Man injured during restraint and arrest - Thames Valley Police, March 2018
On 3 March 2018 Thames Valley Police officers attended a shop in Aylesbury, Buckinghamshire, following an allegation that a man was threatening members of the public with a chair. Officers found the man and arrested him. He was taken down to the ground by officers after resisting, and sustained an injury to his nose. The man was transported to custody, where he was assessed by a health care professional (HCP), who determined he was fit for detention. The man remained …
Recommendations
2 totalNational recommendation The College of Policing should review the guidance on head injuries in Authorised Professional Practice (APP) to: This follows a case where a man appeared to sustain an injury to his nose after being taken to the ground by police officers. The officers believed the man had suffered a head injury, which according to APP requires a detainee to be taken to hospital immediately. The officers called an ambulance to meet them at the police custody suite. However, the man was seen in the custody suite by a Health Care Professional, who assessed him as having a facial injury and decided that the man did not need an ambulance. The man became unwell 24 hours into his detention and was then taken to hospital for a head injury assessment, where it was determined that he had a possible fracture to his nose. Our investigation found that there had been some confusion about whether the man’s injury should be classified as a head injury. We also identified that the APP signposted officers to other guidance that was not the most recent version and that gave slightly different advice to that given in the APP itself. Do you accept the recommendation? N/A
Recommendation to Thames Valley Police Thames Valley Police should review its training to ensure that it is providing officers with clear advice on what constitutes a head injury and when immediate medical advice must be sought and/or when a detainee must be transferred to hospital. This follows a case where a man appeared to sustain an injury to his nose after being taken to the ground by police officers. The officers believed the man had suffered a head injury, which according to APP requires a detainee to be taken to hospital immediately. The officers called an ambulance to meet them at the police custody suite. However, the man was seen in the custody suite by a Health Care Professional, who assessed him as having a facial injury and decided that the man did not need an ambulance. The man became unwell 24 hours into his detention and was then taken to hospital for a head injury assessment, where it was determined that he had a possible fracture to his nose. Our investigation found that there had been some confusion about whether the man’s injury should be classified as a head injury. We also identified that the APP signposted officers to other guidance that was not the most recent version and that gave slightly different advice to that given in the APP itself. Do you accept the recommendation? Yes
Accepted action: [The Force Medical Director] and I [First Aid Team Leader] have reviewed the First Aid training for Head Injuries and consequently the training material has been revised in accordance with the recommendation herewith. PP Slide 1 and notes Head Injuries Most head injuries will not be life threatening, but anyone who has lost consciousness for any period of time, whose levels of consciousness deteriorate, or you suspect has a fractured skull - should be treated as a medical emergency and transported to hospital to be assessed by medical staff. The signs and symptoms vary from person to person and in severity. There is always a history of a significant blow to the head and the casualty may become unconscious for a short period, after which the levels of response should improve. (Concussion) They may not be able to remember some of the events either side of the head injury. They will probably have a headache and be dizzy or confused. Frequently they feel nauseous or are sick, breathing and pulse rate could increase and the skin may look shocked – pale, cold and clammy. If there is traumatic injury to the head, the levels of consciousness become worse as the condition develops (Compression). There is little you can do about this apart from recognise it and get medical help to you as quickly as possible. The most significant sign is if one pupil is dilated more than the other (unequal pupils). Other signs of a very serious head injury include a flushed, dry skin, intense headache and nausea; if the skull is fractured there could be swelling or bruising of the head, around one or both eyes, or behind the ears. Treatment This is a Medical Emergency – call for an ambulance In the meantime, maintain airway and breathing.If the casualty is conscious, help them lie down and keep the head, neck and body in line in case there is a spinal injury.If the casualty is unconscious, keep them still and constantly monitor their breathing. If you struggle to keep the airway clear, place them in recovery position using the spinal log roll technique as best as you can.Control any bleeding by applying gentle pressure around the wound. Do not plug any bleeding coming from an ear.Look for and treat any other injuries. PP Slide 2 and Notes When dealing with Disorder e.g. incidents outside a pub involving alcohol, drugs and fights, you must be aware of the potential for serious injuries. These may happen as a result of fighting and/or falling over and it is not uncommon for people in these circumstances to suffer with traumatic head injuries. The most serious causes of a nosebleed could be a fractured skull. It is essential to be aware that the signs and symptoms of alcohol abuse are similar to those of a traumatic head injury or a stroke. Gain as much history as possible e.g. fights? falls? and look for signs and symptoms of a head injury. Remember that a detainee must be transported directly to hospital if they: are showing any symptoms of head injuriesare, or have been, unconscioushave suffered serious injury If there is no evidence of a head injury and your casualty is not capable of standing, is semi-conscious or barely responsive: