needed for law enforcement officers and first responders to increase the use of occupational precautions in the field, and to improve the accuracy of public AIDS education activities conducted by these professionals.
Research and anecdotal reports indicate that suicide and violence risk may be higher among members of law enforcement than those in other occupational categories. This article examines the phenomenon of suicide and violence risk within this population, and law enforcement cultural variables that may contribute to elevated risk. Suicide and violence risk factors and clues unique to law enforcement are described, as are intervention approaches which may be helpful to managing and reducing risk.
The biological attacks with powders containing Bacillus anthracis sent through the mail during September and October 2001 led to unprecedented public health and law enforcement investigations, which involved thousands of investigators from federal, state, and local agencies. Following recognition of the first cases of anthrax in Florida in early October 2001, investigators from the Centers for Disease Control and Prevention (CDC) and the Federal Bureau of Investigation (FBI) were mobilized to assist investigators from state and local public health and law enforcement agencies. Although public health and criminal investigations have been conducted in concert in the past, the response to the anthrax attacks required close collaboration because of the immediate and ongoing threat to public safety. We describe the collaborations between CDC and FBI during the investigation of the 2001 anthrax attacks and highlight the challenges and successes of public health and law enforcement collaborations in general.
Organised criminality is a great concern for national/international security. The demonstration of complex crimes is increasingly dependant on knowledge distributed within law-enforcement agencies and scientific disciplines. This separation of knowledge creates difficulties in reconstructing and prosecuting such crimes. Basic interdisciplinary research in drug intelligence combined with crime analysis, forensic intelligence, and traditional law enforcement investigation is leading to important advances in crime investigation support. Laboratory results constitute one highly dependable source of information that is both reliable and testable. Their operational use can support investigation and even provide undetected connections or organisation of structure. The foremost difficulties encountered by drug analysts are not principally of a chemical or analytical nature, but methodologies to extract parameters or features that are deemed to be crucial for handling and contextualising drug profiling data. An organised memory has been developed in order to provide accurate, timely, useful and meaningful information for linking spatially and temporally distinct events on a national and international level (including cross-border phenomena). Literature has already pointed out that forensic case data are amenable for use in an intelligence perspective if data and knowledge of specialised actors are appropriately organised, shared and processed. As a particular form of forensic case data, the authors' research focuses on parameters obtained through the systematic physical and chemical profiling of samples of illicit drugs. The procedure is used to infer and characterise links between samples that originate from the same and different seizures. The discussion will not, however, focus on how samples are actually analysed and compared as substantial literature on this topic already exists. Rather, attention is primarily drawn to an active and close collaboration between magistrates, forensic scientists, law enforcement investigators and crime analysts from different institutions with the aim of generating, using and validating relevant profiling case data as integral part of investigative and crime analysis processes. Original advances are highlighted through experiences from criminal investigations of offences related to the unlawful importation, exportation, supply and possession of illicit drugs.
Several international agreements set constraints on the legitimate use of firearms as representing lethal force. Their meaning in terms of weapons technology must take into account their operational frame of reference, and legitimate warfare can be regarded as a law enforcement operation with similar principles on the use of force. Changes in weapons technology, such as new types of ammunition, transforming firearms into weapons with less-lethal and even humanitarian options, require new interpretations of the legislation. A division into lethal and non-lethal weapons is an oversimplification and the separation of international humanitarian law into military and law enforcement provisions can be questioned from the technical aspect. The type of technology acceptable for law enforcement use of firearms should be defined. An assessment for weapon injury should not be based on lethality, but rather on the potential for tissue damage and its reversibility.
This study examined the predictability of dysfunctional job behaviors among law enforcement officers using 3 scales (Responsibility, Socialization, and Self-Control) of the California Psychological Inventory (H. G. Gough, 1995) that were hypothesized to assess the construct of conscientiousness, and 3 construct-oriented life history indices (drug use, criminal, work). Law enforcement officers were classified into disciplinary and control groups (n = 109 each), using a matched-case control study design. Mean differences between the 2 criterion groups on the 6 predictor variables were all statistically significant and in the hypothesized direction. The results are discussed in the context of conscientiousness as an explanatory construct, the relationship between life history and personality constructs, and methodological concerns in the development of construct-oriented life history indices.
This study was undertaken to learn whether law enforcement agencies in California ("agencies") have standard policies and procedures in place for responding to reports of domestic violence injuries from health practitioners ("HP reports"), and to describe the variation in policies and procedures across agencies. Using a structured interviewing tool with closed- and open-ended questions, a survey was taken of domestic violence experts from 39 agencies throughout California. Forty-one agencies were asked to participate in the study. Interviews were completed with 39. Almost all agencies reported that they have standard procedures in place for responding to HP reports when the reports are made by telephone. Agencies handle written HP reports differently than telephone HP reports. HP reports constitute a very small proportion of agencies' overall domestic violence caseloads. Emergency departments are the usual source of HP reports. Although the law requires both an immediate telephone report and a written report, fewer than one quarter of sampled agencies always received both types of HP reports. Most agencies use standard response protocols when reports of domestic violence incidents are made by telephone, whether the reporting party is a health practitioner or someone else. Written HP reports do not fit into the agencies' usual response protocol for domestic violence situations. Because agencies' protocols are best suited to situations requiring prompt dispatch of an investigating officer, only reports made by telephone have the opportunity to promote an effective law enforcement response.