Police-to-Hospital Transport for Violently Injured Individuals: A Way to Save Lives?

• DOI: 10.1177/0002716219891698
• Author: Charles C. Branas,Sara F. Jacoby,Paul M. Reeping
• Published date: 01 January 2020
• Date: 01 January 2020
• Subject Matter: Preventing Avoidable Fatalities

186 ANNALS, AAPSS, 687, January 2020

DOI: 10.1177/0002716219891698

Police-to-

Hospital

Transport for

Violently

Injured

Individuals:

A Way to Save

Lives?

By

SARA F. JACOBY,

PAUL M. REEPING,

and

CHARLES C. BRANAS

891698ANN The Annals of The American AcademyPolice-To-Hospital Transport

research-article2019

Transportation of violently injured individuals to the

hospital by police, also known as “scoop and run,” may

shorten the time between injury and hospital care when

emergency medical services are delayed or unavailable.

In this article, we explore the history and contemporary

applications of this strategy and its broader impact on

public safety systems. Current evidence suggests that

when comparing police hospital transport and emer-

gency medical services transport for violently injured

individuals, survival rates are at least equivalent; in some

studies, survival rates are better for violently injured

individuals transported by police. Though understud-

ied, police transport may improve survival for violently

injured individuals as well as perceptions of police in

communities where mistrust is common. Only a select

few cities have codified this approach and police role.

Geographic context, emergency response capacity, and

the nature of encounters between law enforcement and

victims of violence are important for other jurisdictions

considering police-to-hospital transport.

Keywords: violence; prehospital medical care; traumatic

injury; violence; police; first responders

In the aftermath of violence, nonmedical

police personnel can and have acted in place

of emergency medical service (EMS) providers

by expeditiously extricating and transporting

injured individuals to definitive medical care in

otherwise dangerous situations. A modicum of

evidence has emerged in past decades suggest-

ing that prehospital transport by police for vio-

lently injured individuals, in lieu of EMS, may

be a lifesaving municipal policy worthy of

broader consideration. This policy may be espe-

cially applicable in situations where firearm

Sara F. Jacoby is an assistant professor in the

Department of Family and Community Health at the

University of Pennsylvania School of Nursing and a

senior fellow of the Leonard Davis Institute of Health

Economics.

Correspondence: c.branas@columbia.edu

POLICE-TO-HOSPITAL TRANSPORT 187

violence has occurred, advanced trauma care is accessible, and police and other

security forces exceed the capacity of EMS.

Despite its potential, police transport for violently injured individuals is an

infrequently used prehospital strategy. Only a small number of U.S. cities have

formalized policies, permitted, or have otherwise explored using police transport

to respond to injuries incurred during shootings or other violent events (Van

Brocklin 2018a). Underutilization may reflect a host of implementation concerns,

including the possibility of unintended harm by nonmedical police personnel,

public perceptions of police and the role of police, and scope of work conflicts

between police and EMS providers. In this article, we explore the history and

potential of police-to-hospital transportation strategies and their broader social

impact on public safety systems.

Cities That Permit and Employ Police Transport

of Violently Injured Individuals

Immediately after a serious traumatic injury, the most urgent imperative is to

transport a wounded individual safely from the scene of injury and into the care

of medical providers equipped with lifesaving knowledge and resources (Sakran

et al. 2018; Hashmi et al. 2019). In the civilian population, this responsibility

routinely falls to EMS providers who have been trained in field-based first aid

and best practices for moving injured people into ambulances or other kinds of

transport vehicles. In some cases, EMS providers offer more advanced prehospi-

tal interventions, such as intravenous fluid resuscitation, or assisted breathing

following endotracheal intubation. Yet as hospital trauma systems have improved,

there is mounting evidence that on-scene interventions may be less effective than

a “scoop-and-run” strategy, defined as minimal on-scene intervention and expe-

dited hospital transport—at least for certain classes of traumatic injuries (Haas

and Nathens 2008; Smith and Conn 2009). Specifically, penetrating injuries like

gunshots or stab wounds can cause extensive and rapid hemorrhaging. For these

cases, minimizing the “stay and play” time required for at-scene interventions in

favor of prompt transport to hospitals may mean the difference between life and

death (Harmsen et al. 2015). Moreover, many at-scene interventions for

penetrating injuries have been shown to be of questionable value in achieving

optimal patient outcomes (Bickell etal. 1994).

Police officers are often the first to respond to injuries caused by shootings and

other acts of violence. (When police themselves have shot the individual, they are

by definition always the first potential lifesavers at the scene.) Many municipal

911 systems will dispatch police to all violent situations prior to activating other

Paul M. Reeping is an epidemiology PhD student studying at the Columbia Mailman School of

Public Health.

Charles C. Branas is the Gelman Endowed Professor and chair of the Department of

Epidemiology at the Columbia Mailman School of Public Health.