Police Involvement in Out-of-Hospital Cardiac Arrest: A Qualitative Exploration of Law Enforcement Roles and Contributing Organizational Factors

Abstract

Objectives Many American police organizations respond to out-of-hospital cardiac arrest (OHCA). This study sought to: 1) explore variation in the role of police in OHCA across emergency medical systems and 2) identify factors influencing this variation. Methods We conducted a qualitative multisite case study analysis using data collected through semi-structured key informant interviews and multidisciplinary focus groups with telecommunicators, fire, police, emergency medical services, and hospital personnel across nine Michigan emergency systems of care. Sites were sampled based on return of spontaneous circulation rates, trauma region, geography, rurality, and population density. Data were analyzed to examine police role in OHCA and the organizational factors that contribute to these roles. Transcripts and coded data were explored using iterative thematic analysis and matrices. Results Interviews included approximately 160 public safety informants of varying administrative levels (i.e., field staff, mid-level managers, and leadership). Across systems, police played four on-scene roles in OHCA response: 1) early responder, 2) resuscitation team member, 3) security, and 4) information gathering. Less consistently, police performed supplementary roles as telecommunicators and cardiac arrest educators. We found that factors including administrative structure of the police agency, resources (e.g., human and material), organizational culture, medical training, deployment and response policies, nature of response environment, and relationships with other prehospital stakeholders contributed to the degree certain roles were present. Conclusions Police serve numerous on-scene and supplementary roles in OHCA response across jurisdictions. Their roles were influenced by multiple factors at each site. Future studies may help to better understand the value of and how to optimize police engagement in OHCA response.