Introduction: Although LEOs frequently provide medical care to injured individuals, this care is more likely to be perceived by EMS as harmful compared with non-LEO emergency medical responders. Despite the rapid provision of LEO care after OIS, no mortality benefit has been demonstrated. The purpose of this study is to characterize the nature and appropriateness of care rendered by LEOs. Methods: Retrospective analysis of open-source video footage of OIS occurring between January 1, 2023, and December 31, 2023. Only footage containing LEO medical care was included in the final cohort. Care provided, appropriateness of care, presence of cognitive errors, and mortality outcomes were evaluated. The study was deemed exempt by the Mayo Clinic Institutional Review Board. Results: Of 347 videos, 87 were included in the final cohort. Time to LEO intervention was 170.2 ± 218.6 s; care was rendered in 300 s in 14.3%. Mortality was 55.3%. Torso trauma occurred in 58.6% of cases, while isolated extremity trauma occurred in 19.5%. Tourniquets were placed in 27/30 casualties and were not indicated in 18. One of three casualties who did not receive a tourniquet may have benefited from one. Chest seals were appropriate in 29 casualties and applied in 18. Hemostatic gauze was applied in 14 casualties; it appeared appropriate in 5 and was incorrectly applied in 6. CPR was performed in 25 casualties; 4 had signs of life and 4 received CPR from a standing position. Difficulty identifying medical supplies appropriate for the injury was noted in 11 videos. Cognitive compromise was noted in 14 videos. Conclusion: Although care was rapidly rendered in the majority of cases, mortality remained high. Inappropriate or incorrectly applied medical interventions were commonly noted. Multiple opportunities to improve LEO medical care exist.
Wood et al. (Sun,) studied this question.