PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14 Issued Date: 03-08-96 Effective Date: 03-08-96 Updated Date: 05-28-10 SUBJECT: HOSPITAL CASES INDEX SECTION TITLE PAGE NUMBER 1 Policy 1 2 Procedure 1 3 Medical Treatment of Prisoner 3 4 Aeromedical Transport of Trauma Emergencies 4 Appendix A Accredited Trauma Centers and Trauma Receiving Hospitals Appendix B Automated External Defibrillator (A.E.D.) Example Memorandum for Reporting A.E.D. Usage Appendix C Protective Services for Older Adults Appendix D Heat Emergencies Appendix E Duty of Police Officer to Identify and Facilitate Medical Care for Persons Found in Semi-Conscious or Unconscious Condition as a Result of Epilepsy, Diabetes or Other Illness

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14 Issued Date: 03-08-96 Effective Date: 03-08-96 Updated Date: 12-17-01 SUBJECT: HOSPITAL CASES 1. POLICY A. Police personnel will consider the assignment of a hospital case an emergency unless advised otherwise by a medically competent person. First aid will be rendered and the person transported to the nearest hospital. However, any person with a serious penetrating wound or a blunt trauma to the body will be transported to the nearest accredited trauma center. B. Police personnel assigned to radio patrol cars will, whenever possible, without detriment to the person, handle hospital cases to ensure availability of emergency patrol wagons for other assignments. C. The Philadelphia Police Department will not dispatch police officers to the scene of hospital cases when Fire/Rescue responds except in the following circumstances: 1. When requested by Fire Communications. 2. Hospital cases arising from criminal acts, auto accidents or any other instances in which a police investigation / action is required. 2. PROCEDURE A. Police personnel will transport: 1. Persons suffering from a serious penetrating wound, e.g., gunshot, stab wound, and similar injuries of the head, neck, chest, abdomen, and groin to the nearest accredited trauma center. Transportation of such cases will not be delayed to await the arrival of Fire Department paramedics. NOTE: Persons suffering from blunt trauma or a violent injury to the body (e.g. closed trauma to the head or chest as may result from a motor vehicle accident or a fall) should be transported to the nearest accredited trauma center by Fire Department paramedics because of the level of treatment that can be provided by the Fire Medics. DIRECTIVE 3.14-1

2. Police/Fire Personnel as follows: a. On duty emergency - to appropriate treatment facility b. On duty non-emergency - to closest Compensation Clinic c. Off duty injury/illness - to appropriate treatment facility B. Police personnel will: 1. Exercise safety precautions as per Directive 3.15, "Communicable Disease Patients." 2. Permit family members or friends to accompany the person to the hospital. 3. Use handcuffs when transporting prisoners (unless otherwise directed by a supervisor). 4. Ride in the rear of an Emergency Patrol Wagon with the person unless: a. The person is a prisoner. b. The injury/illness is not serious. c. The person is accompanied by family or friend. 5. Notify Police Radio of type of injury and hospital destination. 6. After the arrival at a trauma center with the person having a serious penetrating wound or a blunt trauma to the body, notify Police Radio Operations Desk and Operations Room Supervisor of district of occurrence by phone with the pertinent facts of the assignment. a. Notify Detective Division Supervisor if the injury is undetermined, suspicious or a crime has been committed. 7. Prepare a Complaint or Incident Report (75-48) on all hospital cases in compliance with Directive 12.11. C. Patrol Supervisor will: 1. Make the final determination for hospital cases requiring specialized treatment at a hospital other than an accredited trauma center. DIRECTIVE 3.14-2

D. Police Radio will: 1. Notify Fire Department Paramedics to respond to serious injuries/illnesses. 2. Notify the receiving hospital of the person's condition and expected time of arrival. 3. Maintain a log on all trauma cases. E. Fire Department Paramedics will: 1. Respond to serious injuries/illnesses such as seizures chest pains, strokes, overdoses, diabetic problems, unconsciousness, poisoning, broken bones, or back injuries. 2. Assume full responsibility for the medical welfare of the person. 3. MEDICAL TREATMENT OF PRISONER A. When a prisoner is taken to an emergency facility, the transporting officers will: 1. A brief description of the injury and the physician's name. If the prisoner refuses medical treatment, request the physician sign the 75-48. a. Prior to removing a prisoner from the hospital, the transporting officers will contact the pertinent Detective Division/Unit Supervisor for instructions. *2 b. The Operations Room Supervisor will ensure that a separate set of district control numbers will be requested for the hospital case. This set of district control numbers will be in addition to those issued for the original incident. c. The 75-48 will be coded 3017 (Hospital Case in Police Custody). The district control number of the original incident will be placed in the description of incident section of the hospital case 75-48. d. The ORS will ensure that the IAB Incident Notification Screen is filled in completely. The Incident Notification Screen will now require both the original DC# and the hospital case DC#. (Access to screen SEND/IA1A/901). B. Distribution of the 75-48 for a prisoner receiving medical treatment: Original. Reports Control and Review Yellow Copy District File DIRECTIVE 3.14-3

Pink Copy.. To accompany the prisoner *1 C. Notification of Internal Affairs: 1. When the cause for the medical treatment results in death or serious life threatening injury a supervisor will immediately notify his/her commanding officer or Command Inspections Bureau (CIB) commander. That commander will then immediately notify Internal Affairs by phone. Police Radio will be notified on the 12 8 tour or on weekends. 2. The Operations Room Supervisor (ORS) will also ensure that the IAB Incident Notification Screen is filled in completely and accurately. (Access the screen using computer code - SEND/IA1A/901). 3. When the cause for the medical treatment results in only minor injury or complaint of pain, only the IAB notification screen need be completed, no phone call to Internal Affairs from a commander is necessary. 4. AEROMEDICAL TRANSPORT OF TRAUMA EMERGENCIES A. Patients who should be considered for aeromedical transport include: 1. Critically ill patients needing immediate intensive care. 2. Victims of serious, life-threatening trauma. 3. Patients with life-threatening, neonatal, obstetrical or pediatric emergencies. 4. Patients in need of rapid diagnostic testing and highly specialized medical attention. B. Fire Department Emergency Medical Technicians, when at the scene, will determine when to contact the aeromedical transport. C. When Fire Department Emergency Medical Technicians are not at the scene, the highest-ranking supervisor at the scene will determine when to contact the aero medical transport. D. Patients will be taken to Hahnemann University Hospital's Trauma center in all cases when aero medical transport is used. DIRECTIVE 3.14-4

BY COMMAND OF THE POLICE COMMISSIONER *FOOTNOTE# GENERAL # DATE SENT REVISION *1 1915 06-19-01 Addition *2 6505 12-17-01 Addition *3 9061 10-12-04 Change & Addition Appendix C 2773 05-21-10 Addition Appendix D 4440 05-27-10 Addition Appendix E 5975 05-28-10 Addition DIRECTIVE 3.14-5

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14 APPENDIX "A" Issued Date: 03-08-96 Effective Date: 03-08-96 Updated Date: SUBJECT: ACCREDITED TRAUMA CENTERS AND TRAUMA RECEIVING HOSPITALS 1. POLICY 1. The following hospitals have trauma treatment capabilities. When within 10 minutes transport time, transport to accredited trauma hospital (*asterisked hospitals).transport to closest hospital on list. POLICE HOSPITAL LOCATION DIVISION * Hahnemann Broad & Vine Sts. Central * Jefferson 11th & Walnut Sts. Central ** St. Christopher's Erie Ave. at Front St. East * Temple 3400 North Broad St. East * Einstein (Northern) Old York & Tabor Rds. Northwest * Aria (Torresdale) Knights & Red Lion Rds. Northeast ** Children's Hospital 34th & Civic Center Blvd. Southwest * University of Pennsylvania 3400 Spruce St. Southwest * Penn Presbyterian 3800 Market St Southwest * Accredited trauma centers for adult and pediatric multi-system patients. (Note: Temple- adults only.) ** Accredited trauma center for pediatric (16 years and under) multi-system patients. BY COMMAND OF THE POLICE COMMISSIONER DIRECTIVE 3.14-1 APPENDIX A

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14 APPENDIX B Issued Date: 03-24-04 Effective Date: 03-24-04 Updated Date: 10-12-04 SUBJECT: AUTOMATED EXTERNAL DEFIBRILLATOR (A.E.D.) 1. PURPOSE A. To establish guidelines for the use of the Automated External Defibrillator (A.E.D.) by members of the Philadelphia Police Department including placement of units, provider training, documentation of use, equipment maintenance, interface with the Philadelphia Fire Department Emergency Medical Services (PFD EMS), Medical Oversight and the responsibility of the Philadelphia Police Department A.E.D. coordinator. 2. POLICY A. Sudden cardiac arrest is a major cause of death in the United States. A critical step in treating victims suffering from cardiac arrest is the delivery of an electrical shock (defibrillation) to the heart with the use of an A.E.D. when indicated. In an attempt to reduce mortality from sudden cardiac arrest, members of this department trained in cardiopulmonary resuscitation (CPR) and trained in use of the A.E.D. will follow the guidelines established by the certifying agency. B. A.E.D providers will assess the circumstances and follow the A.E.D protocol for delivering shocks, as trained. An A.E.D unit will not be used in any situation precluding safe use such as the patient being immersed in water or lying on a metal surface. NOTE: Anytime an A.E.D. is applied to a patient, a Complaint or Incident Report (75-48) for a hospital case will be prepared along with an A.E.D. Incident Memorandum. (See example format). In the event that an A.E.D. is used other than that assigned to the Philadelphia Police Department, officers will abide by the reporting procedures pertinent to that device (e.g. Public Access Device s (PAD s) such as those located at the Philadelphia International Airport). DIRECTIVE 3.14-1 APPENDIX B

C. The placement of the Medtronic Physio-Control Life-Pak 500 series A.E.D. will be at fixed locations and secured inside the assigned A.E.D. wall cabinet in the Operations Room of the districts and units where designated. Placement at other locations will be determined on a case by case basis. 1. Each unit will contain two sets of electrodes, First Responder Kit and an A.E.D./CPR instructional card. 2. The A.E.D. Coordinator will be responsible for the replacement of electrodes and First Responder Kit after each use. *3 D. The Operations Room Supervisor/Detective Supervisor/Building Security Supervisor will be responsible for checking the A.E.D. at the beginning of each tour of duty ensuring the LCD (liquid crystal display) O.K. indicator is displayed on the handle of the unit. E. In the event of a malfunctioning unit, the Advanced Training Unit (A.T.U.) will be notified via computer message for a replacement unit and/or repair of the unit. F. The A.T.U. will be notified via computer message anytime an AED is used and an entry will be made on the district/unit s Daily Complaint Summary (75-67). A copy of the 75-48 and the A.E.D. incident memo will be picked up by A.T.U. personnel. *3 G. The Operations Room Supervisor/Detective Supervisor/Building Security Supervisor will have the overall responsibility for timely and appropriate A.E.D. usage, EMS notification and departmental reporting. 3. A.E.D. PROGRAM MEDICAL DIRECTOR A. The medical oversight for the Philadelphia Police Department A.E.D. program will be provided by the P.F.D. EMS Medical Director. 4. A.E.D. PROGRAM COORDINATOR A. A member of the Training and Education Services Bureau will be assigned as the A.E.D. Program Coordinator between the A.E.D. Program Medical Director and the Philadelphia Police Department. B. Responsibilities of the A.E.D. Coordinator will include assuring that the requirements of the A.E.D. policy are met. DIRECTIVE 3.14-2 APPENDIX B

5. REPORTING A. It is the responsibility of the A.E.D. Coordinator to forward A.E.D. usage reports to the P.F.D. EMS Medical Director within five days of occurrence; this will include the A.E.D. data printout. In addition, a quarterly report will be forwarded by the A.E.D. Coordinator to the P.F.D. EMS Director, which will include a summary of A.E.D. usage, the number of trained personnel, and any changes to include the location of the A.E.D. s and changes to the program. 6. TRAINING A. Members are required to successfully complete initial A.E.D. training before using the A.E.D. B. Members must undergo retraining on the use of the A.E.D. as required by the certifying agency. BY COMMAND OF THE POLICE COMMISSIONER DIRECTIVE 3.14-3 APPENDIX B

EXAMPLE FORMAT MEMORANDUM P O L I C E CITY OF PHILADELPHIA DATE: TO FROM : A.E.D. Coordinator, Training and Education Services Bureau : P.O. xxxxx xxxxx # xxxx, District/Unit SUBJECT : A.E.D. USAGE / DC#XX-XX-XXXXXX 1. Date and time of incident: 2. Location of incident: 3. Name of patient: 4. Age of patient: 5. Gender of patient: 6. Was EMS activated? 7. Was CPR initiated? 8. Was the patient transported to the hospital? 9. Which medic unit transported the patient? 10. To which hospital was the patient transported? 11. Did the A.E.D. restore the patient s heartbeat? 12. Were there any problems in using the A.E.D.? 13. Summary of the incident: Submitted, Name Rank / Badge # District/Unit 82-S-1 (Rev. 3/59) Response to this MEMORANDUM may be made hereon in longhand DIRECTIVE 3.14-4 APPENDIX B

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14 APPENDIX C Issued Date: 05-21-10 Effective Date: 05-21-10 Updated Date: SUBJECT: PROTECTIVE SERVICES FOR OLDER ADULTS 1. BACKGROUND A. The Older Adults Protective Services Act (Act 79) is designed to protect the abused, neglected, exploited, and abandoned elderly in Pennsylvania. This Act gives the local area agency on aging (Philadelphia Corporation for Aging) responsibility for developing and maintaining a protective services plan for vulnerable older adults age 60 and above. B. The Older Adults Protective Services Act (79) reads (in part): It is declared the policy of the Commonwealth of Pennsylvania that older adults who lack the capacity to protect themselves and are at imminent risk of abuse, neglect, exploitation or abandonment, shall have access to and be provided with services necessary to protect their health, safety, and welfare. It is not the purpose of this Act to place restrictions upon the personal liberty of incapacitated older adults, but this Act should be liberally constructed to assure the availability of protective services to all older adults in need of them. Such services shall safeguard the rights of incapacitated older adults while protecting them from abuse, neglect, exploitation, and abandonment. 2. POLICY A. Whenever police personnel are aware of a person who is at least 60 years of age and is at risk of abuse, neglect, exploitation or abandonment pursuant to the Protective Services Act, the Philadelphia Corporation for Aging (PCA) will be contacted and police assistance will be provided upon request. 1. The Philadelphia Corporation for Aging can be contacted at (215) xxx-xxxx on a 24-hour basis, and is located at 642 North Broad Street, Philadelphia, PA 19130. There is always an investigator and supervisor on-call. DIRECTIVE 3.14-1 APPENDIX C

3. PROCEDURE A. Whenever an officer is made aware of a situation requiring PCA intervention where self-neglect is evident, he/she will: 1. When necessary take immediate police action. EXAMPLE: Render first aid and notify the Fire Department for a Medic Unit to have the complainant transported to the hospital. 2. Notify the Philadelphia Corporation for Aging. 3. Record on the Complaint or Incident Report (75-48) the person contacted, and the time the call was made, in addition to the description of the incident. 4. The pink copy of the 75-48 will be forwarded to the district Victims Assistance Officer (VAO) for information. B. Whenever an officer is made aware of a situation requiring PCA intervention, where abuse, neglect, or abandonment is evident, he/she will: 1. When necessary take immediate police action. 2. Contact the detective division of occurrence. 3. Notify the Philadelphia Corporation for Aging. 4. Record on the 75-48 the person contacted, and the time the call was made, in addition to the description of the incident. 5. Fax a copy of the 75-48 to the Crimes Against the Retired and Elderly Unit (CARE) at (215) xxx-xxxx. 6. The pink copy of the 75-48 will be forwarded to the district VAO (sexual assaults will also be forwarded to the Special Victims Unit VAO). C. Whenever the Police Department receives a request for assistance from the PCA, the district VAO or the Crime Prevention Officer (CPO) will: 1. Accompany PCA personnel for protective services. 2. Notify a police supervisor when there is a potential for danger. DIRECTIVE 3.14-2 APPENDIX C

3. Record on the 75-48 the name of the PCA employee assisted, in addition to the description of the incident, and any action taken. 4. Forward the pink copy of the 75-48 to the district VAO for information. NOTE: District personnel will provide necessary services when the Victims Assistance Officer or Crime Prevention Officer is unavailable. BY COMMAND OF THE POLICE COMMISSIONER DIRECTIVE 3.14-3 APPENDIX C

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14 APPENDIX D Issued Date: 05-27-10 Effective Date: 05-27-10 Updated Date: SUBJECT: HEAT EMERGENCIES 1. POLICY A. The plan is designed to provide identification, outreach, and intervention to those most at risk of heat stress. Age, chronic disease, housing, physical condition, substance abuse, and medication usage are variables used to select the most vulnerable populations. 2. PURPOSE A. The Philadelphia Department of Public Health (DPH), Division of Health Promotion has lead responsibility for implementing and monitoring emergency summer heat intervention and outreach activities. The Health Promotion Division will have primary responsibility for over-seeing and responding to Summer Heat Emergency (SHE) operational issues. The Philadelphia Police Department s role in these situations are limited. 3. TARGET POPULATION A. The Philadelphia and Pennsylvania Heat Wave Task Forces and the Centers for Disease Control and Prevention have identified the following as risk factors which help us define the target population: 1. Elderly 2. Chronic disease, particularly cardiovascular 3. People who are culturally, socially, or geographically isolated 4. People who live alone 5. Lack of increased fluid intake 6. High heat environment or increased physical activity 7. People who are homeless 8. People who do not speak English 9. People who cannot read 10. No air conditioning in the home 11. Not being able to care for oneself (infants left in wrong environment) 12. No time spent in air conditioning other than their home DIRECTIVE 3.14-1 APPENDIX D

13. No reduction in activity 14. Substance abuse and alcoholism 15. Maintaining normal activity level B. The group most at risk is older people, living alone in non-air conditioned structures and who have cardiovascular disease. 1. Heart disorders are often caused by the inability of the body to keep up with the demands on its circulatory system and the resulting chemical imbalance caused by too much sweating. The inner core of the body's temperature begins to rise and heat-related illnesses develop. 2. Since an older persons natural cooling system has been altered through the process of aging, they are at greater risk. They are also more likely than the rest of the population to be taking medications that alter the body's ability to cool down. C. Children are also at risk because they produce more metabolic heat per pound of body weight, perspire less and direct less blood flow to their proportionally greater surface area than adults. Infants are more easily dehydrated and are not able to drink liquids on their own. Additionally, every year children die because they are in an automobile with the windows closed. D. People with low incomes are often more vulnerable to heat illness because they have reduced access to good housing, air conditioning, transportation, medical care, and other supportive services. They are also unlikely to use fans or air conditioners, even when they are available, because they feel they cannot afford higher utility bills. 4. HOT WEATHER HEALTH WATCH WARNING SYSTEM A. Philadelphia has field-tested and instituted a new Hot Weather-Health Watch/Warning System (PWWS), to alert the city's residents of potentially oppressive weather situations which could negatively affect health. 1. Media announcements: The media (television, radio stations, and the newspapers) are contacted and informed of all declarations by the Health Commissioner and are provided with information on how to avoid heat-related illnesses during oppressive weather. Press releases and notifications of warnings will be issued to the media in advance of the Commissioner s Health Warning. 2. Activation of the Heat Line : When the Health Commissioner declares a warning, the Heat Line, a hotline operated in conjunction with the Philadelphia Corporation for Aging (PCA) is activated to provide information and counseling to the general public on avoidance from heat stress (telephone (215) xxx-xxxx). DIRECTIVE 3.14-2 APPENDIX D

5. RESPONSIBILITIES OF POLICE A. Check on the well-being of the most at-risk individuals as described above. B. Anyone in need of, or requesting transportation to a medical facility will be taken to the nearest hospital. C. Police districts with air conditioning will open their facilities to citizens seeking a cool environment. If a person seeks shelter at a police district, the Department of Human Services (DHS) will be notified at (215) xxx-xxxx or xxxx to provide the location of the nearest cooling center. D. Requests for electric fans can directed to the PCA Senior help line (business hours only) at (215) xxx-xxxx. E. When beat officers are not on an assignment, they will make visits to senior citizens they know are living alone to check on their well-being. F. Any death as a result of the heat emergency will be reported to the Philadelphia Medical Examiner s Office at (215) xxx-xxxx. G. In all cases where an officer encounters a young child left inside a vehicle in the extreme heat and are unable to quickly remove the child, Fire Department Medics and a street supervisor should be notified. DHS and Special Victims Unit should also be contacted. H. A computer message will be sent by Police Radio upon notification from DPH or the Office of the Managing Director. The message will contain information that the Health Watch Warning system has been activated. This information as well as other instructions relating to the heat emergency will be sent to all police terminals on an updated basis. Police Radio will also broadcast on J band the information that a Code Red has been declared and the above outlined procedures will be in effect. I. Close open fire hydrants. BY COMMAND OF THE POLICE COMMISSIONER DIRECTIVE 3.14-3 APPENDIX D

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 3.14 APPENDIX E Issued Date: 05-28-10 Effective Date: 05-28-10 Updated Date: SUBJECT: DUTY OF POLICE OFFICERS TO IDENTIFY AND FACILITATE MEDICAL CARE FOR PERSONS FOUND IN SEMI-CONSCIOUS OR UNCONSCIOUS CONDITION AS A RESULT OF EPILEPSY, DIABETES OR OTHER ILLNESS 1. PURPOSE A. An act of the Pennsylvania General Assembly, (35 P.S. S.10011, et seq.) imposes certain obligations on both police officers and citizens in relation to the above. 2. PROCEDURE A. Persons found in semi-conscious or unconscious condition or exhibiting symptoms due to epileptic or diabetic illness shall immediately be transported to the nearest hospital for treatment by a physician. B. This action shall include the specific inferences outlined in Directive 5.6 Intoxicated Persons in Police Custody as well as requirements for Hospital Cases specified in this directive. 1. One method by which the officer, supervisor or turnkey can make a determination as to an individual s condition is to check for an identification bracelet, card or tag which contains the type of illness, persons name, physician s name, and medication requirements. This information is either engraved, stamped or imprinted thereon and may be in possession of the individual at the time of occurrence. C. Any person who willfully and knowingly falsifies such identification or deliberately misrepresents an illness as described above shall be guilty of a Misdemeanor of the 3 rd degree, Unsworn Falsification to Authorities PCC 4904, and upon conviction thereof, shall be sentenced to pay a fine of not more than one thousand dollars ($1,000) or to undergo imprisonment for not more than one (1) year or both. BY COMMAND OF THE POLICE COMMISSIONER DIRECTIVE 3.14-1 APPENDIX E