QuestionDo police officers need to know CPR?
Hopes&Fears answers questions with the help of people who know what they are talking about. Today, we wondered if cops are required to be CPR certified.
In the wake of Eric Garner and many other situations where people have said that a police officer should have been able to perform CPR but didn’t, we wondered if CPR training and certification was a basic police officer requirement. The question functions as a cross-cultural comparison, since police duties and department standards vary in different places. Within the U.S., 49 states and the District of Columbia have some kind of statewide police standards board (Hawaii still doesn’t have one) that oversee police officer training and standards. But do they all require officers to know CPR?
To find out, we contacted several organizations and individuals we thought were most likely to know the answer: the NYPD, the American Civil Liberties Union (ACLU), the New York Civil Liberties Union, Emergency Care New York, as well as EMTs and EMS directors, paramedics, field training officers, and CPR instructors in different states (New York, California, Massachusetts, Texas, North Carolina, Pennsylvania). Out of the 27 experts we reached out to, less than half were willing to answer (or attempt to answer) our question, and fewer spoke with any authority on the issue. A representative of the ACLU Board of Directors shot down the question, saying she would be of no help—since she was on vacation and hadn’t given the question the first bit of thought. Clearly, she wasn’t the only one. Another ACLU representative very graciously wished us the best of luck with this feature, offering no particular expertise on the subject raised. Most of the EMTs and paramedics did not know whether police are required to know CPR as part of their training but expressed very strongly that police should know the technique.
The respondents who have thought about the question either knew the answer but couldn’t talk to the media without first getting their department’s approval, knew the answer but couldn’t say anything that might jeopardize their positions, and therefore withheld the information, or had no idea.
Finally, we were able to get some definitive responses from a retired Lieutenant of the LAPD, a former Deputy Commissioner for Training of the NYPD, and a historian.
former Deputy Commissioner for Training at the NYPD and current Vice Provost and Professor of Criminal Justice at St. John's University
When you ask about CPR training in policing, two distinct things come to my mind. First, I’m sure you mean Cardiopulmonary resuscitation training (CPR)? A second aspect of CPR, however, especially in New York City, is Courtesy, Professionalism and Respect Training (also CPR). Every police car in the NYPD has “CPR” on the radio car, and we did build a fairly extensive training component revolving around courtesy, professional communication skills, and mutual respect. I do believe both are essential to professional policing.
Relative to the traditional CPR, yes I do think police officers need the training in this essential life-saving skill set. While on patrol, the police are frequently called upon for life-saving assistance. Even off-duty, police officers are often expected to take some action in a life-threatening situation. The ideal scenario is that am EMT and/or an ambulance responds to a scene first, but quite often the police are first responders. All types of emergencies from vehicle accidents, to apparent heart attacks, to near drowning incidents, the police are the first to arrive at the scene and they must take immediate action. Experience has shown that simply checking a patient's airway and beginning chest compressions can save lives.
All the big city police academies that I am familiar with require and provide accredited CPR training and certification for adults, small children and infants to their police officers and civilian employees. The training is typically accredited by the American Heart Association. They also provide annual updates and refreshers to remind the officers of the essential skill sets and also to maintain certification. In fact, most organizations have advanced beyond the basic CPR to include AED (Automated external defibrillators) training and routinely provide AED machines in all public buildings and police patrol vehicles.
of Americans may feel helpless to act during a cardiac emergency because they either do not know how to administer CPR or their training has significantly lapsed
out-of-hospital sudden cardiac arrests occur annually
Permanent brain damage occurs after 4-6 minutes without oxygen
Emergency Medical Services requirement for Police Officers in NY: 48 hours of training (Basic Course for Police Officers)
Source: CPR Statistics, American Heart Association, respondent David Korneluk, EMT lecturer and field training officer, New York State Department of Criminal Justice Services
retired Lieutenant of the LAPD
Is CPR part of position and training? Is it a requirement? Yes—in California.
Forty-nine of the States have some type of police officer accreditation. In California, it is “Peace Officers Standards and Training” or POST. In Delaware, it is called “Council on Police Training” and so forth. In California, CPR is a basic police officer requirement. A quick look also shows that New Jersey, Texas, Connecticut, also require it. But they all have this requirement. And I know in California it IS part of the curriculum. It’s an 8-hour day and you actually have to be re-certified every… however often the Red Cross says.
So, the answer is yes, for California. The rest of them I’m not really certain on.
of cardiac arrests occur at home
African-Americans are almost 2 times as likely to experience cardiac arrest at home, work, or in another public location than Caucasians
African-Americans’ survival rates after experiencing cardiac arrest are 2 times as poor as for Caucasians.
Director of Temple University EMS
Police training protocols differ between each police department. For many departments it is required, but for others it may only be suggested.
19,100 officers have had their licenses revoked by various training and standards agencies over the past four decades or so.
Source: Civil Beat
Volunteer Firefighter and EMT in New York, and an EMT and CPR Instructor in Boston
A common route: people who are FDNY firefighters can actually START as FDNY EMTs. I’ve got a couple of friends who have done it that route. Start out doing EMS, and then move into Fire.
There are a lot of medically trained people within the organization, to my understanding of it. I didn’t realize how many of them are firefighters but also have training as either First Responders, EMTs, what have you.
In Massachusetts, the police I work with often hold current EMT certifications. Their employers encourage them to get additional certifications or take additional classes. It works out nicely because then they know what we as EMTs are trying to accomplish. When you can look at the situation and both know what has to happen for the patient to receive care, it has made the process much more fluid.
The requirements change depending on where you are and your organization, because they have different rules. But that also goes to shift to meet the demand, where it’s going to take more response time, you’d want people who are medically trained to be more out there than say, in NYC, where you’ll get a response much quicker. But I’m not sure what the requirements are in NYC.
It’s interesting to me, especially after having met a bunch of people who ARE police, or they are in the fire department, or they’re EMTs, whatever, there’s a lot of bouncing around that happens. All of my Fire Chiefs were cops. And two of them are EMTs. They have a diverse background and I think they are more fit to lead the department because of it.
Based on my experiences, I think it’s an absolute necessity for police to know CPR. I think that everyone, not just first responders, should learn the skill if they have the opportunity. I don’t think the public realizes how extensive the collaboration is between police, fire, and EMS agencies at an emergency scene—it is definitely a group effort. In my experience, police are often the first to arrive at the scene of an emergency and may have the ability to provide care before other resources arrive. Time is crucial in trying to provide care for a patient in cardiac arrest. If officers are certified, they have a chance to help patients even further before they arrive at an emergency room for more extensive care.
hours minimum of instruction in specified areas were standard when mandated effective July 1, 1960, by the Basic Course for Police Officers
Increases in hours required
hours in 1963
hours in 1967
hours in 1971
hours in 1986
hours in 1988
hours in 1991
hours in 1997
hours in 2006
hours in 2008
hours in 2013
Different names for police officer training requirements: POST (California, Arizona), Council on Police Training (Delaware), etc.
Professor of History at NYU Polytechnic School of Engineering, and Chair of the Department of Technology, Culture, and Society. He has taught courses on New York City's infrastructure and covered topics related to security. He's also Associated Faculty in the NYU History Department
I don’t know that much about medical procedures. I’m a historian, and most of my work on policing is about demonstration policing, and crime in the 1970s and 1980s, so it’s really difficult for me to give you any expert opinion on this question. But I can give you some sort of general ideas about policy. The way in which this question has come up is in the context of Eric Garner or other cases, where some people have said that the police should have been able to give CPR on the scene, when it appeared that someone was unconscious, sometimes as a result of their own actions, is that correct?
I believe that--and fact-check this, please--I believe that NYPD officers are given CPR training at the Academy. But CPR certifications are only good for two years, and they’re not necessarily required to recertify. But to re-certify takes time, and takes police off patrols, and costs money.
The other objection I see with some police officers seems a bit more specious, or maybe a question of equipment, but certainly an understandable human response, which is: I don’t want do mouth-to-mouth resuscitation on some drug addict, and get some infection.
And the fact is, the rate of people getting infections in those situations is extremely low. It’s an understandable human response, but given that there is some risk, there’s equipment--such as barriers--that can be used to overcome that. So, it seems to me that the city should look into proper equipment and training, so the police officers can administer first aid competently and effectively.
I don’t know what it would cost, so I’m not going to pretend that I have the answer to it. But it seems to me that, Number One, it’s looking into the feasibility and cost of proper training, re-certification, and proper equipment, perhaps including barriers for mouth-to-mouth and oxygen tanks in patrol cars.
There’s one other piece to it that’s interesting, which is that I was just doing a bit of googling to familiarize myself with the issues and trying to get different points of views on it, and to (add) my own knowledge of city policy and policing. And one of the things, one of the documents, I came up with was that “CPR” in NYPD lingo actually stands for Courtesy, Professionalism, and Respect training--which is kind of amazing.
While that’s funny in a sense, I think that the attitude of the police toward the policed, toward the people they are policing, is a key part of this question about lifesaving and first aid. Police training should instill a strong ETHIC, that officers are out there to save lives.
Many police do heroic things to save lives, but is their ethic one of social control, or service? Even if it is an ethic of social control, does it have this service component to it? And what are the ways in which that could be better? I think that is a legitimate question as well.
minutes is the Average response time for ambulance to arrive in Los Angeles
Only 32% of cardiac arrest victims get CPR from a bystander
Less than 8% of people who suffer cardiac arrests outside the hospital survive (Source: CPR Statistics, American Heart Association), OR, about 92% of them die
Approximately 95% of sudden cardiac arrest victims die before reaching the hospital.
Using an AED increases probability of survival to 80%
Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival
an EMS lecturer for the Emergency Medical Services of University of Southern California
I think the best way to answer your question is to start with explaining CPR procedure and physiology before answering your direct question.
CPR patients are classified by those who are pulseless, unconscious, and not responsive to verbal ("Ma'am/sir are you ok?") or physical cues from the emergency provider. Once this is established, the provider follows a simple procedure - compressing the chest (30 times at a rate of 100/min), opening the airway with a head-tilt-chin-lift maneuver, and rescue breathing (2 breaths either mouth to mouth or with an oxygen delivery device). This procedure cycles for about two minutes until either the patient recovers or the providers want to switch positions.
Basically, the body needs oxygen to function. Without it, organs and tissues will die. In fact, permanent brain damage occurs after 4-6 minutes without oxygen. This is where CPR comes in handy. By compressing the chest, you are forcing blood (which carries oxygen by a molecule called hemoglobin) to be circulated throughout the body. This needs to happen because the patient does not have a pulse (meaning they do not have a heart beat). Next, repositioning the head allows us to establish open an airway so that we can provide oxygen via rescue breathing to the patient. Therefore, the ultimate physiological goal of CPR is to circulate and oxygenate the blood so that the patient will survive until they reach the hospital which can provide a higher level of care.
Do police need to know CPR?
In my opinion, I believe everyone needs to know CPR. It is an easy and basic thing to learn that can really have a profound impact on saving a life.
The way I see it in terms of the police, they are usually the first ones on scene (as EMTs our first rule we learn is to establish that the scene is safe before we treat anyone - and the police provide us with that security). As a result, they are the ones who establish first contact with the patient. From there, the two options are to either radio for additional medical help or let the EMTs/paramedics already on scene handle the patients themselves. For the latter, it is not imperative for the police to know CPR. But, in a profession that is filled with unknowns in terms of what the police can expect when arriving on a scene, they need to be prepared for all types of situations.
In a worst-case scenario, a patrol car responds to a 911 call where the EMTs/paramedics are not sent. Once on scene, the officer finds a patient who is pulseless, unconscious, and is in need of CPR. So, what if the officer doesn't know CPR? He has to call for medical backup. But, at least in Los Angeles, the average response time for an ambulance to arrive is 6 minutes. If you remember, after 6 minutes permanent brain damage has already occurred, and the EMTs/paramedics are already fighting a losing battle. This is why I believe that all police personnel should know CPR in order to keep a patient stable until medical professionals arrive.
Furthermore, I have heard many talk about "dangers" of CPR to personal health. To my knowledge, police units do not carry oxygen tanks. As a result, people think that rescue breathing must be performed in a mouth-to-mouth fashion, which of course would put them at risk to any sickness/disease that would come from the patient's mouth. Even though this is true, just knowing how to perform compressions properly will circulate some oxygen and can give more time to keep the patient alive before an ambulance arrives.
The number needed to treat to save 1 life ranged from
16 to 23
for EMS-witnessed arrests
17 to 71
24 to 36
for receiving bystander CPR
depending on baseline survival rates
Aggregate survival rate of out-of-hospital cardiac arrests, recorded across various populations: 7.6%, or between 6.7% and 8.4% (this rate has not changed much in almost 3 decades).
Source: “Predictors of Survival From Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis”, First Aid Corps, “Predictors of Survival From Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis”
Illustration: Yulia Goldman