This article highlights some key learning points for both corrections agencies and EMS services when responding to incidents involving inmate transport. We encourage you to share this article during training or preplanning with the EMS services located in the areas through which your agency regularly transports prisoners.
It is the plot of more than a few classic movies and television shows: a group of convicts are being transported outside of the prison and, either accidentally or intentionally, the bus or plane crashes, releasing the dangerous occupants to flee into the nearby woods, neighborhoods or malls.
Thankfully, in real life, correctional agencies are particularly good at safely and securely transporting prisoners, but incidents do occasionally happen. The recent crash of a Pennsylvania Department of Corrections bus on the Pennsylvania Turnpike resulted in one correctional officer and 11 inmates requiring transport to a hospital for minor injuries.
Does your mass casualty incident plan include details about managing multiple in-custody patients that need security to make sure they do not escape or become a danger to responders or the public? Take a moment to consider the following takeaways on this unique occurrence.
1. Coordination of agencies
A primary concern will be the interagency communication and coordination needed to safely respond and transport the prisoners. This is no time for silos or authority squabbles. For the safety of everyone involved, law enforcement, EMS, fire and hospitals must be able to work together efficiently and professionally to:
- Identify patient care and transport needs and priorities;
- Provide security to transporting crews;
- Coordinate hospital destinations based on patient care needs and the ability to secure detainees.
Except for life-threatening conditions, prisoners should not be loaded into ambulances and transported until the law enforcement officer or CO in charge gives the OK and assigns someone to provide security and maintain custody. It may take time for them to bring in their resources but safety is the priority.
2. Patient tracking
Incident command must definitively know the identity, status and location of each and every person involved in the event. No patients can be allowed to leave the scene without the transporting personnel reporting the details of who they are transporting and the intended destination. The transportation log should also include details about the LEO or CO accompanying the transport to maintain the security of the prisoner.
3. Transport safety
EMS transport of a person in custody is not an unusual occurrence and EMS agencies should have policies in place for the safe care and transport of these individuals. Considerations include:
- Appropriate methods to provide prisoner restraint. It is usually not acceptable to handcuff or shackle a prisoner directly to a fixed part of a vehicle, but they may be secured to the stretcher.
- The need to have an LEO or CO on the ambulance versus following close behind in their vehicle.
- Search of the prisoner for weapons before placing them in the ambulance. It is common law enforcement practice that anytime a detainee is turned over from one officer to another or loaded into a vehicle, they are searched.
- Clearing the patient care area of anything the prisoner could grab and use as a weapon to harm themselves or others. Think about trauma shears, pens, clipboards, tablets, stethoscopes, oxygen tubing, IV lines, needles and batteries. Are there any supply or equipment cabinets within reach?
4. Special resources
Whether it be activation of mutual aid resources, multiple patient transport vehicles, specialized rescue units or operation support teams, additional layers of resources will be needed. You may simply need several ambulances to avoid having more than one prisoner in an ambulance.
Do not forget to include the hospital or hospitals that will likely receive patients. Are there emergency departments in the area that are designated and prepared to treat prisoners safely and securely? In some instances, the prison system will have a contract with a particular hospital for inmate emergencies. Contact them early so that they can activate their plans and have secure rooms ready.
NEXT: Implementing scenario-based prisoner transport training
About the author
Michael Fraley, BS, BA, NRP, has over 25 years of experience in EMS in a wide range of roles, including flight paramedic, EMS coordinator, service director and educator. Fraley began his career in EMS while earning a bachelor’s degree at Texas A&M University. He also earned a BA in business administration from Lakeland College. When not working as a paramedic or the coordinator of a regional trauma advisory council, Michael serves as a public safety diver and SCUBA instructor in northern Wisconsin.