I feel compelled to respond to a recent column by Nassau County Legislator Seth Koslow — who is running for county executive — titled, “Let’s put politics aside and just save lives,” about his proposed bill to equip police patrol cars with epinephrine auto-injectors, or EpiPens. Koslow’s article is long on emotion and political attacks, but woefully short on facts, knowledge and analysis.
Had Koslow done his homework, he would know that Nassau County’s Emergency Ambulance Bureau already has the infrastructure, equipment and personnel to rapidly deploy epinephrine to those suffering from anaphylaxis.
Unlike Suffolk County, which utilizes a volunteer EMT system, the Nassau County Police Department has paid police medics deployed in county police ambulances throughout its patrol precincts. These medics are immediately available to respond alongside police officers to 911 calls for medical emergencies, and there is no delay following dispatch, as occurs in other parts of the state — including Suffolk County, where the ambulance service is notified separately, and often must wait to raise a crew of EMS technicians to respond to the emergency.
By contrast, the NCPD’s police medics share the same radio channels with police officers. A police medic will often arrive before a police officer, and in all cases the police officers assist our medics and become part of the ambulance crew. NCPD police medics are all advanced life-support providers, able to assess the medical situation and administer emergency medicines, including several, such as epinephrine, for people experiencing allergic reactions and anaphylaxis.
Koslow’s glib assertion that training police officers in the use of these injectors can be done in less than half an hour is dangerous. Epinephrine is not a benign medicine, and there are serious safety concerns associated with epinephrine auto-injector use. Epinephrine is a powerful cardiovascular medication, and administering it to someone where it is not indicated, and especially to someone with pre-existing cardiac conditions who is not having an anaphylactic reaction, can trigger life-threatening reactions including abnormal cardiac rhythms, heart attack, sharp increases in pulse and blood pressure and fluid build-up in the lungs.
Not every person experiencing an allergic reaction is having an anaphylactic reaction and in need of epinephrine. Highly trained police medics can assess, treat and stabilize these patients with several medications, including epinephrine when it is appropriate and indicated. There is also the risk of accidental deployment of an auto-injector, resulting in self-administration into a responder’s fingers that can easily cause a limb-threatening emergency in addition to cardiac side effects.
Nassau’s configuration of EMS directly integrated with police officers responding to medical emergencies is unique in New York state. In jurisdictions that do not have police medics in their police departments, the benefits of properly training and then equipping police with epinephrine auto-injectors might be worth consideration, but it’s simply not necessary — and potentially dangerous — in Nassau County and would overlap with the effective system that’s already in place.
Interestingly, according to the NCPD, in 2024, epinephrine was used just 62 times in 45,000 ambulance transports. That equates to less than 0.14 percent of all transports. Further, most people with severe allergies carry EpiPens with them. While that doesn’t diminish the need to address any potentially life-threatening allergic reaction as quickly as possible, the average response time of our police medics is typically between four and eight minutes, similar to police response times.
The office of county executive is a critical one, demanding a serious occupant — one who would have done research and known that the authority that Koslow proposes to create already exists, and that the county is already accomplishing what he is asking for, with great effectiveness. His legislation is, therefore, nothing more than a political statement. Proposing legislation that does not actually accomplish anything useful is not only a waste of valuable governmental time, but diverts attention from the truly critical issues we face.
Of course, no one wants even a single unnecessary death due to anaphylaxis, or any medical emergency. However, the old adage “The devil is in the details” certainly applies. I hope that if Koslow truly wishes to take on the serious job of county executive, he will take the time to ascertain the facts before engaging in unfounded political attacks and hyperbole.
Howard Kopel represents Nassau County’s 7th Legislative District and is the Legislature’s presiding officer.