What happened to first aid?
Police officers should try to save the people they shoot
The first time I tried to intubate a patient who had stopped breathing, my supervisor snatched the tube from me at the last minute. “What are you going to do after you place the tube?” she asked.
Her intuition was right: I was completely unprepared for the next step. It was an important reminder that no matter how dire the situation, it is inappropriate to act unless you’re ready for what comes next.
After the release of the video of the shooting this month of Terence Crutcher by a police officer in Tulsa, Okla., many questions remain. One thing is clear, however: In the immediate aftermath of the shooting, there was no attempt to provide medical assistance to Mr. Crutcher.
At one point in the video, officers appear to put on medical gloves. But rather than use them to perform CPR or apply pressure to stop any bleeding, they use them to search Mr. Crutcher as he lies on the ground.
Sadly, something similar is on display in the videos of the police shootings this summer of Paul O’Neal in Chicago, Philando Castile in a suburb of Minneapolis-St. Paul and Alton Sterling in Baton Rouge, La. Officers ostensibly trained in both firearms and first aid appear to focus on the former and ignore the latter.
Perhaps the most vivid recent example of an officer’s first-aid unpreparedness was in 2014, when Peter Liang of the New York City Police Department fired a shot in a Brooklyn housing project. The bullet ricocheted down a stairwell and hit a man named Akai Gurley. While Mr. Gurley lay on the floor dying, Officer Liang stood by as Mr. Gurley’s girlfriend dialed 911 and was coached to perform CPR over the phone.
Asked in court why he didn’t assist with the resuscitation, Mr. Liang testified, “I thought she was more qualified than me.” Evidence later emerged that during training, Mr. Liang and his classmates received poor CPR instruction.
In such cases, I leave determinations of guilt and non-guilt to the courts and to people with more legal expertise than I have. I will, however, argue that if we are going to give our police officers guns (and this is indeed an “if” — officers in many developed countries do not carry guns on patrol), the officers must be properly trained to deal with the consequences of firing them.
As a physician, I am expected to know how to use an array of powerful medications — and how to act when those medications result in dangerous side effects or allergic reactions. The same ought to be true of our police officers: They must be able to serve and protect not only when things go according to plan but also when things go awry.
Unfortunately, first aid does not always seem to be a high priority in the culture of police academies. The NYPD’s CPR course that was offered to Officer Liang and his classmates, for example, was taught by a single instructor for about 300 students, with little to no time provided to practice on mannequins. (The head of the Patrolmen’s Benevolent Association, Patrick J. Lynch, called that course “an ineffective training program.”) And while police departments frequently require recertifications for firearms on an annual basis, CPR recertification every two years is often only “recommended.”
Police officers too often dismiss the idea that providing basic first aid is a critical part of their job. When New Orleans police officers were criticized for not doing enough to assist wounded victims in a 2014 shooting, Ronal Serpas, then the superintendent of the New Orleans Police Department, offered the following defense: “What the public can expect from the police officer is, the police officer is a police officer. They’re not a nurse, they’re not a doctor. They get fundamental training in CPR, and that’s all they can do, if nothing else is taxing their time at that moment.”
But time is precisely what matters. Police work regularly places officers in urgent situations with critically injured people. If a person isn’t getting oxygen to his brain, permanent brain damage occurs after about four minutes and death occurs within about six minutes.
Given that the average response time for an ambulance in New York City is about seven minutes — not an unusual amount of time in other places as well — immediate first aid can be critical to keeping oxygen flowing until professional medical personnel are able to take more definitive action. First aid — including the use of CPR, defibrillators and tourniquets — is a set of simple skills that anyone can learn.
Like emergency medicine, policing is hard. It is stressful. But the good news is that policing, like emergency medicine, is predictably hard and predictably stressful. This allows practitioners to train for their challenges.
Emergency medical situations will arise again and again when officers discharge their guns. We should expect that, the next time they do, the officers will know exactly what to do next.
Farzon A. Nahvi is an emergency medicine physician at New York University’s Langone Medical Center and at Bellevue Hospital Center in New York City. He wrote this for The New York Times.