I've seen countless moments how the combined efforts of EMS and law enforcement can make a difference in critical situations. Knowing how to work with law enforcement at an EMS call should be taught to every first responder. 

Snapshot of The Law Enforcement Community
According to the Cybersecurity and Infrastructure Security Agency (CISA), the Emergency Services Sector Profile includes the first responder community, which is made up of 4.6 million career and volunteer professionals within five primary disciplines: Law Enforcement, Fire and Rescue Services, Emergency Medical Services, Emergency Management, and Public Works.

The profile describes Law Enforcement (LE) as: the individuals and agencies responsible for enforcing laws and maintaining public order and public safety. The LE community consists of 17,759 Federal, State, Local, Tribal, and Territorial LE agencies with approximately 860,950 LE officers. It also includes 73 Federal LE agencies with approximately 120,000 officers and approximately 1,103,120 individuals employed by private sector security companies.  

LE roles include prevention, detection, investigation of crimes, apprehension, and detention of individuals suspected of violating laws.

When First Responders and Law Enforcement Meet
As first responders, we are most familiar and often work side by side with the LE officers assigned to police response/patrols and certain specialized units. In many communities more police are on patrol than fire or EMS vehicles, and often the nearest unit to an EMS call is an LE officer on patrol. In addition, LE officers are routinely assigned to many EMS calls due to potential scene safety issues, violence, potential crimes in progress, traffic control, documentation, and investigation needs.

Once at the scene, teamwork between EMS and law enforcement is essential for an effective emergency response. When first responders and law enforcement officers work together, they can address various aspects of an emergency situation more efficiently. This partnership ensures that all necessary actions are taken to manage the scene, provide medical care, and maintain safety.

Do Law Enforcement Officers Receive any Medical Training?
Due to how close LE officers work with first responders, it is helpful, and sometimes lifesaving, that the LE officer has some basic medical training. However, LE officers only receive a minimal amount of medical training at the beginning of their education. Even then, it depends on their agency policies and leadership, their specific role, and any state or federal requirements. Typical LE Academy training includes first aid and CPR, and many academies provide emergency medical responder (EMR) or equivalent training. Not all EMR training involves “certification,” and of those that do receive a certification, not all agencies continue the recertification of the credential after it expires. This is where the factors of agency policies and leadership factor in as well as the resources to fund ongoing training.

Because law enforcement officers typically receive minimal medical training, it becomes even more important for EMS professionals to understand how to work with police at the scene. While some officers may have basic training in first aid and CPR, their medical knowledge is often limited. This means that EMS workers should not expect to rely on LE to administer care during an emergency.

The Chain of Survival
It was a typical August Monday evening, 12 years ago, at Cook Park’s Little League field. Suddenly, Joe, an 11-year-old boy, was hit by a pitch in his chest. He collapsed in cardiac arrest. Fortunately, Joe survived due to the immediate efforts of the team’s coach, a a police officer on patrol in Colonie, New York, EMTs and paramedics from the Colonie EMS Department, and the expert care at the Albany Medical Center. The cause of the cardiac arrest turned out to be the rare commotio cordis, and fortunately he did not sustain any brain damage. This happy ending was due to the efforts of the entire team implementing the links in the Chain of Survival, which include: 

• Recognition of cardiac arrest and activation of 911 

• Early CPR with an emphasis on chest compressions 

• Rapid defibrillation 

• Advanced resuscitation by EMS and other healthcare providers 

• Post-cardiac arrest care 

• Recovery treatment, observation, rehabilitation, and psychological support 

A few years later, I had the privilege to work with Joe while advocating for a CPR in the Schools law in New York State. He was and continues to be one of the best survivors and advocates for CPR. I recommend you look at this very moving video that was prepared for the 2023 AHA Heart Ball in the New York Capital District. 

Joe's story is another example of the value of collaboration between EMS and law enforcement officers who often are the first to arrive on the scene of medical emergencies, motor vehicle collisions, and incidents of violence. Everyone knew the part they played in the Chain of Survival, which led to the happy outcome for Joe and his family.

What if We Don’t All Agree?
The emergency services agencies (LE, FD, EMS) should work together, train together, drill together, and understand each other’s responsibilities at the scene. Of course, we do not exist in a perfect "textbook world" and “life/stress happens” as well as not everyone is having their best day. If there is a medical issue, the SOPs of all emergency service agencies should be clear that EMS takes the lead on the medical decisions. The scene of a call is not the place to resolve disputes between emergency service agencies. After the call is always a better time to work to resolve disputes once tempers have calmed down.  

As an example, I remember when paramedics used to share some info about the severity of the patient with the LE for their report. Then the HIPAA laws went into effect and some LE officers suddenly felt the paramedics were no longer cooperating with them by sharing info at the scene. Fortunately, before the bad vibes got out of hand a wise LE Chief and EMS Chief got together to discuss the new law change. Together the chiefs decided to inform their department personnel about the new law and that the paramedics were just following their new SOP. In addition, if the police were to acquire medical information from the paramedics in a now illegal manner, the whole case could be lost. Once the time was taken to explain the new law and its impact the LE officers stopped asking for info on the patient and everyone understood why.  

Ways EMS Professionals Can Work Together with LE
When it comes to working with law enforcement at the scene, there are a few key things EMS professionals should keep in mind to make sure everything runs smoothly: 

• Define Roles Clearly: As discussed in Joe’s emergency, knowing who’s doing what is important. Following the Chain of Survival gave everyone a job to play at the scene, and it saved Joe’s life. Defining roles helps avoid responders from stepping on each other’s toes and ensures everyone has a part to play. 

• Put Scene Safety First: Work together to secure the scene. Let law enforcement handle bystanders and traffic, so you can focus on the patient. 

• Keep Communicating: Make sure you and law enforcement are on the same page. Use clear language and signals to avoid any problems with communication. 

• Train Together: If possible in your jurisdiction, participate in joint training sessions with law enforcement. This builds teamwork and helps you understand each other’s procedures. 

• Share Information: Exchange relevant information that can help both EMS and police do their jobs better. This includes anything that might impact patient care or the police investigation. 

• Support Each Other: Remember, both EMS and police have crucial jobs to do. Offer help when needed, whether it’s medical assistance for an injured officer or managing a difficult patient. 

• Debrief Together: After an incident, take time to discuss what went well and what could be improved. This helps everyone learn and work better together in the future. 

In the end, working with law enforcement at EMS calls is all about teamwork and communication. And remember: every call is an opportunity to learn and improve.