TULSA POLICE DEPARTMENT

Medical Support and Training Specialty

Unit

Manual (03/22/2016)

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Table of Contents

I. MISSION STATEMENT ............................................ 2 I. VISION STATEMENT ............................................... 2 II. GLOSSARY ............................................................... 3 III. UNIT STRUCTURE ................................................ 4 IV. TRAINING ................................................................ 5 V. UNIT RESPONSIBILITIES ..................................... 7 VI. SELECTION PROCESS ......................................... 9 VII. RETENTION ........................................................ 14 VIII. UNIFORM ........................................................... 15 IX. EQUIPMENT ......................................................... 16 X. DOCUMENTATION/ PATIENT CONFIDENTIALITY .................................................. 18

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I. MISSION STATEMENT The mission of the Tulsa Police Department Medical Support and Training Unit is to provide both patrol and specialty units

with a cadre of police officers who are cross-trained as Emergency Medical Technicians. By operating as Police Medics

and through instruction provided to non-medical police personnel this unit will increase our department’s overall

readiness to respond to both individual medical emergencies and mass casualty incidents.

I. VISION STATEMENT The Tulsa Police Department Medical Support and Training Unit will train and deploy Nationally Registered and state

licensed Emergency Medical Technicians to support other patrol officers on calls and specialty units deployed on high risk

missions. These Police Medics will be capable of providing emergency medical care in hostile environments when EMS and

Fire services are unable to safely operate. MSTU medics will also provide emergency medical instruction to all other

department personnel to prepare them to provide immediate, life-saving medical interventions to themselves or others in

need.

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II. GLOSSARY

BLS: Basic Life Support (May refer to either a call requiring only basic level care OR

CPR)

Certification: Formal documentation that a student has attended a class and has successfully completed any testing or skills required to complete said class.

CEU: Continuing education hours. These are clock hours of training in specific topics required to acquire and/or maintain certification and/or licensure.

Licensure: Formal permission to perform a task or skill set

NAEMT: National Association of Emergency Medical Technicians

NREMT: National Registry of Emergency Medical Technicians

OTC: Over the Counter (Medications)

OMD: Office of the Medical Director. Any EMT or Paramedic wishing to practice at their respective level of licensure must do so under the supervision of a medical control doctor and under his or her medical license. It is the medical control doctor who ultimately decides which treatment modalities are to be provided for specific medical issues and who he or she will allow to provide these treatments. All medics, regardless of their licensure, work at the pleasure of the medical control doctor.

OSDH EMS: Oklahoma State Department of Health EMS Division

PHTLS: Pre-Hospital Trauma Life Support

RSA: Response Service Area. This is the area within which TPD, EMSA, and TFD medics are allowed to work to the full level of their licensure.

Protocol(s): Pre-established and standing orders from the OMD that specify the treatments and courses of action to be taken during specific medical situations. These exist in lieu of the medical control doctor personally providing you with orders and/or supervising your actions.

TC3: Tactical Combat Casualty Care

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III. UNIT STRUCTURE

The Medical Support and Training Unit will be comprised of the Training Division Director, the Captain of Training, the Medical Support and Training Officer, and non-specific number of qualified Police EMT’s. The Medical Support and Training Officer will report to the Captain of Training for Administrative actions.

1. Training Division Director 2. Captain of Training 3. Medical Support and Training Officer 4. Police EMT’s

See section VI. For selection process

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IV. TRAINING

A. Initial Certification / Licensure Requirements

Initial EMT training: The Tulsa Police Department enjoys a partnership with Tulsa Community College to provide our personnel with EMT training. While this is the primary school that most officers attend it is not the only school. Officers wishing to participate in the EMT program must receive their initial EMT training (regardless of level) from an accredited college or vocational school. Upon entering the TPD medic program, if an officer received their initial training from a school other than TCC, they must affiliate with TCC as their training agency. This is to streamline the process of renewing certification and to reduce confusion.

National Registry: All police medics must have / earn certification with the National Registry of EMT’s and must maintain their certification with the NREMT throughout their association with the program.

OSDH Licensure: All police medics must be currently licensed through the Oklahoma State Department of Health EMS Division and remain so throughout their association with the program.

Basic Life Support: All police medics must be currently certified as BLS Health Care Provider

PHTLS /TC3: All police medics must remain currently certified in EITHER NAEMT Prehospital Trauma Life Support (PHTLS) or in TC3 as developed and taught by either the NAEMT or CLEET

ACLS/PALS: Paramedics must remain current in both Advanced Cardiac Life Support and Pediatric Life Support.

B. Unit Training Requirements

MSTU members are required to complete 72 hours of CEU’s every TWO years to maintain their respective levels of licensure. While the composition of these hours varies by licensure level, the MSTU training program is designed to ensure that each member will have department-provided ability to earn the CEU’s required for their licensure. All CEU’s and refresher classes will meet

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the educational requirements of the NREMT with the Tulsa Community College EMS Program serving as our Training Center.

1. Unit training days will be held on a quarterly basis and be approved by the Chief of Police annually. Unit members may also attend additional training and certification courses not included in the quarterly training. The quarterly training will include Mandatory In Service preparation as well as numerous topics within the tactical medicine / rescue field. Each of these 10-hour training days will provide CEU’s towards renewal of EMT licensure. Where applicable, these training days will also provide CLEET CEU’s. These quarterly training days will provide a total of 80 hours of CEU’s every two years which exceeds National Registry requirements.

MSTU members will be required to attend each of these training days and will be scheduled to do so through their divisions. Should an officer be unable to attend a training day, the absent officer will have the responsibility of making up the 10 missed CEU’s on their own.

2. Depending on the individual level, additional training / certifications may be required to maintain licensure. These classes will be scheduled with the approval of the Chief of Police and will meet the requirements of the NREMT and the OSDH-EMS Division.

3. MSTU members are allowed and encouraged to attend training provided by outside agencies provided their attendance has been approved through their chain of command or the class is attended on their personal time.

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V. UNIT RESPONSIBILITIES

A. Support Field Personnel / Units The primary mission for MSTU members is to provide medical support to field personnel. Examples of such support may be assisting individual officers responding to calls, standing by for non-support specialty units such as detective squads as they make contacts, assisting supervisors by coordinating emergency medical response with outside agencies, and providing informal “spot” or squad meeting training at a divisional level.

An officer encountering a citizen with a medical emergency is required by law only to summon medical assistance as quickly as possible. With this in mind, MSTU members MAY also provide care to citizens where and when tactically appropriate.

B. Support Specialty Units When requested or when otherwise assigned, MSTU members will also provide medical support to SOD specialty units such as the SOT, Dive Team, Bomb Squad and Air Support. The nature of the deployments made by these units often necessitates unique medical skill sets that local EMS agencies are often not equipped to provide.

C. Support Outside Agencies via Mutual Aid Tactical / Special Operations medicine is a very unique specialty within law enforcement that few agencies have access to. When a special operations team belonging to an agency with which we have a mutual aid agreement deploys, a request for TPD SOT medics or MSTU members may be made. With command staff approval, MSTU members may deploy to support these agencies and their teams.

D. Mandatory In Service Instruction The Tulsa Police Department will strive to ensure that each year’s mandatory in service training will include a block of medical instruction. As schedules permit, MSTU members will be required to assist in the instruction of these blocks.

E. Elective In Service Instruction As schedules allow, each year the MSTU will conduct several elective in service training days for TPD officers wishing to enhance their medical capability. These classes will range from basic skills up to advanced and may include scenario development and

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implementation. When available, MSTU members may be required to assist in instruction during these elective in service days.

F. APO Academy Instruction Each APO academy will receive 2-3 days of first aid, CPR, and tactical medicine instruction over the course of their training. As schedules permit, MSTU members may be required to assist in this training.

G. MSTU Instruction From time to time MSTU members may be asked to plan, prepare, and deliver specific blocks of instruction to other members during quarterly training days. This will allow members with differing backgrounds and experiences to share what they know with the rest of the team.

H. Callouts In cases of natural disaster, mass-casualty incident, or other incidents requiring more personnel than on-duty field officers can provide, command staff has the option and the ability to call the MSTU out via email/phone/text notification. Should such a callout occur, MSTU members should be capable of responding in a timely manner and remaining deployed until relieved.

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VI. SELECTION PROCESS

A. Qualifications The minimal qualifications for applicants include:

1. One years’ experience with the Tulsa Police Department to be eligible to begin initial EMT training or have completed FTO training if already certified / licensed as an EMT.

2. A clear record with Internal Affairs with no complaints pending

3. The ability to pass the TPD Physical Assessment Test within the required time as established by the Physical Fitness Unit.

4. The ability to meet / pass all student requirements as established by the Tulsa Community College EMS Training program. These requirements include, but are not limited to, drug screening, background checks, and immunizations.

B. Selection Process Interested applicants will submit an interoffice to the Training Director through their chain of command. All approved applicants will be notified and provided the date for the PAT. Applicants who successfully complete the PAT will be invited to sit for a scored oral board to be scheduled as soon as possible following the PAT.

The oral board will consist of structured questions intended to vet the applicant’s suitability for both EMT school and operating as a Police Medic. The oral board will include the Director of Training, the Training Captain, the Medical Support and Training Officer, and the Director of the TCC EMS Training Program or his/her designee.

This oral interview also serves as the TCC required application process for more advanced levels of EMT training should the officer continue beyond EMT.

Both the PAT times and the oral board scores will be considered during the selection process.

C. Vacancy Announcement The announcement letter / Vacancy Announcement will follow all Departmental Rules listing the minimal qualifications as outlined above. Please see the Vacancy Letter below.

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Tulsa Police Department Vacancy Announcement

Division: Date Issued: XXXXXX Training Division Position: Emergency Medical Technician-Medical Support and Training Unit Background: The Tulsa Police Department recognizes that today’s police officers are increasingly expected to have the ability to provide immediate life-saving interventions for both injured police officers and civilians. To meet this expectation we have partnered with Tulsa Community College to offer Basic Emergency Medical Technician training to interested officers. Once they have successfully completed the class and are state licensed as EMT’s these officers will, in addition to their regular duties, support other officers and specialty units by providing a higher level of on-scene care. In addition these police medics will be expected to assist in both formal and informal training of other officers when schedules permit. Finally these police medics, if interested, will be eligible to apply for the Special Operations Team as an SOT medic as needs develop. Initial Training: The Basic EMT School is a 16-week program beginning in (month) of (year) and scheduled to end in (month). This school consists of approximately 190 hours of training most of which is completed online. In addition to successfully completing the online blocks of instruction officers will also be required to attend 3 hours of skills lab each week on the TCC Northeast campus. Currently there are three separate 3-hour labs scheduled each week; Monday morning, Monday afternoon and one on Tuesday evening. Officers need only attend one of these sessions each week. This can be done on duty or for overtime as determined by divisional manpower.

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In (month) officers will begin completing the required 48 hours of clinicals. These clinicals will require officers to ride out with local EMS agencies and provide actual patient care under the supervision of a Paramedic FTO’s. These clincials are done in 12-hour shifts and will be completed with both EMSA and TFD. These clinicals will be completed as Special Assignment shifts or overtime depending on manpower needs of the officer’s division. The TCC attendance policy will apply to any schedule conflicts. At the end of this class offices will take “finals” just like any other class. Officers will also take both the written and hands-on tests to earn National Registry certification At the conclusion of the class officers will be required to successfully complete a 1-day protocol class. This class will provide officers with the information they need to pass a test that is required by the Office of the Medical Director before practicing as an EMT in Tulsa County. Once all this has been successfully completed and officers have their state licensure these Police Medics will be allowed to practice as EMT’s under the supervision of the Office of the Medical Director. Ongoing Training: EMT’s at all levels are required to renew their certification every TWO years. All continuing education requirements / hours will be spread out over the course of the two year renewal period and will be provided by our department in partnership with TCC. Police medics will also be required to complete 3 to 4 ride-alongs with EMSA each year to stay proficient in medical skills. Future Advanced Training: As manpower allows we will have the ability to send a select few officers to more advanced training including Advanced EMT. Officers interested in pursuing these courses will first need to successfully complete the Basic EMT school. As our medical education program expands there will also be several opportunities to attend outside schools and classes that offer greater specialization in numerous areas of emergency care. Qualifications: Interested personnel must meet the requirements set out by TCC for their students including a background check and a drug test. Due to the nature of the training

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some students may be required to get additional immunizations depending on their shot records. Interested personnel must have 1 year of service from their graduation date and a good / clear record with Internal Affairs. Both officers and supervisors are eligible to apply. Due to the physical nature of this work applicants must also be able to complete the TPD PAT in the departmentally required time of 3:24 or less. Finally, applicants must sit for an oral review board with Training Division staff and the Director of the TCC EMS Training Program. Other Expectations: Those selected for this class will be expected to attend all of their required classes and clinicals. As these officers will be representing our department they will be expected be on time when and where they are expected to be and to maintain high grades. It is important to note that, because this is a “blended” class (meaning mostly online with little actual face-to-face lecture) those enrolled in this class can and should expect to study 24-30 hours a week. Those who are considering applying for this training program are advised to make sure that such a time commitment can be maintained throughout the 16 weeks of this class. Further Considerations: As mentioned previously this program has been made possible through a partnership with Tulsa Community College. It is through this partnership that tuition, school network access and online textbook materials, and the required CPR certification for each officer / student are paid for. What cannot be covered at this time are uniform items (clinical shirt and stethoscope) and National Registry testing and licensing fees. The total of all these items averages $180-200. Selection: A maximum of six personnel will be selected for this class. It is anticipated, however, that as long as we have interested applicants we will begin another Basic EMT class in the (month) semester of (year), another the following (month), etc… Selection will consist of an interview with training staff and successful completion of the PAT.

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Letters Due: Officers interested in applying for this program must submit an interoffice through their chain of command to (Training Captain) at TD by (date). In this interoffice please include a summary of any direct patient care experience and any previous medical licensures held.

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VII. RETENTION Retention in the MSTU is of great importance for several reasons.

• Becoming a member of the MSTU represents a significant investment on the part of the Tulsa Police Department This investment comes in the form of time, pay, equipment, and potential liability should a member act in a grossly negligent manner. Additionally, even though the department enjoys a partnership with TCC for training, TCC is also making an investment in MSTU members through training, materials, and brand affiliation.

• Officers who wish to cross-train / specialize in emergency medicine are few in number and not easily replaced. From selection to medical system clearance can take nearly a year.

• Emergency medicine is a rapidly changing field that obligates providers to remain on the cutting edge of skills and practices. Allowing a medic to miss, avoid, or otherwise depart training would almost certainly place them at risk of providing out-of-date care or failing to meet certification requirements.

The standards for retention in the MSTU include:

1. A member must attend at least 3 of the 4 department-facilitated MSTU training days per year. Should a member be unable to attend all four then it will be the member’s responsibility to complete the CEU’s necessary to remain certified and licensed.

2. A member must remain in good standing with the Office of the Medical Director. Good standing is defined as remaining current with the OMD protocol testing and having no issues/complaints originating from the OMD. It shall be understood that the OMD has the power to immediately suspend or revoke the medical privileges of any medic working within our system and under OMD protocols.

3. A member must be and remain accountable for and maintain all department-issued medical equipment. Failure to maintain or misuse of assigned equipment may result in discipline and/or removal from the MSTU.

4. A member must maintain positive professional relationships with the staff of any agency that interacts with the MSTU. This includes Tulsa Community College, Tulsa Fire Department, the Emergency Medical Service Authority, Office of the Medical Director, all Tulsa Hospitals, Tulsa Lifeflight, and regional Law Enforcement Agencies.

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Any MSTU member placed on restricted duty not related to an injury will immediately be placed in a non-deployable status.

VIII. UNIFORM A. While acting in the role of classroom instructor, MSTU members will wear:

1. Approved MSTU polo shirt, either black or white in color

2. Khaki utility pants

3. Black belt

4. Black boots

B. While acting in the role of instructor in the outdoor or scenario setting

1. Approved MSTU shirt, t-shirt or long sleeve

2. Class B utility uniform pants or dark blue or khaki utility / EMT pants

3. Black or khaki pants

4. Black or khaki boots

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IX. EQUIPMENT

Upon completion of all the necessary class and skills requirements, Police Medics will be issued a cache of emergency medical equipment and supplies. Maintaining this equipment and replacing anything used will be the responsibility of the Police Medic to whom it is issued. Tulsa Police Medics will not carry any equipment or supplies that are not allowed within their respective level of licensure.

A. While the number and manufacturer of supplies may vary these cache’s will / must consist of (depending on level of licensure):

Hemorrhage Control:

Combat Application Tourniquets

Quikclot

Trauma / Compression / OLEAS-style dressings

Rolled Gauze

4 x 4’s

ABD Pads

Burn Sheet

Burn Gel Bandage (Small)

TXA

IV Supplies and Equipment

Airway:

Nasopharyngeal Airways

Oropharyngeal Airways

Bag Valve Mask (Adult and Pediatric)

King LT Airway

Laryngoscope sets with ET tubes and rescue pod

Crycothyroidotomy Kit

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Breathing / Chest:

HALO chest seals

Oxygen (if available)

Nasal Cannula (if O2 is carried)

Non Rebreather (if O2 is carried)

Albuterol (if O2 is carried)

Thoracentesis Catheters

Diagnostic:

BP Cuff

Stethoscope (personally owned)

Pulse-Ox

Medical / Other:

Glucose Paste

Ace Bandages

Narcan

Other medications as permitted by licensure

B. It shall be the responsibility of the each Police Medic to ensure that any supplies or medications that have expiration dates are within date.

C. Upon separation from the MSTU the police medic shall return all issued equipment.

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X. DOCUMENTATION/ PATIENT CONFIDENTIALITY A. MSTU personnel are expected to document patient contacts in a manner consistent with

the local Standard of Care and as required by the Office of the Medical Director.

B. For the purposes of MSTU personnel, patient contact is defined as the assessment and/or treatment for any injury or illness:

1. That has any likelihood of requiring more definitive care at a later time

2. That has any likelihood of being referenced at a later time in any judicial proceeding including worker’s compensation and/or the injury hotline. This also includes CEW probe removals and situations in which the patient refuses care.

3. In which the Police Medic wishes to document

C. A great deal of responsibility is placed on the Police Medic in determining what cases to document. Police Medics are expected to have the ability to support other officers and keep these officers operational. Much of this support will be in the form of OTC medications, minor wound bandaging, V/S monitoring, etc… Such care does not require documentation unless it meets any of the criteria listed in the above section.

D. All patient contacts will be documented on the MSTU Patient Care Report (PCR). At the time of this writing, this form is a hardcopy only but when the form is placed in Blue Team, Police Medics will switch to this format.

E. As a general rule, PCR’s should be completed and submitted to the department’s MSTU Officer within 24 hours. Exceptions may be made in cases of critical incidents and in cases were the PCR is to supplement a Use of Force Report.

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PATIENT CONTACT REPORT

Date: Click here to enter a date. Time: Location:

PATIENT INFORMATION (IF THE PATIENT IS AN LEO, LIST ONLY NAME AND DOB)

Last name: First Middle Address:

TPD/PID: DOB: Age: Male ☐ Female ☐ Refusal? Yes ☐ No☐

REPORTING MEDIC Officer / Medic: Badge: Div: Other Officers Involved w/ Patient Care

TRACIS: (If Applicable) Does This Contact Involve a Use of Force? Reportable Exposure?

Yes ☐ No☐ If so, name of officer_____________________ Yes ☐ No☐

Was This Contact ONLY to Remove CEW Probes? Yes ☐ No☐

Was Narcan Used During this Contact? (If Yes, Contact the MSTO) Yes ☐ No☐

EMSA Unit(s): TFD Unit(s): Other Agencies / Units:

REPORT OF CARE (CHRONOLOGICAL NARRATIVE) MOI / NOI:

Primary Assessment:

Secondary Assessment:

Vital Signs

Time HR BP RR O2Sat

Please List Any Expended Supplies:

DISPOSTION Patient Care Transferred to: (If Applicable) Hospital: Was the Patient Critical?

Yes☐ No☐

Notes / Issues:

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F. Patient Confidentiality While HIPPA does not apply to law enforcement agencies it is still incumbent on MSTU

personnel to do all that is possible to ensure the privacy of any patients we make contact with. Examples of efforts to maintain this privacy include, but are not limited to,

1. Ensuring that PCR’s, either hardcopies or electronic, are not left in places that are accessible to others

2. Not discussing Police Medic / Patient interactions with those who do not have a medical need to know.

3. Ensuring that any other media created for the purposes of communication or training contain no information that can be used to identify the patient. This includes social media platforms.

At no time will a Police Medic make any post to any social media platform that would allow a reader to identify a patient nor will any Police Medic post any pictures of any patient care interaction.

4. The Police Medic must keep in mind that any media generated (pictures, video, etc…) are subject to discovery in later court actions and may be considered evidence that must be submitted to the Tulsa Police Department.

5. As mentioned earlier, HIPPA applies only to healthcare agencies thus police officers are not bound by it. However, when care is provided in the capacity of a medic (Police Medic), there does exist a provider-patient privilege for the purpose of courtroom testimony. Should a Police Medic be called upon to testify about information SPECIFIC to a suspect / patient’s medical condition or treatment it is incumbent on the officer to discuss the matter with the prosecution beforehand to determine if such testimony is appropriate or even possible.