Cardiac and Psycho-physiological Reactions Induced by Police Tactical Tasks and Combat Shooting

"Fight-or-flight reflex" is the instinctive survival reaction to perceived danger. In humans the first emotional reaction is fear, which mobilizes strength for "fight" and survival. This happens to police officers (POs), responding to danger. So far no information is available about the interaction between emotional and cardiovascular (CV) response during police tactical tasks (PTTs) and their effects on the tactical efficiency during dangerous confrontation. Methods: We studied CV and psychological reactions using two models of PTTs: 1) action under Oleoresin Capsicum Spray Contamination (OCSC) and 2) combat shooting. Methods: 22 volunteer POs were studied, 6 during training-related OCSC, 6 during dynamic sport combat shooting in National competitions, and 10 during realistic training in combat shooting. All POs had a normal heart. 12-lead Holter ECG was recorded from 2 hours before to 1 hour after PTTs. Blood pressure (BP) was recorded with a customized wrist BP detector. Psychological stress (PS) during PTTs was rated by a questionnaire and behavior was studied with multiple TV cameras. Heart rate (HR)and HRV parameters (pNN50% and r-MSSD)were evaluated under basal conditions and during PTTs. Results: During OCSC, 5/6 POs, in spite of typical physical reactions (eye and skin painful inflammation, lacrimation, mild respiratory distress) were able to perform all PTTs. Maximum HR increase was 166% (peak 161 bpm). HRV, normal under basal conditions, changed as a function of increased sympathetic tone. 1 PO had a panic attack, uncontrollable weeping and incapability to maintain standing, for more than 30 minutes. 4/6 POs had supraventricular (4/4) or ventricular (2/4) arrhythmias (ARs). 4/6 POs reported strong PS. OCSC effects disappeared within an average of 30 minutes after decontamination. Marked tachycardia, above 180 beats per minute was recorded in 4/6 POs during sports shooting. In 2 of them the HR exceeded 200 bpm, due to paroxysmal atrial ARs. BP increase varied among the 6 shooters, with maximal systolic values between 160 e 240 mmHg. HR raised above 150 bpm in all POs during expectation of danger, and above 190 bpm during fire. HR above 180 bpm was often associated with irrational behavior and poor situational control. Conclusion: PTTs with perceived danger are highly demanding situations, which might imply severe CV strain especially when PS is associated with physical effort. This has to be taken into account when evaluating fitness for duty, because abnormal CV values were clearly associated with individual behavioral impairment and tactical inefficacy