PERF’s Daily Clips recently featured a Philadelphia Inquirer article about a recent study of the Philadelphia Police Department’s “scoop and run” policy, which instructs officers to transport some shooting and stabbing victims to the nearest trauma center in their patrol cars.

PERF Executive Director spoke with Joel Dales, Deputy Commissioner of Patrol Operations at the Philadelphia Police Department, and Dr. Jeremy Cannon, who is a trauma surgeon at the University of Pennsylvania Medical Center and a co-author of the study.

Philadelphia Police Deputy Commissioner Joel Dales

Chuck Wexler: Tell me about this program.

Deputy Commissioner Dales: This has been going on for many years. Even before it became a policy, we were doing the scoop-and-run. Our policy instructs police officers to transport anyone suffering from a serious penetrating wound, such as a gunshot or stab wound, to the nearest trauma center.

Wexler: Why did Philadelphia PD first decide to do this program?

Deputy Commissioner Dales: The reason we implemented this policy is because we believe it saves lives. When you’re the first responder at the scene with a gunshot victim lying there bleeding, the family is begging you to take this person to the hospital, and you see them dying in front of your eyes, that can be a problem. The main purpose was to save more lives.

Wexler: Is this a written policy? How do officers decide when they should take someone?

Deputy Commissioner Dales:  Yes, it’s a written policy. It falls under our hospital case policy. There’s a section that says, “Police officers will transport persons suffering from serious penetrating wounds, such as gunshot wounds or stab wounds, to the nearest trauma center.”

It also states that for anyone suffering from blunt trauma or any type of violent injury due to an auto accident, such as trauma to the head or chest, we would wait for medics to show up and transport those types of victims. That’s because of the higher level of treatment that the fire department can provide in those circumstances.

Wexler: How do the officers feel about this policy?

Deputy Commissioner Dales: I haven’t heard any complaints from police officers, and I’ve been doing this for over 30 years. It’s locked in the police officers’ minds that this is what we do. We’re here to save lives, and we protect and serve. When we see someone suffering from a gunshot wound, no matter who they are, we rush them to the hospital as soon as we can.

Wexler: What is the fire department’s response to this policy?

Deputy Commissioner Dales: They understand why we do what we do. When they show up and we’re not there, they understand. I’m sure if it was their loved one lying there, suffering from a gunshot wound or stab wound, they would want us to rush them to the hospital immediately. So there’s no friction between us and the fire department based on our scoop-and-run practices.

Wexler: Are officers given any training to implement this policy?

Deputy Commissioner Dales: In the police academy, recruits participate in reality-based training, and I’m sure there’s a scenario where someone needs to be rushed to the hospital. If you’re solo, how do you drag someone to put them in a car? If there are two officers, one person takes the arms and the other person takes the legs to put them in the vehicle. They also practice safe driving as they head to the trauma center.

Wexler:  How is this seen in the community?

Deputy Commissioner Dales: It’s good for us to do this in the community, especially in communities where we have folks who dislike the police. When they see that we’re out there risking our lives to get them to the hospital and try to save their lives, they look at us a little differently.

I recently received a phone call from a man in his early 60s, who told me about a scoop-and-run incident he had witnessed. He said that when the police arrived, he showed the officer where the guy was, and the guy was begging for his life. “Please, officer, get me to the hospital. I don’t want to die. I don’t want to die.” The officer picked the guy up, and blood was dripping all over the officer’s shirt. The officer put the guy in the car, rushed him to the hospital, and, as of today, this man is still alive.

The man who called me said that he used to feel a certain way about the police, but he considered that officer a true hero. He saved this guy’s life. He wanted to make sure this officer received an award for the heroic act he carried out on the scene.

I reached out to the captain and told him about the call, and the captain delivered that message to the officer.  The officer felt really good about it, that someone recognized what he did. It makes a big difference, especially in the times we’re dealing with now.

Dr. Jeremy Cannon, University of Pennsylvania

Wexler: Can you tell me a little about yourself? And how did you first become aware of the police department’s scoop-and-run program?

Dr. Cannon: I’m a trauma surgeon here in Philadelphia. I work at the University of Pennsylvania. I moved here from San Antonio, Texas in 2015 after serving on active duty in the U.S. Air Force for nine years as a trauma surgeon. I had three deployments during that time, first to Iraq and then two subsequent deployments to Afghanistan.

At the University of Pennsylvania, I’m the trauma program medical director. I have weekly, if not daily, contact with the Philadelphia Police in our trauma bay.

We did not have this program in San Antonio. I saw some practices like this in my military experience, where the special forces guys would bring their buddy in on a Humvee with some basic medical care, like a tourniquet, but not much else. And it would be “go time.” It was up to us to sort out the critical injuries, identify the patients who were severely hemorrhaging, and render lifesaving care.

So I had seen that on the battlefield, and I immediately recognized it as a tremendous innovation, and in some ways, a model that could potentially inform future military care and civilian care in other cities.

As I got settled into my position here at the University of Pennsylvania, I took a great interest in this practice and have been doing whatever I can to promote it over the past five and a half years.

Wexler: What should people know about your study of the scoop-and-run program?

Dr. Cannon: This study was a review of data that is routinely collected at all our trauma centers and funneled into a central repository in Pennsylvania. Pennsylvania is unique among states in that they have a really high-quality trauma database. Trauma scientists and researchers from other cities and states request this high-quality data from this great resource we have.

We’re very familiar with the database and leverage it as much as possible. I consider this very good, reliable data, but maybe not the most reliable and most scientific. So this was a first step to try to understand the practice and determine if there may be a signal for patient survival and benefit.

We mined this data to study the practice. The signals we see are, first, that this practice is embraced. Transport by police has gone up dramatically in the five years of this study. Compared to a previous study that was done by other investigators in the city using data that predated this dataset, the volume and rate of transport by the police has gone up dramatically. So it’s being embraced and practiced on a daily basis and, unfortunately, many times a day.

As Deputy Commissioner Dales mentioned, the community sees the value in it. The officers on the street see the value. The practice has caught on in a big way.

The second question we have is if it’s safe and if we can determine if there’s actually an association with improved survival. I say “association” because we’re looking back at data that’s been collected, and it’s not as if we’re controlling all the different variables and factors. We’re just taking a snapshot and looking back. It’s very high-quality data, but we can’t say whether this causes a harm or benefit, even if it’s associated.

The association we see is that for those patients who are most severely injured, they come in with vital signs and have a chance to make it. Beyond that, it’s safe. You’re getting a chance to survive, and there’s no real downside we could detect.

So we believe it’s very appropriate that it has caught on as dramatically as it has, and there has not been any detectible downside to that increased volume, from what we can see.

Wexler:   There’s a difference between gun injuries and the type of injuries you might get in a car accident, right?

Dr. Cannon:  Yes, “scoop and run” is for patients who have been shot or stabbed and are bleeding. If you started branching out into blunt trauma, car wrecks, or train accidents, I think there is potential for harm. There’s great concern that [if police transport those types of patients], you’re going to cause a spinal cord injury, disrupt a clot, or something like that. But we do not see that with these penetrative trauma patients.

Here in Philadelphia the fire department folks are bringing a long spineboard, they have hard collars, and they have the opportunity to place an intravenous line. In some cases they can place a breathing tube if the patient is unconscious. So they bring value and important medical interventions into the pre-hospital environment. But those are best applied to patients with blunt injuries.

For the bleedingpatient after a gunshot wound or stabbing, the most important thing is to diagnose the site of bleeding and stop the bleeding. Nothing other than placing a tourniquet will stop the bleeding in the pre-hospital environment.

 

The PERF Critical Issues Report is part of the Critical Issues in Policing project, supported by the Motorola Solutions Foundation.

 

PERF also is grateful to the Howard G. Buffett Foundation for supporting this work.