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Course Teaches Officers How to Administer Aid, Improve Survival

By Becky Lewis
August 2013

Evaluation forms filled with column after column of circled “5s” for “Excellent.” Those are the marks being earned by the Law Enforcement and First Response (LEFR) Tactical Casualty Care course, a new training program that teaches law enforcement officers and other first responders about basic interventions that could help save someone’s life in the precious minutes before emergency medical services practitioners can safely enter a trauma scene.

Developed with the Denver Health Department of Emergency Medical Services Education and the Denver Police Department Metro SWAT unit, and offered through the National Association of Emergency Medical Technicians (NAEMT) (, LEFR uses elements of training provided to U.S. military medics combined with other principles developed by NAEMT’s Prehospital Trauma Life Support (PHTLS) Committee. It meets the recommendations of Improving Survival from Active Shooter Events: The Hartford Consensus Joint Committee to Create a National Policy to Enhance Survivability From Mass Casualty Shooting Events, released by NAEMT on April 2, 2013 (

“We’ve seen so many incidents nationally – and internationally – in which a large number of casualties have occurred. If you look at many of these incidents, police reach the scene rapidly but EMS entry is delayed until the scene is secure. What we wanted to do is give the police officers who are first on the scene of an active shooter or other mass trauma incident the necessary medical training to perform the very basics of lifesaving care,” says Dr. Peter Pons, associate medical director for Pre-Hospital Trauma Life Support at Denver Health Medical Center and an emergency physician. “The military has a two-day advanced level training course and we thought a lot of the principles they teach also made sense for police officers. However, we’ve adapted it into a one-day civilian course.”

Pons already an existing relationship with PHTLS, and worked out an agreement for the Denver agencies to develop the training and field test it on a local level, at which point NAEMT would begin to host and offer the program on a national level. Work started on the project in early 2013, and as of mid-August, the pilot portion of the project had ended successfully and more than 50 LEFR sessions had been scheduled nationwide. Training at the medical center in Denver costs only $10 per participant to cover certificate printing costs, thanks to a combination of Urban Area Security Initiative and local funding. Costs at other locations around the country will vary; find out more by visiting the NAEMT website listed above, by emailing [email protected] or by calling (800) 346-2368. For more information on training specific to Colorado, visit

Pons says there are no pre-qualifications needed to take the course, which is “really designed for the lay provider. We recognize that police officers frankly have had very little medical training. And the evaluations on the part of the officers who have taken it have been phenomenal.”

In addition to those columns filled with the number 5, those phenomenal evaluations have included the following comments:

“Amazing training, especially the way it was taught for non-medical [trainees]. I feel comfortable at this time to be able to get involved with an injury…and at least do what is possible to save someone’s life.”

“Very informative and helpful scenarios force you to think on your feet.”

“Great class. Excellent practicals. Thanks for caring for your brothers in blue!”

“Material was presented in such a fashion that a person with no EMS background such as myself was able to understand.”

“Glad to see us being taught to administer aid instead of waiting for rescue.”

The aid that participants learn to administer includes the following:

  • Immediate steps for hemorrhage control, including external hemorrhage control, direct pressure and wound packing, early use of tourniquets for severe hemorrhage, internal hemorrhage control by rapid evacuation, and transportation to major hospital/trauma center.
  • Appropriate application of a tourniquet to an arm or leg.
  • Airway control techniques and devices.
  • Application of a topical hemostatic dressing (combat gauze).
  • Tactically relevant indicators of shock.

Pons says the morning session consists of a combination of classroom lecture and practice at skill stations, while in the afternoon, participants get a chance to apply the skills they’ve learned in several scenarios: “Some of them use actors, some use mannequins that bleed. They all replicate scenarios officers could possibly face in the field. We focus on medical care issues, not on tactics. Every police department has its own approach to tactics, and we’re not trying to teach them tactics to use in an active shooter or hostage situation. We’re teaching them what to do medically if that situation ends with a casualty.”