Notes – Conducted Electrical Weapon Injury (e.g. TASER®)

Conducted Electrical Weapon Injury (e.g. TASER®)

Patient Safety Considerations

  1. Before removal of the barbed dart, make sure the cartridge has been removed from the conducted electrical weapon
  2. Patient should not be restrained in the prone, face down, or hog-tied position as respiratory compromise is a significant risk
  3. The patient may have underlying pathology before being tased (refer to appropriate guidelines for managing the underlying medical/traumatic pathology)
  4. Perform a comprehensive assessment with special attention looking for to signs and symptoms that may indicate agitated delirium
  5. Transport the patient to the hospital if they have concerning signs or symptoms
  6. EMS providers who respond for a conducted electrical weapon patient should not perform a “medical clearance” for law enforcement

Notes/Educational Pearls

Key Considerations

  1. Conducted electrical weapon can be discharged in three fashions:
    1. Direct contact without the use of the darts
    2. A single dart with additional contact by direct contact of weapon
    3. From a distance up to 35 feet with two darts
  2. The device delivers 19 pulses per second with an average current per pulse of 2.1 milliamps which in combination with toxins/drugs, patient’s underlying diseases, excessive physical exertion, and trauma may precipitate arrhythmias, thus consider EKG monitoring and 12-lead EKG assessment
  3. Drive Stun is a direct weapon two-point contact which is designed to generate pain and not incapacitate the subject. Only local muscle groups are stimulated with the Drive Stun technique

Pertinent Assessment Findings

  1. Thoroughly assess the tased patient for trauma as the patient may have fallen from standing or higher
  2. Ascertain if more than one TASER® cartridge was used (by one or more officers, in effort to identify total number of possible darts and contacts)

Quality Improvement

Associated NEMSIS Protocol(s) (eProtocol.01)

  • 9914203 – Injury-Conducted Electrical Weapon (e.g. Taser)

Key Documentation Elements

  • If darts removed, document the removal location in the patient care report
  • Physical exam trauma findings
  • Cardiac rhythm and changes
  • Neurologic status assessment findings

Performance Measures

  • Comprehensive patient documentation as this is a complex patient
  • Abnormal findings or vital signs were addressed
  • Patient received EKG or 12-lead EKG evaluation
  • If indicated, review for appropriate securing technique

References

  1. Ho JD, Dawes DM, Buttman LL, Moscati RM, Janchar TA, Miner JR. Prolonged TASER use on exhausted humans does not worsen markers of acidosis. Am J Emerg Med. 2009;27(4):413-8.
  2. Ho JD, Dawes DM, Cole JC, et al. Corrigendum to ‘‘lactate and pH evaluation in exhausted humans with prolonged TASER X26 exposure or continued exertion.’’ Forensic Sci Int. 2009;190(1-3):80-6.
  3. Ho JD, Dawes DM, Cole JB, Hottinger JC, Overton KG, Miner JR. Lactate and pH evaluation in exhausted humans with prolonged TASER X26 exposure or continued exertion. Forensic Sci Int. 2009;190(1-3):80-6.
  4. Ho JD, Dawes DM, Nelson RS, et al. Acidosis and catecholamine evaluation following simulated law enforcement ‘‘use of force’’ encounters. Acad Emerg Med. 2010;17(7):e60-8.
  5. Ho JD, Dawes DM, Nystrom PC, et al. Markers of acidosis and stress in a sprint versus a conducted electrical weapon. Forensic Sci Int. 2013;233(1-3):84-9.
  6. White Paper Report on Excited Delirium Syndrome. ACEP Excited Delirium Task Force, American College of Emergency Physicians; September 10, 2009.