Physicians in police tactical teams - ethical considerations.

High-profile mass shootings, terrorist attacks, and experience acquired during recent conflicts have led to a shift in police tactics, who now follow an aggressive approach to immediately neutralize the threat in addition to providing early tactical medical care. A growing number of police tactical teams now include physicians in their ranks to increase the level of forward care. Many ethical questions arise from having physicians on police tactical teams, such as the notion of risk, the use of force, and the ultimate role the physician is expected to play. Having a physician in such a team may be an invaluable asset to increase the team's safety and allow for advanced forward care, however, this requires two important conditions. The first is that the role of the physician is clearly defined and that what is expected of him is in line with medical ethics, while the second is extensive tactical training with the team to collaborate flawlessly in this complex, high-stress environment.

Physiological, cognitive and neuromuscular effects of heat exposure on firefighters after a live training scenario.

This study investigated physiological, cognitive and neuromuscular performances in firefighters after a structural live-fire scenario. Changes in vital signs, environmental parameters and cognitive and neuromuscular performance were measured before and after a live-fire training session in a closed environment, in conditions similar to those one could encounter in a structural fire. Very high ambient temperature peaks were reached during the 30-min sessions. After the session, the forehead temperature was increased by 0.5 °C, mean water body loss was 639 ml and the mean heart rate increase was 7.5 bpm. Mental calculation speed did not vary significantly, however we observed a reduction in reaction time. These findings demonstrated that after 30 min of exposure, heat stress had little impact on firemen. Stress activation seems beneficial after firefighting operations. Normal vital parameters should allow re-engagement for a second firefighting task. This result must be compared with longer exposures.

French firefighters exposure to Benzo[a]pyrene after simulated structure fires.

INTRODUCTION: Firefighters have occupational exposure to toxic compounds during firefighting, but not only. Surface contamination of equipment has never been studied in French firefighters. MATERIALS AND METHODS: This study measured the surface load in benzo [a]pyrene (BaP), a carcinogenic polycyclic aromatic hydrocarbon, on the outer surface of fire jackets, personal protective equipment and tools used by firefighters after a live fire training in a closed environment. The effectiveness of a standard jacket washing procedure on BaP contamination was assessed. RESULTS: A single training session was responsible for a BaP deposit of 113.75 ±â€¯45.03µg/m2 on exposed fire jacket material. After a single session, the deposit of BaP found on PPE and tools was measured on different surfaces ranged from 12 to 157 µg/m2. After multiple training sessions, a cumulative effect was suspected. The current PPE cleaning and maintenance procedures does not appear to effectively reduce contamination. CONCLUSION: French firefighters' exposure during in a live-fire training session in fire simulator is responsible for exposure to BaP. The estimated load of BaP on the outer surface of fire jackets could potentially have acute and chronic effects if absorbed in one's body. Further studies are needed to better understand individual French firefighters' exposure and determine appropriate measures to prevent contamination. It will be also be necessary find maintenance procedures that significantly reduce the BaP load.