Background: According to US military data, tension pneumothorax (TPx) is the second leading cause of possibly preventable combat death after isolated extremity hemorrhage. The purpose of this study was to determine whether TPx similarly represents a significant cause of possibly preventable death in police officers.

Methods: FBI data for the years 1998 through 2007 were reviewed. Cases were included if officers were on-duty at the time of fatal injury, and died within one hour from time of wounding from penetrating torso trauma. After case identification, letters were sent to the departments of victim officers requesting autopsy reports.

Results: One hundred and eight victim officers met inclusion criteria. Four charts were excluded due to inability to re-identify officers. Departmental response rate was 83.7%. Autopsy reports were provided for 60 officers (57.7%). All officers died from gunshot wounds. No coroner specifically identified TPx as either a direct cause of death or a contributing factor (95% CI, 0.00%-5.96%).

Conclusion: In contrast to the military experience, TPx appears to be a rare cause of possibly preventable death in police officers. Further study of non-fatal “near miss” events will be required to determine the actual need for law enforcement-specific medical training in the recognition and management of TPx.