Officer Amaro with a member of the Citizens' Police Academy.

Ithaca, N.Y. — Ithaca police Officer David Amaro begins his presentation by flashing a photo of his family on the screen.

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“This is me when I’m not wearing this,” says Amaro, fully dressed in uniform, as he points to a photo of himself in plainclothes with his wife and children in a car.

Amaro stood in front of a room of about 20 participants in a meeting of the Citizens’ Police Academy on Wednesday night. (The academy is being held to help the public learn more about the inner-workings of the Ithaca Police Department.)

Officer Amaro with a tourniquet in front of the Citizens’ Police Academy classroom.
Officer Amaro with a tourniquet in front of the Citizens’ Police Academy classroom.

Amaro explained that he has five years of experience in the police department and serves IPD in a variety of roles — as a union trustee, as an officer on the Commons unit, as a member of the recruitment team.

He’s also heavily involved in several different facets of officer instruction. “Pretty much anything that explodes, I’m in charge of,” he adds, to laughter from the room.

But while Amaro was loose, charismatic and funny during his hour-long presentation, his talk was about the most serious of topics: Why it’s absolutely crucial for police officers to be fully prepared to administer emergency medical care in stressful situations.

Officer Amaro showing a member of the Citizens’ Police Academy how to apply a tourniquet.
Officer Amaro showing a member of the Citizens’ Police Academy how to apply a tourniquet.

Here are 6 things we learned from Officer Amaro’s presentation:

1 — Why police need to be prepared for medical emergencies

Amaro spoke to one incident in Ithaca he was involved with where four women were stabbed in the neck.

“Bangs Ambulance is not coming in there,” he says. “We have to save them.”

That kind of event is the important context for understanding the extensive medical training that’s necessary for police.

“Some of the situations we go to are simply too dangerous for Bangs Ambulance to show up at,” he says. “It’s not their job to go into areas where people have been stabbed or shot. That’s our job.”

2 — What is a “Casualty Collection Point?”

During the incident where the women were stabbed police “from all over” came to the scene, according to Officer Amaro.

“And when that happened, there was a bottleneck of police cars. And when that happens, it doesn’t allow ambulances to get in,” he said.

Luckily, the officers on the scene of that incident started what’s called a “casualty collection point” to put the victims in a designated area that allowed them to be taken away by ambulances.

“Had we not done that, it could be an issue: An ambulance has a patient in it but can’t leave,” he said.

3 — What should police do in ‘direct threat’ situations?

“If I’ve been hit, this is not the time to fix yourself,” he says. “Trying to put a band-aid on is going to be a waste because you’re going to need more band-aids.”

For that reason, officers have to work to remove the patient from a “direct threat” care situation — perhaps by hiding, or by striking back at a suspect, or by some other means.

4 — How do police know which injury to treat first?

Once the situation has been downgraded from “direct threat care” to one requiring “indirect threat care,” Amaro says, there’s a hierarchy for what medical problems officers are supposed to direct first.

The useful acronym for this is “MARCHE.”

“This is how we establish what is the most important thing during indirect threat care,” Amaro says.

Here’s what each stands for, in order of what police are supposed to do first:

M — “Massive hemorrhage.”…  “If we see heavy red bleeding, that has got to be controlled.”

A — “Airway.” … make sure they’re not choking.

R — “Respirations.” …  “properly seal open chest wounds … we need to cover that hole.”

C — “Circulation.”

H — “Head/Hypothermia.”

E — “Everything else.” … or any other injuries.

5 — How do officers know when to use a tourniquet?

“If a bleed is showing that bright red blood, you know it’s from an artery,” Amaro said.

Amaro acknowledged that there was some subjectivity and guesswork involved in deciding whether a tourniquet will be necessary to apply.

“If it’s severe bleeding we’re going to use a tourniquet … we’re not medical personnel and we want to keep things very simple,” he said.

“I’d love to sit here and say you know when you need to use it … (but) it is a subjective term.”

6 — Why Officer Amaro did his best Michael Bay impression

Officer Amaro spoke at length about how much training Ithaca police officers do to prepare for emergencies where they’re forced to act against natural instinct.

He said he and other Ithaca police instructors simulated wounds to train officers in the emergency application of medical tools. “It wasn’t a Michael Bay/Stephen Spielberg production,” he said with a smile.

Amaro said he’s confident medical training for officers has already helped save lives.


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Jeff Stein

Jeff Stein is the founder and former editor of the Ithaca Voice.