The Hartford Consensus and the Major
Cities Chiefs Association
From its inception, the agencies represented by the Major Cities Chiefs
Association (MCCA) and many other law enforcement agencies around
the U.S. and the world have been supporters and contributors to the
Hartford Consensus. In addition to the adoption of the response concepts
represented by the acronym THREAT (T hreat suppression, Hemorrhage
control, Rapid Extrication to safety, Assessment by medical providers,
and Transport to definitive care), the provision of hemorrhage control
has been recognized by many as a core law enforcement skill. Although
data regarding specific use of hemorrhage control during active shooter
situations are scarce, agencies across the country are reporting multiple
lives saved with the use of these techniques. In Tucson, AZ, the police
and sheriff’s departments have a long history of a law enforcement
agency–based hemorrhage control program. Responsible for saving
more than 75 lives over the years, it is hailed as a real example of the
improvement in community safety when LEOs can provide effective
hemorrhage control at the point of wounding.
At the October 2013 meeting of the MCCA, the Hartford Consensus was presented to the membership and its concepts unanimously
endorsed. Since that meeting, nearly 45 of the 70 agencies represented
by the MCCA have completed or are in the process of training and
equipping their LEOs with hemorrhage control training and equipment. This trend translates into more than 180,000 LEOs in our nation’s
largest cities (or approximately one of every five U.S. LEOs) who are
now capable of saving an injured civilian or one of their fellow officers
injured in an active shooter or other situation. These officers provide
this protection to nearly 80 million Americans.
Additional agencies are coming on board each week, moving their
LEOs into the present by training and equipping them with hemorrhage control equipment. Some novel and effective local partnerships
exist, but our nation’s trauma centers must be engaged and ensure that
every law enforcement agency has both the expertise and the resources
to develop these lifesaving capabilities.
As threats continue to evolve, our nation’s LEOs will continue to be
our frontline responders to incidents in which citizens are injured. We
must continue to train these LEOs to meet these challenges. For individuals who face these threats or have to respond to these incidents, it
is the ultimate community policing program. ♦
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with public safety organizations on
bioterrorism response. Prehosp Emerg
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2. Eastman AL, Metzger JC, Pepe PE,
et al. Conductive electrical devices: A
prospective, population-based study of
the medical safety of law enforcement
use. J Trauma. 2008; 64( 6):1567-1572.
3. Metzger JC. Civil sector tactical EMS.
J Trauma. 2007; 62(suppl 6):S17.
4. Sathyavagiswaran L, Rogers C,
Noguchi T T. Restraint asphyxia in
in-custody deaths: Medical examiner’s
role in prevention of deaths. Leg Med.
2007; 9( 2);88-93.
5. Hawkins SC, Shapiro AH, Sever AE,
Delbridge TR, Mosesso VN. The role
of law enforcement agencies in out-of-hospital emergency care. Resuscitation.
2007; 72( 3):386-393.
6. Veliz C, Montgomery H, Kotwal
R. Ranger first responder and the
evolution of tactical combat casualty
care. J Spec Oper Med. 2010; 10( 3):90-91.
DALLAS POLICE DEPARTMENT
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