The Mission of Protection: Part 3

Prevention of Medical Emergencies

Actuaries tell us that the majority of persons over the age of forty-five will eventually find themselves in a statistical population that requires more frequent trips to the doctor, regular access to prescribed medications and diminishing physical skills.

Even in younger age groups, one needs only to turn on the evening news or call their local elementary school to find out about the latest batch of bacteria, fungi and viruses making their way through your neighborhood. Like it or not, we are all going to get sick… eventually.

In anticipation of these eventualities, when first assigned to a protectee, specialists should become familiar with any medical problems, special dietary requirements or food/environmental/drug allergies so that they can rapidly respond to medical emergencies.

Keep in mind that in the United States and many other countries, access to this information may be strictly controlled by state or federal law. This means that you must be careful how you acquire, disseminate or process confidential medical information.

However, despite our best efforts to safeguard this information, depending on their media profile, news of your Protectee’s personal medical issues may find its way into the public forum through any number of journalistic endeavors and entertainment tabloids (including http://www.hollywoodgrind.com/tag/celebrity-illness/
http://www.stoppagingme.com/ to name but a couple).

We should be prepared to do what we can to minimize embarrassment and facilitate their treatment regimen:

•    Avoid discussions about your Protectee’s health or schedules
•    Consider alternate entrances/exits for doctor visits
•    Investigate information leaks immediately
•    Obtain confidentiality agreements from staff and contractors
•    With your Protectee’s consent, obtain certifications and physician protocols to assist with medications if necessary (if permitted in your area).
•    Monitor your Protectee for changes in behavior or level of consciousness following clinical visits or the administration of medication.
•    If your Protectee has food allergies, inquire about food preparation when advancing hotels/restaurants

Persons of prominence are human, and thus susceptible to viruses, bacteria, chronic disease and anaphylactic reaction just like any other segment of the population. Many of our US presidents and vice presidents suffered from chronic medical conditions.

The list of asthma sufferers alone includes Calvin Coolidge, John F. Kennedy, Theodore Roosevelt and Walter Mondale.  Other leaders have had allergies to food items such as shellfish or peanuts. These allergies, left unmanaged can result in serious complications including the need for emergency surgery to open an airway.

Still, the work must go on, and the protection specialist should simply prepare for this element as a part of their normal advance. And, preparation begins with knowledge.

All team members should have current First Aid, CPR and AED certifications, and be diligent in renewing them every year. However, at least one member of a protection team should have advanced training that enables them to carry out a physician’s protocol, specific to their Protectee.

Also, as a reminder for those of us who re-certify with TASERS every year, but may have let our AED certifications lapse: AN AED IS NOT A TASER!

While we are used to handling individuals during TASER exposure, we cannot touch a patient about to undergo defibrillation. First, the device may interpret your movement as the patient’s and not advise a shock when one should be indicated.

Second, if you are touching a patient between the pads or a pad is on a conductive surface during defibrillation, you can get quite a surprise in the 200-360 joule range (A TASER shock is about 0.3 joule).

For those of us who have been through formal EMT/para-medic programs we remember having it drilled into us that the first consideration when responding to a medical emergency is “…is the scene safe?”

Most assuredly, we want to ascertain that we’re not stepping on live electrical lines or entering a confined space with a toxic atmosphere. However, in the field of protection, we have already recognized that the life of our Protectee comes first and we come second.

This doesn’t mean that we recklessly take chances in furtherance of these goals, but rather we educate ourselves to the extent that we understand the range of likely environmental hazards and our patient’s susceptibility to a potential medical emergency.

As a protection specialist, factor in that we may have to undertake a response that would be perceived by others to be slightly more risky than what the average EMT might encounter.

How Disease Spreads
With fears of influenza receiving the media’s lead-story positioning, it is important for the protection specialist to have an elementary understanding of communicable disease…and how not to commune.

Doctors, nurses, lab techs and other responders work around disease every day and manage to keep themselves out of a hospital bed, primarily because they understand how disease is transmitted and take the necessary precautions. The bacteria and viruses that cause disease can be transmitted among populations through any or all of the below “horizontal” methods:

•    Direct contact – touching a contaminated individual
•    Indirect contact – touching a contaminated surface
•    Droplet contact – coughing/sneezing on another person
•    Airborne transmission – micro-organism remains in the air
•    Vector-borne transmission – carried by insects or animals
•    Fecal-oral transmission – usually from contaminated food/water products

The term, “Vertical” transmission refers to the disease transmission from mother to infant either in the womb or through breast milk or other bodily fluids.

Since none of us are epidemiologists (I’m not, anyway), we should keep this subject simple by thinking about OSHA’s succinct recommendations for you and your Protectees:

•    Have immunizations brought current
•    Use precautions when giving care
•    Maintain good personal hygiene
•    Emphasize safe work practices
•    Clean and disinfect frequently
•    Seek treatment if exposed and symptomatic

In addition to your client’s personal physician, excellent sources of information relating to the current list of bad-bugs are available through:
http://www.cdc.gov/  (Center for Disease Control)
http://www.who.int/en/  (World Health Organization)
http://www.needletips.org/catg.d/p2011.pdf  (Summary of Recommended Immunizations)
http://www.iamat.org/  (International Association of Medical Assistance to Travelers)
http://www.online-medical-dictionary.org/Horizontal+Disease+Transmission.asp?q=Horizontal+Disease+Transmission

Other valuable sources of information include organizations requiring paid-subscriptions such as:
http://www.ijet.com/index.asp    (i-Jet Intelligent Risk)
http://www.nc4.us/         (NC4)
http://www.internationalsos.com/en/index.htm?CFID=26740345&CFTOKEN=43994748
(International SOS)

We should agree that patient survival of any medical emergency is dependent on how fast we can get them to professional care. But, we can sometimes extend this time element by supplying varying levels of first aid and responsible pre-hospital care. As the Boy Scouts say, “Be Prepared”!

Stay safe out there – I have to sneeze.
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Rick Colliver has served as the global security director for two multi-national corporations with operations in 24 time zones, and has managed protection details in Europe, Africa, Asia and the Americas. He is the course developer and lead instructor in the Principal Protection program at the Ohio Peace Officer Training Academy and is an adjunct instructor in protective operations through several police, military and academic organizations. His book, “Principal Protection; Lessons Learned” is due out in summer 2010.