I watched the traffic stop video of Tyre Nichols with an all-too-familiar mix of revulsion, sadness, and anger. Officers beat him brutally and once he is in custody, fail to render aid. Other recent cases, such as the deaths of Earl Moore, Jr., belittled by medics before being restrained prone on the stretcher, and of George Floyd suffocated under the knee of Derek Chauvin while other officers stood by, are examples of particularly callous disregard for the rights, health and safety of citizens during police contact. In-custody deaths sow division between our police and the citizens they are sworn to serve and protect.

These examples and similar cases expose a fundamental lack of recognition of medical emergencies and the need for acute interventions to alleviate risks of preventable injury and death. We must put a stop to the egregious failures we continue to see on the news. As emergency physicians and the clinical conscience of prehospital medicine, we have a responsibility to help make that happen. Though I sincerely doubt anything would have changed the outcome from the protracted and deliberate attack on and withholding of care from Mr. Nichols, our advocacy now could prevent future similar deaths.

Medical oversight of EMS is part of the core curriculum of emergency medicine. The recognition of EMS Medicine as a subspecialty of emergency medicine shows clearly that prehospital care standards are directly created by our expertise. This promotes best practices and evidence-based care for the millions of patients treated each year by EMS, while creating ongoing quality assurance and improvement.

According to the United States Department of Justice, every year close to a quarter of the U.S. population have contact with the police. Initiated by citizens, police officers, or some other factor, these interactions revolve around criminal activity, traffic accidents, calls for law enforcement aid, and medical emergencies, among a myriad of other societal incidents. While most law enforcement officers are trained in basic first aid, CPR, and AED use, many lack a more formalized medical skill-set to recognize and address significant illness or injury.

Though many private and government agencies offer tactical medical training (designed to optimize treatment in the austere environment) there is no broad consensus on what that training best entails. To summarize: despite often being the first point of patient contact in medical and high-threat emergencies such as overdoses, shootings, domestic violence, and mass casualty events, law enforcement officers have limited medical training, often with little to no medical oversight.

The ACEP Tactical Emergency Medicine Section, with over 400 members, has served as an enthusiastic resource for emergency physicians working to improve medical care during law enforcement training and operations. Policing, like medicine itself, is a noble profession where men and women in uniform put themselves at risk to help others. Our section members have long recognized that the medical opportunities towards optimizing law enforcement officer medical aid abilities go far beyond the support of SWAT and other police special operations units.

Based on our input, the ACEP Board of Directors approved a change in the section name to Tactical and Law Enforcement Medicine, better reflecting this breadth to include self- and buddy-care development and training, patrol officer medical needs, officer health and wellness, recognizing and managing psychiatric and other emergencies to include hyperactive delirium with severe agitation, and the medical role of law enforcement in mass killing events.

While we do not know how it will ultimately manifest (fellowship, focused practice designation, etc.), we have already initiated the journey towards Tactical and Law Enforcement Medicine becoming formally recognized as a unique subspecialty of emergency medicine. It is our belief that law enforcement agencies should integrate physician medical directors in the manner of EMS, to the benefit of the agency, the individual officers, and ultimately the citizens they serve.

Emergency physicians assess many determinants of health daily, including poverty, racism, addiction, gun violence, and other conditions, exploring how we can best address these issues towards ensuring a safer, healthier, and more just society. Police officers deal first-hand with these same social determinants of health every day in their duties. What better place for ACEP to start making a difference than at this shared ground level? We owe it to police, to the citizens they serve, and to our patients to assume the needed leadership role in Law Enforcement Medicine and put a stop to any preventable in-custody deaths.

Dr. Springer is Chair of the ACEP Tactical and Law Enforcement Medicine Section, and Director of the Wright State University Division of Tactical Emergency Medicine in Dayton, Ohio.