Excited Delirium (ED) and In-Custody Death (ICD) Related Articles
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New ECD Information:
(05/20/08) NIJ Sponsored Medical Study - Deaths Following Electro Muscular Disruption.
Study Framework: The study is directed by a steering group with representation from NIJ, the College of American Pathologists, the Centers for Disease Control, and the National Association of Medical Examiners.
To support the study, the steering group appointed a medical panel comprised of physicians, medical examiners and other relevant specialists in cardiology, emergency medicine, epidemiology, pathology, and toxicology.
"While exposure to CED is not risk-free, there is no conclusive medical evidence within the state of current research that indicates a high risk of serious injury or death from the direct effects of CED exposure. Field experience with CED use indicates that exposure is safe in the vast majority of cases. Therefore, law enforcement need not refrain from deploying CED’s, provided the devices are used in accordance with accepted national guidelines such as the model policy of the International Association of Chiefs of Police."
John Morgan, Deputy Director for Science & Technology, National Institute of Justice, May 20, 2008, Less Lethal and Critical Incident Technologies.
New ECD Articles:
(05/28/08) Excited Delirium and the Patrol Officer. How you handle the demented naked guy running wild in traffic is vital to your safety and your future. by Kevin Davis. LawOfficer.com.
(05/01/08) Kumaraswamy Nanthakumar MD, Stephane Massé PEng MASc, Karthikeyan Umapathy PhD, Paul Dorian MD, Elias Sevaptsidis, Menashe Waxman MD, Review, Mechanisms and innovations, Cardiac stimulation with high voltage discharge from stun guns, CMAJ, May 20, 2008, 178(11).
CONCLUSIONS: Standard TASER discharges did not cause VF at any of the positions. Induction of VF at higher output multiples appear to be sensitive to electrode distance from the heart, giving highest ventricular fibrillation safety margin when the electrodes are placed on the dorsum. Rapid ventricular capture appears to be a likely mechanism of VF induction by higher output TASER discharges.
(04/02/08) Confirmation of Respiration during Trapezial Conducted Electrical Weapon Application, Jeffrey Ho MD, Anne Lapine MD, Scott Joing MD, Robert Reardon MD, Donald Dawes MD, (2008), Academic Emergency Medicine 15 (4), 398–398 doi:10.1111/j.1553-2712.2008.00077.x.
Page 23: There was general consensus that officers were using conducted energy devices (CEDs), primarily the TASER® [ECD], as the first option.
Page 37:
Deployment of conducted energy devices (CEDs), primarily TASER [ECD], within
many jurisdictions has affected the consideration and deployment of other
tactical options and less-lethal weapons. There was general consensus that
officers were using TASER [ECD] as the first option. This was, perhaps, borne out
of growing confidence in the system over time and a reduced likelihood of injury to both fficers and subjects (actual and perceived) - as well as the accompanying potential to reduce the likelihood of complaint and post- incident
investigation.
Page 38:
It is important to note that TASER lnternational [,Inc.] is the leader in the
development and manufacture of CEDs. The ILEF recognizes that this vendor
has invested in and conducted exhaustive research in order to increase device effectiveness as a tool for law enforcement while minimizing injury to subjects. Additionally, they have cooperated with and supported both government and
independent researchers to continue to grow the body of knowledge on these systems. The ILEF views this open and responsible approach to research and testing as a model for other manufacturers to emulate.
Page 39:
The psychological impact of CEDs on subjects has been illuminating. Subjects
often become defiant when an officer presents a lethal weapon. They do not
believe an officer will fire. When an officer presents a CEO, however, often that is enough to gain compliance, since these subjects believe officers are very willing to actually fire the device. Some in the group related experiences
where merely pointing the device, orienting the laser dot, or verbally warning,"stop or I will taze you" was enough to gain compliance.
Page 39:
Of note also was the sense from many of the group members that police use of
CEOs to gain compliance of subjects who are suffering from mental health
problems (e.g., schizophrenia) has found broad support among mental health groups (The Schizophrenic Society in Canada, The Schizophrenic Association in the UK, and the National Institute of Mental Health in the US were all mentioned).
Presentations to Look For:
(FREE) LET-KRM 2 Hour Online Training Program - (Wednesday April 16, 2008) Excited Delirium - A Call to Action Putting Theory into Practice, Law Enforcement Training, a Division of KRM Information Services, Inc. Presented by
Dr. Michael D. Curtis.
Summary.
This program is being offered, free of charge, as a public service by Dr. Michael D. Curtis, in cooperation with KRM's Law Enforcement Training Division.
What can law enforcement leaders do to prevent in-custody deaths? Can law enforcement leaders initiate a community effort to prevent in-custody deaths resulting from excited delirium during violent confrontations with police? Do effective action plans exist in other communities and what do they look like?
Heart Rhythm 2008, 29th Annual Scientific Sessions, May 14-17, 2008, San Francisco, CA USA:
(05/15/08) Presenting Rhythm in Sudden Custodial Deaths After Use of TASER® Electronic Control Device,
Charles Swerdlow, MD, FHRS, Mark W. Kroll, PhD, FHRS, Howard Williams, Mazda Biria, MD, Dhanunjaya Lakkireddy, MD and Patrick J. Tchou, MD. Cedars-Sinai Medical Center, Los Angeles, CA, University of Minnesota, Minneapolis, MN, San Marcos Police Department, San Marcos, TX, University of Kansas Medical Center, Kansas City, KS, Cleveland Clinic, Cleveland, OH.
(05/16/08) Can Electrical-Conductive Weapons (TASER®) alter the functional integrity of pacemakers and defibrillators and cause rapid myocardial capture?
Dhanunjaya R. Lakkireddy, MD, Mazda Biria, MD, Esam Baryun, MD, Loren Berenbom, MD, Rhea Pimentel, MD, Martin P. Emert, MD, Kevin Kreighbaum, RN, Mark W. Kroll, PhD and Atul Verma, MD. Mid America Cardiology @ University of Kansas Hospital, Kansas City, KS, University of Minnesota, Minneapolis, MN, Southlake Regional Health Center, Toronto, ON, Canada.
(05/16/08) (Poster) Echocardiographic Evaluation of Human Transcutaneous TASER® Application Along the Cardiac Axis,
Jeffrey D. Ho, MD, Donald M. Dawes, MD, Robert F. Reardon, MD, Anne L. Lapine, MD, Jeremy D. Olsen, MD, Benjamin J. Dolan, BA and James R. Miner, MD. Hennepin County Medical Center, Minneapolis, MN, Lompoc District Hospital, Lompoc, CA.
New Agitated/Excited Delirium Articles (Emergency Medicine News)
(02/08) EMN (Letter) Ketamine Dosing for Adults (pt 1)? Jno Disch, MD, Emergency Medicine News.
(02/08) EMN (Response) Ketamine Dosing for Adults (pt 2)? John R. Roberts, MD, Emergency Medicine News.
Recent Presentations [Back to Top]:
(Poster) (01/11/08) (78.) PROLONGED TASER® “DRIVE STUN” EXPOSURE IN HUMANS DOES NOT CAUSE WORRISOME BIOMARKER CHANGES, Ho JD, Dawes DM, Lapine AL, et al., Hennepin County Medical Center: National Association of EMS Physicians (NAEMSP); 2008.
(Abstract)(Poster)(09/17/07) ULTRASOUND MEASUREMENT OF CARDIAC ACTIVITY DURING CONDUCTED ELECTRICAL WEAPON APPLICATION IN EXERCISING ADULTS. J. Ho; R. Reardon; D. M. Dawes; M. Johnson; J. Miner.
CONCLUSIONS: A 15 second CEW application on exercised volunteers did not demonstrate any evidence of induced tachyarrhythmia. It is unlikely that CEW exposure induces cardiac rate capture or tachyarrhythmia in humans.
(Abstract)(Poster)(09/18/07) ABSENCE OF ELECTROCARDIOGRAPHIC CHANGE FOLLOWING PROLONGED APPLICATION OF A CONDUCTED ELECTRICAL WEAPON IN PHYSICALLY EXHAUSTED ADULTS. J. Ho; D. Dawes; H. Calkins; M. Johnson.
CONCLUSIONS: Prolonged 15 second CEW application in a physically exhausted adult human sample did not cause a detectable change in their 12-lead ECGs. Theories of CEW induced dysrhythmias are not supported by our findings.
(Abstract)(Poster)(09/19/07) 15-SECOND CONDUCTED ELECTRICAL WEAPON EXPOSURE DOES NOT CAUSE CORE TEMPERATURE ELEVATION IN NON-ENVIRONMENTALLY STRESSED RESTING ADULTS. D. M. Dawes; J. Ho; M. Johnson; J. Miner.
CONCLUSIONS: In summary, our results do not show that a 15-second conducted electrical weapon discharge significantly affects core body temperature in non-environmentally stressed resting adults. While additional studies are needed, our data suggests that theories about conducted electrical weapons contributing to hyperthermia are likely unfounded.
(Abstract)(Poster)(09/19/07) THE NEUROENDOCRINE EFFECTS OF THE TASER X26 CONDUCTED ELECTRICAL WEAPON AS COMPARED TO OLEORESIN CAPSICUM. D. M. Dawes; J. Ho; M. Johnson; J. Miner.
CONCLUSIONS: The results suggest a significant greater level of activation of the SAM cascade with O.C. compared to the CEW. Overlapping confidence intervals preclude a definitive statement about the other measurements, but do not suggest a greater activation of the stress cascade by the CEW than O.C.
(Abstract)(Poster)(09/19/07) 15-SECOND CONDUCTED ELECTRICAL WEAPON APPLICATION DOES NOT IMPAIR BASIC RESPIRATORY PARAMETERS, VENOUS BLOOD GASES, OR BLOOD CHEMISTRIES. D. M. Dawes; J. Ho; M. Johnson; J. Miner.
CONCLUSIONS: As with the previous study, this study suggests that exposure to a CEW does not significantly impair respiration. As in the previous study, pCO2 decreased and pO2 increased as a result of the exposure. There was no change in blood pH. While this study is small, it adds to the growing body of literature that is demonstrating that these weapons have a favorable risk-benefit ratio and are appropriate additions to the use of force continua of police agencies.
(Abstract)(Poster)(09/19/07) BREATHING PARAMETERS, VENOUS GASES, AND CHEMISTRIES WITH EXPOSURE TO A NEW WIRELESS PROJECTILE CONDUCTED ELECTRICAL WEAPON. D. M. Dawes; J. Ho; M. Johnson; J. Miner; E. Lundin.
CONCLUSIONS: This study demonstrates that the new CEW has no important deleterious effects on respiratory parameters, blood chemistries, or venous blood gases. These results are consistent with previous results for the TASER X26 CEW.
(Poster) 16. 15-Second Conducted Electrical Weapon Application Does Not Impair Basic Respiratory Parameters, Venous Blood Gases, or Blood Chemistries and Does Not Increase Core Body Temperature, Dawes DM, Lompoc District Hospital, Lompoc, CA.
Conclusion: As with the previous study, this study suggests that exposure to a CEW does not significantly impair respiration. As in the previous study, pCO2 decreased and pO2 increased as a result of the exposure. There was no change in blood pH. There was no change in core temperature. While this study is small, it adds to the growing body of literature that is demonstrating that these weapons have a favorable risk-benefit ratio and are appropriate additions to the use of force continua of police agencies.
(09/07) 16: 15-Second Conducted Electrical Weapon Application Does Not Impair Basic Respiratory Parameters, Venous Blood Gases, or Blood Chemistries and Does Not Increase Core Body Temperature, D.M. Dawes, J.D. Ho, M.A. Johnson, E. Lundin, J.R. Miner, Annals of Emergency Medicine, September 2007 (Vol. 50, Issue 3, Page S6).
173. Physiologic Effects of the TASER on Human Subjects After Exercise, Vilke GM, University of California, San Diego Medical Center, San Diego, CA.
Conclusion: There were no clinically significant or lasting statistically significant
changes in selected blood measures or cardiovascular levels in exercised human subjects after rigorous exercise and a 5 second TASER activation.
(09/07) 173: Physiologic Effects of the TASER on Human Subjects After Exercise, G.M. Vilke, C. Sloane, A.C. Suffecool, T.S. Neuman, E.M. Castillo, F.W. Kolkhorst, T.C. Chan,
Annals of Emergency Medicine, September 2007 (Vol. 50, Issue 3, Page S55).
Conclusions: In a review of nearly 1,000 cases [962], 99.7 per cent of those subjected to a TASER ECD had mild injuries, such as scrapes and bruises, or none at all. Only three subjects (0.3%) suffered injuries severe enough to need hospital admission. Two had head injuries suffered in falls after TASER ECD use. A third subject was admitted to a hospital two days after arrest with a medical condition of unclear relationship to the TASER ECD. Two subjects died, but autopsy reports indicate that neither death was related to the TASER device. Earlier partial results involving 597 cases were published in the September issue of Annals of Emergency Medicine.
Earlier Published Conclusions: After CEW use, 99.5% of 597 subjects had no injuries or mild injuries only. The observed significant injury rate was 0.5%, and is unlikely to be greater than 1.4%. No deaths related to CEWs occurred. These preliminary data represent the largest independent injury epidemiology study of these weapons to date and support the safety of CEW use. Data collection will continue through summer 2007; final data will be presented at the fall ACEP meeting.
(10/08/07) (Press Release) Nationwide Independent TASER® Study Results Suggest Devices are Safe, Wake Forest University Baptist Medical Center®.
345. Ultrasound Measurement of Cardiac Activity During Conducted Electrical Weapon Application in Exercising Adults. Ho JD, Hennepin County Medical Center, Minneapolis, MN.
Conclusion: A 15 second CEW application on exercised volunteers did not
demonstrate any evidence of induced tachyarrhythmia. It is unlikely that CEW
exposure induces cardiac rate capture or tachyarrhythmia in humans.
(09/07) 345: Ultrasound Measurement of Cardiac Activity During Conducted Electrical Weapon Application in Exercising Adults, J.D. Ho, R.F. Reardon, D.M. Dawes, M.A. Johnson, J.R. Miner, Annals of Emergency Medicine,
September 2007 (Vol. 50, Issue 3, Page S108).
(Poster) 421. The Neuroendocrine Effects of the TASER X26 Conducted Electrical Weapon as Compared to Oleoresin Capsicum. Dawes DM, Lompoc District Hospital, Santa Barbara, CA.
Conclusion: The results suggest a significant greater level of activation of the SAM cascade with O.C. compared to the CEW. Overlapping confidence intervals preclude a definitive statement about the other measurements, but do not suggest a greater activation of the stress cascade by the CEW than O.C. Given that the CEW is generally considered more efficacious in the control of subjects with impaired nocioception secondary to drug intoxication or an excited delirium, and that it induces a smaller or equal stress response, it maybe the use of force of choice in certain settings.
(09/07) 421: The Neuroendocrine Effects of the TASER X26 Conducted Electrical Weapon as Compared to Oleoresin Capsicum, D.M. Dawes, J.D. Ho, J.R. Miner, M. Johnson, Annals of Emergency Medicine, September 2007 (Vol. 50, Issue 3, Pages S132-S133).
(Poster) 423. Breathing Parameters, Venous Blood Gases, and Serum Chemistries with Exposure to a New Wireless Projectile Conducted Electrical Weapon in Human Volunteers. Dawes DM, Lompoc District Hospital, Lompoc, CA.
Conclusion: This study demonstrates that the new CEW has no important
deleterious effects on respiratory parameters, blood chemistries, or venous blood gases. These results are consistent with previous results for the TASER X26 CEW.
(09/07) 423: Breathing Parameters, Venous Blood Gases, and Serum Chemistries With Exposure to a New Wireless Projectile Conducted Electrical Weapon in Human Volunteers, D.M. Dawes, J.D. Ho, M.A. Johnson, E. Lundin, J. Miner,
Annals of Emergency Medicine, September 2007 (Vol. 50, Issue 3, Page S133).
Conclusion: A comprehensive approach to workplace violence that allows for the selected use of the TASER and requires mandatory reviews of all uses can be effectively implemented to help to control dangerous situations in heath care environments.
(09/07) 428: Evaluation of the Use of the TASER and Elevated Force to Control Workplace Violence in a Health Care Environment, R.L. Norton, G. Granger,
Annals of Emergency Medicine, September 2007 (Vol. 50, Issue 3, Page S135).
(10/14/07) [11:15 a.m. to 11:45 a.m.] Updates on NIJ Research on Less Lethal Devices, Police Physicans Section Track, Joseph Cecconi.
Recent research topics funded by the National Institute of Justice on less lethal devices will be presented.
(10/14/07) [1:00 p.m. to 2:15 p.m.) Excited Delirium, Police Physicians Section Track, Donald Dawes, MD, and Jeffrey Ho, MD.
Deaths in police custody can evoke strong reactions from the victims' families, the lay press, and the public. Police departments may be forced to prove that their actions (or inactions) did not contribute to these deaths. It is imperative for police chiefs and their staffs to have a good understanding of the history of this phenomenon, to understand the theories of causation in these sudden deaths, and to have a basic understanding of the current medical literature. In this workshop, these topics will be reviewed with a particular emphasis on conducted electrical weapons (CEW). The complex phenomenon of excited delirium will be reviewed as a theory of causation.
(10/14/07) [2:30 p.m. to 3:00 p.m.] Investigation of In-Custody Deaths, Police Physicians Track, Chris Lawrence.
A systematic protocol to investigate sudden in-custody deaths will be presented.
(10/14/07) [3:00 p.m. to 3:30 p.m.] Panel on Excited Delirium, Police Physicians Section Track, Robert M. Bragg MSPE, Fabrice Czarnecki, MD, MA, MPH, Donald Dawes, MD,
Jeffrey Ho, MD MD, Chris Lawrence.
Participants will review current issues and recent research regarding excited delirium. Recommendations to prevent sudden in-custody deaths will be presented.
(10/14/07) [3:45 p.m. to 4: 15 p.m.] Update on Electronic Control Weapons: Review of the Recent Medical Publications and Recommensations, Police Physicians Section Track, Febrice Czarnecki, MD, MA, MPH.
We will review recent medical literature to guide law enforcement leadership in the proper and safer use of electronic control weapons. We will present specific recommendations to decrease the risk of medical complications after electronic control weapon application.
(10/22-26/07) Land Warfare Conference, Adelaide, South Australia, ECD Poster Presentations:
(10/07) (Poster) 15-Second Conducted Electrical Weapon Application Does Not Impair Basic Respiratory Parameters, Venous Blood Gases, or Blood Chemistries, Jeffrey Ho, MD, Robert Reardon, MD, Donald Dawes, MD, MarkJohnson, BS, Erik Lundin, BS, James Miner, MD.
(10/07) (Poster) 15-Second Conducted Electrical Weapon Exposure Does Not Cause Core Temperature Elevation In Non-Environmentally Stressed Resting Adults, Jeffrey Ho, MD, Robert Reardon, MD, Donald Dawes, MD, Mark Johnson, BS, Erik Lundin, BS, James Miner, MD.
(10/07) (Poster) Breathing Parameters, Venous Blood Gases, Serum Chemistries and Physiologic Effects of a New Wireless Projectile Conducted Electrical Weapon in Human Volunteers, Jeffrey Ho, MD, Robert Reardon, MD, Donald Dawes, MD, Mark Johnson, BS, Erik Lundin, BS, James Miner, MD.
(10/07) (Poster) The Neuroendocrine Effects of the TASER X26 Conducted Electrical Weapon as Compared to Oleoresin Capsicum, Jeffrey Ho, MD, Robert Reardon, MD, Donald Dawes, MD, Mark Johnson, BS, Erik Lundin, BS, James Miner, MO.
Conclusion: A 15-s discharge from a TASER X26® CEW does not increase the core body temperature of resting, non-environmentally stressed adult subjects. These results challenge the speculation that this weapon technology may be contributing to the hyperthermia in subjects who die from excited delirium, drug toxicity, or other causes while in custody.
Conclusion: None of the subjects had a positive troponin I level 6 h after exposure. It was concluded that human volunteers exposed to a single shock from the Taser(R) did not develop an abnormal serum troponin I level 6 h after shock, suggesting that there was no myocardial necrosis or infarction.
The TASER is a less lethal weapon seeing increased use by police jurisdictions across the country. As a result, subjects of TASER use are being seen with increasing frequency in emergency departments across the country. The potential injury patterns of the device are important for emergency physicians to understand. This report describes the case of an officer who complained of back pain after a single 5-s TASER discharge during a routine training exercise. Subsequent evaluation led to the diagnosis of an acute thoracic vertebral compression fracture. We discuss the potential mechanisms of injury in this case. Because we were unable to find any cases like this in our review of TASER-related injuries, we liken it to compression fractures that have been documented after seizures. We recommend that physicians consider obtaining back radiographs to rule out a vertebral compression fracture in any individual who has sustained a TASER discharge and has ongoing or persistent back pain.
OBJECTIVES: Data from the authors and others suggest that TASER X26 stun devices can acutely alter cardiac function in swine. The authors hypothesized that TASER discharges degrade cardiac performance through a mechanism not involving concurrent acidosis.
METHODS: Using an Institutional Animal Care and Use Committee (IACUC)-approved protocol, Yorkshire pigs (25-71 kg) were anesthetized, paralyzed with succinylcholine (SCh; 2 mg/kg), and then exposed to two 40-second discharges from a TASER X26 with a transcardiac vector. Vital signs, blood chemistry, and electrolyte levels were obtained before exposure and periodically for 48 hours postdischarge. Electrocardiograms and echocardiography (echo) were performed before, during, and after the discharges. p-Values < 0.05 were considered significant.
RESULTS: Electrocardiograms were unreadable during the discharges due to electrical interference, but echo images showed unmistakably that cardiac rhythm was captured immediately at a rate of 301 +/- 18 beats/min (n = 8) in all animals tested. Capture continued for the duration of the discharge and in one animal degenerated into fatal ventricular fibrillation (VF). In the remaining animals, ventricular tachycardia (VT) occurred postdischarge for 1-17 seconds, whereupon sinus rhythm was regained spontaneously. Blood chemistry values and vital signs were minimally altered postdischarge and no significant acidosis was seen.
CONCLUSIONS: Extreme acid-base disturbances usually seen after lengthy TASER discharges were absent with SCh, but TASER X26 discharges immediately and invariably produced myocardial capture. This usually reverted spontaneously to sinus rhythm postdischarge, but fatal VF was seen in one animal. Thus, in the absence of systemic acidosis, lengthy transcardiac TASER X26 discharges (2 x 40 seconds) captured myocardial rhythm, potentially resulting in VT or VF in swine.
(02/08) Medical Effects of TASERs, In Focus, Part 4 of a Series, Emergency Medicine News. 29(12):14-16, December 2007. Roberts, James R. MD.
(01/02/08) Less Lethal Weapons for Law Enforcement: A Performance-Based Analysis,
Mesloh, Wolf, Henych & Thompson,
18 (1) Law Enf. Exec. Forum 133-149 (2008).
CONCLUSIONS: There were no cardiac dysrhythmia and interval or morphology changes in subjects who received a Taser discharge based on a 12-lead ECG performed immediately before and within 1 minute after a Taser activation.
Increasing use by law enforcement agencies of the M26 and X26 TASER electrical incapacitation devices has raised concerns about the arrhythmogenic potential of these weapons. Using a numerical phantom constructed from medical images of the human body in which the material properties of the tissues are represented, computational electromagnetic modelling has been used to predict the currents arising at the heart following injection of M26 and X26 waveforms at the anterior surface of the chest (with one TASER 'barb' directly overlying the ventricles). The modelling indicated that the peak absolute current densities at the ventricles were 0.66 and 0.11 mA mm-2 for the M26 and X26 waveforms, respectively. When applied during the vulnerable period to the ventricular epicardial surface of guinea-pig isolated hearts, the M26 and X26 waveforms induced ectopic beats, but only at current densities greater than 60-fold those predicted by the modelling. When applied to the ventricles in trains designed to mimic the discharge patterns of the TASER devices, neither waveform induced ventricular fibrillation at peak currents >70-fold (for the M26 waveform) and >240-fold (for the X26) higher than the modelled current densities. This study provides evidence for a lack of arrhythmogenic action of the M26 and X26 TASER devices.
(10/09/07) Less lethal technology: medical issues, Gary M. Vilke, Theodore C. Chan, Policing: An International Journal of Police Strategies & Management, 2007 Volume: 30 Issue: 3 Page: 341 - 357.
Findings – In general, these three different types of less lethal weapons have been effective for their
intended use. Each type of less lethal weapon has a number of physiologic effects and specific medical issues that must be considered when the weapon is used. There is no clear evidence that these devices are inherently lethal, nor is there good evidence to suggest a causal link between sudden in-custody
death and the use of irritant sprays or conducted energy devices.
(10/09/07) Less lethal weapons: a technologist's perspective, Raymond L. Downs, Policing: An International Journal of Police Strategies & Management, 2007 Volume: 30 Issue: 3 Page: 358 - 384.
Findings – The essential attributes of less lethal weapons for law enforcement applications are described as well as the many practical considerations that must be made when acquiring and using them.
(10/09/07) Impact munitions: a discussion of key information, David Klinger, Policing: An International Journal of Police Strategies & Management, 2007 Volume: 30 Issue: 3 Page: 385 – 397.
Findings – Impact munitions are an increasingly popular feature of contemporary American policing that rarely lead to serious injury, but can, under certain circumstances, cause fatal injuries.
Findings – The majority of reported cases have resulted in the dismissal of claims against officers
and municipalities for alleged Taser-related excessive force violations. In most cases, plaintiffs were
unable to show the existence of an unconstitutional policy or custom to support municipal liability. As
for the liability of individual officers, most cases were decided in the officer’s favor on summary
judgment, particularly when the suspect was exhibiting physical resistance. In a few cases, summary judgment was denied to officers when the plaintiff alleged that he or she was fully compliant when the Tasering occurred.
(10/09/07) What we do not know about police use of Tasers™, Kenneth Adams, Victoria Jennison, Policing: An International Journal of Police Strategies & Management, 2007 Volume: 30 Issue: 3 Page: 447 – 465.
Findings – Limited research reflects a lack of consensus in the development and application of policies
related toTaser training and use.Variations in policy and training and the substitution of Tasers for other technologies across the use-of-force continuum result in operational inconsistency. This inconsistency makes it difficult to compare police departments in terms of the impact of Tasers on improved officer and
citizen safety and reductions in the use of lethal force. This inconsistency is also reflected inmedia reports
and has the potential to jeopardize community relations. Key policy issues center on length and content of
training, training staff qualifications, and substitutions on the use-of-force continuum. Further study of
Taser policy development, implementation, and evaluation is necessary to build a substantial and reliable body of knowledge to informsafe and effective police policy. Additional research is needed to evaluate the organizational and community implications of Taser implementation.
Findings – The use of CEDs was associated with reduced odds of officer and suspect injury and the
severity of suspect injury in one agency. In the other agency CED use was unrelated to the odds of injury; however, the use of pepper spray was associated with reduced odds of suspect injury. Among other findings, in both agencies the use of hands-on tactics by police was associated with increased
odds of officer and suspect injury, while the use of canines was associated with increased odds of suspect injury.
Pg 437 - "CED use was associated with a 677 percent increase in the odds of suspects not being injured during use-of-force encounters. Thus, whereas hands on tactics significantly increased the risk of injury among both officers and suspects, CEDs significantly decreased the risk of injury to both groups."
"[T]he use of soft-hand tactics,hard-hand tactics, and canines by officers increased the odds of both minor and major injury to suspects, while the use of CEDs significantly decreased the odds of both types of injury."
"The findings from Richland County indicated that the use of OC on suspects was one of the most important variables linked to a reduction in suspect injury, while CED use was not associated with either a decrease or increase in injury."
"The data from the MDPD, whose [438] officers did not have access to OC as an intermediate weapon, showed that the use of CEDs was associated with reductions in injury to both officers and suspects."
Pg 438 - "[T]he analysis of suspect injury severity in the MDPD found that the use of CEDs was associated with reductions of both minor and major injuries, clearly a more desirable outcome than if CEDs were linked to reductions in minor injuries only."
"Why CED use was not associated with a significant reduction in injuries in the RCSD is unclear. However, since the majority of the RCSD deputies had a long history of using OC spray and the introduction of CEDs was relatively recent, the reliance on OC may have mitigated its injury reduction effects. Perhaps, if both sites had a similar history with the same less-lethal weapon options, the findings would have been more comparable."
"Additional research in other settings may shed further light on this, but [439] the results of this study suggest that not every agency’s experience will be the same regarding CED use and injuries. Nonetheless, it is clear that the use of CEDs and OC can have a significant and positive effect on injury reduction."
"To the degree that OC and/or CEDs would be authorized and appropriate for use in such encounters, their deployment in place of soft empty-hand controls may help prevent some injuries, albeit mostly minor ones."
"Although our research did not address specifically the reduction in deadly force,other research and common sense demonstrates that it is probable that the use of CEDs would replace the use of firearms in some limited number of instances where lethal
force is justified, and thereby reduce deaths that would occur had a firearm been used (Ho et al., 2006a; Adams, this volume). Further, although rare cases of sudden in-custody death do occur with the use of CEDs, the causal connection remains unclear (Vilke and Chan, this volume) and the number of lives saved appears to far outweigh the number of deaths associated with CED exposure (Ho et al., 2006a). Therefore, given the accumulated evidence to date and the results of the present study, and assuming the existence of appropriate training, policies, restrictions on use and monitoring (Police Executive Research Forum, 2005; ACLU of South California, 1995), it is our conclusion and recommendation that police agencies adopt use-of-force policies and training regimens that permit officers to use CEDs to control threatening or physically resistant suspects. The findings from Miami-Dade and Richland Counties suggest that officers and citizens are at greatest risk for injury when they engage in physical struggles, particularly when the suspect is actively or violently resisting arrest, and that CEDs and OC spray reduce the probability of injury."
Pg 440 - "Given the minor nature of most injuries to officers and suspects, though, the substitution of OC spray or CEDs for hands-on control primarily will result in the prevention of bruises, abrasions, sprains, and the like. Balanced against this injury savings are the pain, irritation, and decontamination requirements associated with OC spray and the minor dart puncture wounds and rare complications associated with CEDs. Nonetheless, every use-of-force encounter carries with it the potential for serious injury and even minor injuries can result in the need for medical treatment or time lost from work. More importantly, the use of less lethal technologies from a stand-off distance may help to prevent the occasional serious injury that might otherwise occur from physical contact between officers and citizens. Consequently, the use of CEDs or OC spray under these conditions makes the control of resistant persons safer for everyone."
(09/19/07) Cardiac Current Density Distribution by Electrical Pulses from TASER devices, Kroll MW, McDaniel W, Panescu D, Stratbucker RA., Conf Proc IEEE [Institute of Electrical and Electronics Engineers, Inc.] Eng Med Biol Soc. [IEEE Engineering in Medicine and Biology Society]. 2006;1(1):6305-6307.
TASERs deliver electrical pulses that can temporarily incapacitate subjects. The goal of this paper is to analyze the distribution of TASER currents in the heart and understand their chances of triggering cardiac arrhythmias. The models analyzed herein describe strength-duration thresholds for myocyte excitation and ventricular fibrillation induction. Finite element modeling is used to compute current density in the heart for worst-case TASER electrode placement. The model predicts a maximum TASER current density of 0.27 mA/cm<sup>2</sup> in the heart. It is conclude that the numerically simulated TASER current density in the heart is about half the threshold for myocytes excitation and more than 500 times lower than the threshold required for inducing ventricular fibrillation. Showing a substantial cardiac safety margin, TASER devices do not generate currents in the heart that are high enough to excite myocytes or trigger VF.
(09/19/07) Finite Element Modeling of Electric Field Effects of TASER Devices on Nerve and Muscle. Efimov IR, Kroll MW, Panescu D, Sweeney JD. Conf Proc IEEE [Institute of Electrical and Electronics Engineers, Inc.] Eng Med Biol Soc. [IEEE Engineering in Medicine and Biology Society]. 2006;1(1):1277-1279.
TASERs deliver electrical pulses that can temporarily incapacitate subjects. The goal of this paper is to analyze the distribution of currents in muscle layers and understand the electro-muscular incapacitation safety and efficacy of TASERs. The analyses describe skeletal muscle and motor nerve activation, cell electroporation and current and electric field distributions through skin, fat and muscle layers, under worst-case assumptions for TASER electrode penetration and separation. For the muscle layer, the analysis predicts worst-case current-density and field-strength values of 94 mA/cm<sup>2</sup> and 47 V/cm. Both values are higher than thresholds required for neuromuscular activation but significantly lower than levels needed for permanent cellular electroporation or tissue damage. The results indicate that TASERs are safe and effective in producing temporary subject incapacitation.
(09/15/07) Acute Effects of TASER X26 Discharges in a Swine Model. Dennis, Andrew J. DO; Valentino, Daniel J. MD; Walter, Robert J. PhD; Nagy, Kimberly K. MD; Winners, Jerry BS; Bokhari, Faran MD; Wiley, Dorion E. MD; Joseph, Kimberly T. MD; Roberts, Roxanne R. MD, Journal of Trauma-Injury Infection & Critical Care. 63(3):581-590, September 2007.
Conclusions: Immediately after the [two 40 second ECD] discharge [with a 10 second pause between the 40 second continuous discharges], two [swine] deaths [29 kilogram (kg) (63.93 pounds (lbs)) and 31 kg (68.34 lbs)] occurred because of ventricular fibrillation. In this model of prolonged EID exposure, clinically significant acid-base and cardiovascular disturbances were clearly seen. The severe metabolic and respiratory acidosis seen here suggests the involvement of a primary cardiovascular mechanism.
The Taser is an electrical conducted energy weapon used by law enforcement officers throughout the United States and the world. Though generally regarded as safe, conducted energy weapons can produce injuries. In this case report we describe for the first time thoracic spine compression fractures resulting from a conducted energy weapon discharge. Physicians who may care for patients who have been exposed to a conducted energy weapon discharge should be aware of this as a possible complication.
(09/07/07) Impact of conducted electrical weapons in a mentally ill population: a brief report, Jeffrey D. Ho MD, Donald M. Dawes MD, Mark A. Johnson BS, Erik J. Lundin, and James R. Miner MD, The American Journal of Emergency Medicine, Volume 25, Issue 7, September 2007, pages 780-785.
Conclusion: The mentally ill represents a significant portion of subjects upon whom CEWs are used. These data suggest frequent use of CEWs in situations where deadly force would otherwise be justified and in situations where subjects exhibit imminent danger to themselves. These data also suggest that escalation to deadly force was avoided in many mental illness and suicidal situations by the presence of a CEW.
(09/07/07) Excited Delirium: What Every Chief Needs to Know, by John G. Peters, Jr., Ph.D., CLS, Police and Security News, September/October 2007, Vol. 23, Issue 5.
(08/29/07) Physiological Effects of a Conducted Electrical Weapon on
Human Subjects, Gary M. Vilke, MD, Christian M. Sloane, MD, Katie D. Bouton, BS, Fred W. Kolkhorst, PhD, Saul D. Levine, MD, Tom S. Neuman, MD, Edward M. Castillo, PhD, MPH, Theodore C. Chan, MD. Article in Press, Ann Emerg Med. 2007;xx:xxx.
Conclusion: A 5-second exposure of a Taser X-26 to healthy law enforcement personnel does not result in clinically significant changes of physiologic stress.
Conclusion: In summary, this review of the scientific literature suggests that the immediate induction of ventricular fibrillation by the direct electrical effects of the TASER X26 on the normal adult heart is unlikely and that the induction of delayed cardiac arrest by this mechanism is extremely unlikely.
This conclusion is partially based on several assumptions, eg, that the depiction of the TASER X26 pulse in the paper by McDaniel et al is accurate and that Blair’s method and the fundamental law of electrostimulation accurately predict the stimulatory effects of 0.1-ms pulses. However, unless these assumptions are grossly in error, the large safety factors for the induction of immediate or delayed ventricular fibrillation suggest that this conclusion is still true even if some of the assumptions, such as the effective time constant of the heart for electrical stimulation from the body surface, are not precisely correct. In addition, this conclusion is bolstered by the limited amount of experimental evidence in animals.
(08/28/07) Case Report: Cataract secondary to electrical shock from a Taser gun, Rajeev K. Seth, MD, Galareh Abedi, MD, MS, Armand J. Daccache, MD, James C. Tsai, MD, J Cataract Refract Surg 2007; 33:1664-1665.
(08/24/07) The Physiologic Effects of a Conducted Electrical Weapon [Stinger S-400] in Swine, Amanda O. Esquivel, MS, Elizabeth J. Dawe, DVM, Javier A. Sala-Mercado, MD, PhD., Robert L. Hammond, PhD, Cynthia A. Bir, PhD., Article in Press, American College of Emergency Physicians, Trauma/Original Research, dol:10.1016/j.annemergmed.2007.05.003, Ann Emerg Med. 2007;xx:xxx.
Conclusion: Repeated exposures to a conducted electrical weapon result in respiratory acidosis, metabolic vasodilation, and an increase in blood lactate level. These effects were transient in this study, with full recovery by 4 hours post exposure. The Stinger S-400 appears to have no serious adverse physiologic effects on healthy, anesthetized swine.
(07/18/07) Are TASERs Really Non-Lethal? Current Research on Both Animals and Humans shows that TASERs are among the safest cop weapons, Jeffrey D. Ho, MD, FACEP, Police Magazine, July 2007, pages 32-38.
Conclusion: "Study after study continues to show that TASERs are a safe, non-lethal weapon for law enforcement applications. Based on all of the available data, including the most recent human study, there seems to be no reason to prevent law enforcement agancies from continuing to use these devices with confidence.
(07/18/07) Do electrical stun guns (TASER-X26(R)) affect the functional integrity of implantable pacemakers and defibrillators? Dhanunjaya Lakkireddy, Atul Khasnis, Jennifer Antenacci, Kay Ryshcon,Mina K. Chung, Donald Wallick, William Kowalewski, Dimpi Patel, Hanka Mlcochova, Ashok Kondur, James Vacek, David Martin, Andrea Natale, and Patrick Tchou, Europace. 2007; 9(7): p. 551-556.
Conclusion: Pacemakers and ICD generators and leads functions were not affected by the tested standard 5 s stun gun shocks.
In a previous study, 18 repeated exposures of anaesthetized swine to an electro-muscular incapacitating device (TASER International's ADVANCED TASER((R)) X26 electronic control device) resulted in acidosis and increases in blood electrolytes. In the current study, experiments were performed to investigate effects of a more typical scenario of repeated exposures of the device on muscle contraction and changes in blood factors. Ten swine were exposed for 5s, followed by a 5-s period of no exposure, three times. Selected blood factors were monitored for 3h following exposure. Transient increases in blood glucose, lactate, sodium, potassium, calcium, and pCO(2) were consistent with previous reports in the literature dealing with studies of muscle stimulation or exercise. Blood pH was decreased immediately following exposure, but subsequently returned toward a normal level. Oxygen saturation (measured by pulse oximetry) was not changed significantly. In conclusion, three repeated TASER device exposures had only transient effects on blood factors, which all returned to pre-exposure levels, with the exception of hematocrit (which remained elevated after 3h). Since the increase in this factor was less than that which may occur after short periods of exercise, it is unlikely that this would be an indicator of any serious harm. (emphasis added).
(07/07) National Study On Neck Restraints in Policing, Technical Report, Christine Hall, MD, MSc, FRCPC, Sergeant Chris Butler, Canadian Police Research Centre, June 2007.
(07/01/07) Intracranial penetration of a TASER dart. TU Rehman, H Yonas, and J Marinaro, Am J Emerg Med, July 1, 2007; 25(6): 733.e3-4.
(03/07) Restraint asphyxia in in-custody deaths: Medical examiner’s role in prevention of deaths, Lakshmanan Sathyavagiswaran, Christopher Rogers, Thomas T. Noguchi, Legal Medicine, March 2007 (Vol. 9, Issue 2, Pages 88-93).
2-Hour Webinars by KRM, Law Enforcement Training Division [Back to Top]:
John Peters ICD Articles Series Police & Security News 2006 [Back to Top]:
(05-06) Sudden Death, "Excited" Delirium, and Issues of Force: Part II - Electronic Control Devices, Police & Security News, May/June 2006, Vol. 22, Issue 3, by John G. Peters, Jr., M.B.A., Ph.D., C.L.S.
(07-06) Sudden Death, "Excited" Delirium, and Issues of Force: Part III - Behavioral Cues and Response Plans for Sudden and In-Custody Deaths, Police & Security News, JulyAugust 2006, Vol. 22, Issue 4, by John G. Peters, Jr., M.B.A., Ph.D., C.L.S.
(09-06) Sudden Death, "Excited" Delirium, and Issues of Force: Part IV - A Blueprint for Forensic Investigators, Police & Security News, September/October 2006, Vol. 22, Issue 5, by John G. Peters, Jr., M.B.A., Ph.D., C.L.S. and Michael Brave, Esq., M.S., C.L.S.3, C.L.E.T.
(11-06) "Excited" Delirium, and Issues of Force Part V, Preventing Jail Suicide, Police & Security News, November/December 2006, Vol. 22, Issue 6, By John G. Peters, Jr., M.B.A., Ph.D., CLS, and Teri Himebaugh, J.D., L.L.M.
Emergency Medical Service, Coping w/Violent People Series [Back to Top]:
(04/03/07) Coping with Violent People: Level II Physical Restraint,
A Colorado answer to safe, humane use of prehospital restraints, EMS Responder, March 2007 issue of Emergency Medical Service.
(05/11/07) Coping with Violent People: Self-defense during patient assessment, A Colorado answer to safe, humane use of prehospital restraints, May 11, 2007, May 2007 issue of Emergency Medical Service.
Chris Lawrence Excited Delirium (ED) Articles (PoliceOne.com):
Charles Remsberg Excited Delirium (ED) Articles (PoliceOne.com):
(06/01/07) NEW EXCITED DELIRIUM PROTOCOL ISSUED BY SAN JOSE PD, Force Science News #73, June 1, 2007.
Excited Delirium Model/Sample Policies [Back to Top]:
(05/17/07) Model Policy for Excited Delrium, by David Hatch, Corrections Managers' Report, Volume XIII, No. 1, June/July 2007, Pgs 7-9, 12 , ISSN 1083-3382.
(03/19/07) Management of Subjects in Excited Delirium, San Jose (CA) Police Department Training Bulletin No: 006-2007.
(06/01/07) NEW EXCITED DELIRIUM PROTOCOL ISSUED BY SAN JOSE PD, Force Science News #73, June 1, 2007.
Other Excited Delirium and In-Custody Death Articles [Back to Top]:
(05/17/07) Prescription Drugs, Sudden Death, and Risk Management, by John G. Peters, Ph.D., M.B.A., C.L.S., Corrections Managers' Report, Volume XIII, No. 1, June/July 2007, Pgs 1-2, 14-15, ISSN 1083-3382.
(05/17/07) Myth of Positional Asphyxia, Fatal Excited Delirium Case Studies, Model Policy for Excited Delirium, by David Hatch, Corrections Managers' Report, Volume XIII, No. 1, June/July 2007, Pgs 7-9, 12 , ISSN 1083-3382.
(02/21/07) AAFS Presentation: Fatal Ephedrine Intoxication in a Chronic Ephedrine User Who Had Cardiovascular Disease,
Diana G. Wilkins, PhD., Center for Human Toxicology, Biomed Research Polymers Building, Room 490, Salt Lake City, UT 84112; Ling Li, MD and David R. Fowler, MD, Office of the Chief Medical Examiner State of Maryland, 111 Penn Street, Baltimore, MD 21201; Brienne Brown, MS, Center for Human Toxicology, Biomend Research Polymers Building, Room 490, Salt Lake City, UT 84112; and Stephen J. Kish, PhD, Centre Addiction Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.
(04/27/06) Deaths During Police Intervention, FBI Law Enforcement Bulletin, April 2006, pgs 18-22, by Richard Parent, Ph.D.
(11-12/05) Sudden Custody Death Syndrome, Matthew D. Sztajnkrycer, MD, PhD and Sgt. Michael Walsh, The Police Marksman Magazine, November/December 2005, pp. 19-24.
(10/10/05) Boomers' Overdose Deaths Up Markedly, Los Angeles Times - "Californians age 40 and older are dying of drug overdoses at double the rate recorded in 1990 ...."
(10/05) Cocaine, Excited Delirium and Sudden Unexpected Death, by Sztajnkrycer MD, Baez AA., Mayo Clinic, Rochester, MN, USA. sztajnkrycer.matthew@mayo.edu, PMID: 15900873 [PubMed - indexed for MEDLINE], Emerg Med Serv. 2005 Apr;34(4):77-81.
(09/05) Deaths In American Police Custody: A 12 Month Surveillance Study, Jeffrey D. Ho, MD, et. al.
(08/05) Sudden In-Custody Death, by Jeffrey D. Ho, MD, FACEP, Police Magazine, August 2005, pages 47-56.
(03/05) Sudden In-Custody Death Syndrome. Forensics in the ED, Topics in Emergency Medicine, by Robison, Debra RN, SANE-A, CEN; Hunt, Shelby MHA, RN, CEN, 27(1):36-43, January/March 2005.
(06/00) Cocaine metabolism in hyperthermic patients with excited delirium, by Blaho K, Winbery S, Park L, Logan B, Karch SB, Barker LA., Department of Emergency Medicine and Clinical Toxicology, UT Medical Group, Memphis, USA. J Clin Forensic Med. 2000 Jun;7(2):71-6.
(2000) Metabolic consequences of drug misuse, by J. A. Henry, Academic Department of Accident and Emergency Medicine, Imperial College School of Medicine, St Mary’s Hospital, London W2 1NY, UK, British Journal of Anaesthesia, 2000, Vol. 85, No. 1 136-142.
(04/98) Acute excited states and sudden death: Death after restraint can be avoided, by Derrick Pounder, Professor of forensic medicine, Department of Forensic Medicine, University of Dundee, Royal Infirmary, Dundee DD1 9ND, BMJ. 1998 April 11; 316(7138): 1171.
Drug Deaths/TEDS - US and Florida Medical Examiners' Reports:
| |
1995 |
2005 |
| Total Admissions |
1,680,697 |
1,849,548 |
| Cocaine |
278,421 |
256,491 |
| Stimulants |
63,244 |
170,470 |
| Methamphetamine - a subset of Stimulants |
47,695 |
152,368 |
"The research, based on the shooting experiences of one large sheriff’s department in California, shows that subjects who are under the influence of drugs or alcohol and/or have a history of violence are far more likely to be on the receiving end of police gunfire.
Specifically, among subjects the sheriff’s personnel responded to with deadly force,
- those under the influence of drugs were 3 times more likely to be shot or shot at by officers than those who weren’t,
- intoxicated suspects 3.4 times more likely than those who were sober; and
- people with previous arrests for violent crimes 3.7 times more likely than those without that history."
In 2004, poisoning was second only to motor-vehicle crashes as a cause of death from unintentional injury in the United States (1). Nearly all poisoning deaths in the United States are attributed to drugs, and most drug poisonings result from the abuse of prescription and illegal drugs. The number of unintentional poisoning deaths increased from 12,186 in 1999 to 20,950 in 2004.
In 2004, poisoning was second only to motor-vehicle crashes as a cause of death from unintentional injury in the United States (1). Nearly all poisoning deaths in the United States are attributed to drugs, and most drug poisonings result from the abuse of prescription and illegal drugs. The number of unintentional poisoning deaths increased from 12,186 in 1999 to 20,950 in 2004.
Approximately 89,000 deaths in Florida from January through June 2006
- 3,595 people died with one ore more of the drugs in the report in their bodies
- of those, 58 had meth in their bodies (9 meth was the cause of death, 49 meth present)
- 927 had cocaine in their bodies (348 cocaine was the cause of death, 579 cocaine present)
Approximately 172,000 deaths in Florida in 2005
- 7,573 people died with one or more of the drugs in the report in their bodies
- of those, 115 had meth in their bodies (29 meth was the cause of death, 86 meth present)
- 1,943 had cocaine in their bodies (732 cocaine was the cause of death, 1,211 cocaine present)
2004 Report of Drugs: Identified in Deceased Persons by Florida Medical Examiners
- 93 had meth in their bodies (19 meth was the cause of death, 74 meth present)
- 1,702 had cocaine in their bodies (591 cocaine was the cause of death, 1,111 cocaine present)
AELE Electronic Control Device (ECD) Related Legal Articles: [Back to Top]
TASER Electronic Control Device (ECD) Related Articles [Back to Top]:
(06/10-15/07) Numerical Estimation of TASER CEW Current Flow and Effects on Human Body, Dorin Panescu, Ph.D., St. Jude Medical, Sunnyvale, CA, USA, Presented at the Bioelectromagnetics Society 29th Annual Meeting, BEMS 2007, Kanazawa, Japan, June 10-15, 2007.
(06/07) Physiological Effects of a Five Second TASER Exposure, Katie Bouton1, Gary M. Vilke, Theodore C. Chan, Christian Sloane, Saul Levine, Tom S. Neuman, Susan S. Levy, Fred W. Kolkhorst, FACSM.
Conclusions: Based on these limited observations, a 5 s TASER exposure does not cause clinically significant indications of physiological stress that could be causally
linked to sudden death. However, our subjects were healthy and were not under the
influence of any illicit drugs, thus these results may not be generalizable to
populations who are were taking common drugs of abuse and/or who had
developed lactic acidosis from high-intensity exercise.
(05/31/07) Physiological Effects of a Five Second Taser Exposure: 1897: Board #185 May 31 8:00 AM - 9:30 AM., KD Bouton, GM Vilke, TC Chan, C Sloane, S Levine, TS Neuman, SS Levy, and FW Kolkhorst, Med Sci Sports Exerc, May 1, 2007; 39(5 Suppl): S323.
Conclusions: In this study in human volunteers, a significant increase in heart rate was found after a brief shock from a CED, the Taser X-26®. There were no other identified cardiac rhythm disturbances or morphology changes except for a few subjects who appeared to have QT changes, the significance of which is unclear.
(05/23/07) The State of Current Human Research and Electronic Control Devices (ECDs), Jeffrey Douglas Ho, M.D., Mark Alexander Johnson, Donald Murray Dawes, M.D., European Working Group, Non-Lethal Weapons, presented at 4th European Symposium on Non-Lethal Weapons, May 21-23, 2007, Stadthalle Ettlingen, Germany.
(05/12/07) Heart Rhythm Society, Do Electrical Stun Guns (TASER-X26®) Affect the Functional Integrity of Implantable Pacemakers and Defibrillators? Dhanunjaya R Lakkireddy, MD, Donald Wallick, PhD, Jennifer A Antenacci, RN, BSN, William Kowalewski, BA, David Martin, MD, Mina Chung, MD, Oussama Wazni, MD, Dimpi Patel, DO, Andrea Natale, MD, Patrick Tchou, MD.
Conclusions: NMI discharge does not affect the short-term functional integrity of implantable pacemakers and defibrillators even when the darts are placed in a manner to sandwich the generator.
The standard NMI application duration of 5 seconds should not trigger an ICD shock in devices programmed to a non-committed shock delivery mode.
Conclusions. Even with the worst-case locations, with barbs plunged fully towards the heart, we were never able to induce ventricular fibrillation in 34 kg (76 lb) pigs.
(05/09/07) Do electrical stun guns (TASER-X26®) affect the functional integrity of implantable pacemakers and defibrillators? Dhanunjaya Lakkireddy, Atul Khasnis, Jennifer Antenacci, Kay Ryshcon, Mina K. Chung, Donald Wallick, William Kowalewski, Dimpi Patel, Hanka Mlcochova, Ashok Kondur, James Vacek, David Martin, Andrea Natale, and Patrick Tchou. Europace Advance Access published May 9, 2007, Europace doi:10.1093/europace/eum058.
Conclusion Pacemakers and ICD generators and leads functions were not affected by the tested standard 5 s stun gun shocks.
(04/26/07) (Poster)(Abstract) Does the Taser Cause Electrical Changes in Twelve Lead ECG Monitoring of Human Subjects, Gary Vilke, Christian Sloane, Saul Levine, Tom Neuman, Edward Castillo,and Theodore Chan, Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S104.
Conclusions: There were no cardiac dysrhythmia, interval or morphology changes in human subjects who received a Taser shock on evaluation of a 12 lead ECG performed immediately before and after Taser activation.
(04/26/07) (Poster)(Abstract) Serum Troponin I Measurement of Subjects Exposed to the Taser X-26, Christian Sloane, Gary Vilke, Theodore Chan, Saul Levine, and James Dunford, Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S103-b-104S -b.
Conclusions: Though limited by short shock duration, human volunteers exposed to a single shock from the Taser did not develop an abnormal serum troponin I level 6 hours after shock, suggesting that there was no myocardial necrosis.
(04/26/07) (Poster) (Abstract) The Impact of the Taser Weapon on Respiratory And Ventilatory Function in Human Subjects? Ted Chan, Christian Sloane, Tom Neuman, Saul Levine, Edward Castillo, Gary Vilke, Katie Bouton, and Fred Kohokorst, Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S191-b-192S -b.
Conclusions: In our study on human volunteers, VE, TV, and RR increased immediately following a standard Taser discharge, but returned to baseline within 10 minutes.There was no evidence of hypoxemia or hypoventilation in our study subjects.
(04/26/07) TASER Discharges Capture Cardiac Rhythm in a Swine Model, Daniel Valentino, Robert Walter, Andrew Dennis, Bosko Margeta, Kimberly Nagy, Jerry Winners, Faran Bokhari, Dorion Wiley, Kimberly Joseph, and Roxanne Roberts, Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S104-a.
Conclusions: Given the possibility of cardiac capture with TASER discharges, cardiac monitoring should be performed on exposed subjects.
(04/26/07) (Poster)(Abstract) Cardiovascular and Metabolic Effects of the Taser on Human Subjects, Gary Vilke, Christian Sloane, Katie Bouton, Saul Levine, Tom Neuman, Edward Castillo, Fred Kolkhorst, and Theodore Chan, Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S104-b-105S -b.
Conclusions: There were no clinically significant or lasting statistically significant changes in cardiovascular, electrolyte, lactate or pH levels in human subjects after a 5 second Taser activation.
(04/26/07) (Poster) (Abstract) Absence of Electrocardiographic Change Following Prolonged Application of a Conducted Electrical Weapon in Physically Exhausted Adults,Jeffrey Ho, Donald Dawes, Hugh Calkins, and Mark Johnson, Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S128-b-129S -b.
Conclusions: Prolonged 15 second CEW application in a physically exhausted adult human sample did not cause a detectable change in their 12-lead ECGs. Theories of CEW induced dysrhythmias are not supported by our findings.
(04/26/07) (Poster)(Abstract) Physiologic Effects of Prolonged Conducted Electrical Weapon Discharge on Intoxicated Adults, Ronald Moscati, Jeffrey Ho, Donald Dawes, James Miner, Robert Reardon, William Heegaard, Timothy Mark Johnson, and Laura Bultman, Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S63-b-64S -b.
Conclusions: Intoxicated adults with prolonged CEW exposure demonstrate small transient increases in measures of acidosis and no change in markers of cardiac injury. The increased acidosis was not clinically significant and self corrected.
(04/26/07) (Poster) (Abstract) Physiologic Effects of Prolonged Conducted Electrical Weapon Discharge on Acidotic Adults, Jeffrey Ho, Donald Dawes, Laura Bultman, Ronald Moscati, Lisa Skinner, Jennifer Bahr, Robert Reardon, Mark Johnson, and James Miner,Acad. Emerg. Med. 2007; 14(5_Supplement_1): p. S63-a.
Conclusions: Markers of acidosis and cardiac injury were similar among acidotic subjects who underwent both sham and real prolonged CEW exposure. Prolonged CEW exposure in humans does not appear to have an effect with regard to worsening acidosis that is already present.
(02/27/07) 2006 Annual Report: Use of TASERs, February 18, 2007 Report from William Blair, Chief of Police, Toronto Police Services Board
(02/24/07) Conducted Energy Devices:Development of Standards for Consistency and Guidance, The Creation of National CED Policy and Training Guidelines, by James M. Cronin and Joshua A. Ederheimer. U.S. Department of Justice, Office of Community Oriented Policing Services.
(02/07) MW Kroll, H Calkins, and RM Luceri, Electronic control devices and the clinical milieu. J Am Coll Cardiol 13 Feb 2007 49(6): p. 732; author reply 732.
(02/07) Reply, Dorian and Nanthakumar J Am Coll Cardiol.2007; 49: 732-733
" ... [S]tudies have not reported a single case in which the presenting rhythm was VF when an ECD was used. A study of 162 consecutive in-custody deaths found that, whereas there was a significant association of impact weapons with sudden death, the ECDs were never (0 of 50; p = 0.0001) associated with a sudden collapse. This would seem to eliminate electrically induced VF as the cause of death."
"We did not state that NIDs cause ventricular fibrillation in humans, and we agree that we cannot conclude from our study that NID discharges cause arrhythmias in typical use."
(2007) Jauchem, James R., Reply to Letter to the Editor, Forensic Science International. Letter dated August 28, 2006. Re: Acidosis, lactate, electrolytes, muscle enzymes, and other factors in the blood of Sus scrofa following repeated TASER® exposures. Forensic Science International, Volume 168, Issue 1, Pages e19-e19 J. Jauchem.
"It is important to note that our exposure conditions were somewhat extreme compared with those commonly experienced during civilian law-enforcement use of TASER International’s Advanced TASER X26. Therefore, it would not be prudent to draw conclusions about such use on the basis of our study alone."
(2007) (Letter to the Editor) Taser Research in Pigs Not Helpful, Pippin, J. J., JACC 2007 0: p. j.jacc.2006.11.019v1-12623.
(10/06) 75:Evaluation of In-Custody Deaths Proximal to Use of Conductive Energy Devices, G. Vilke, W. Johnson, E.M. Castillo, J.A. Ederheimer, C. Wexler, C.M. Sloane, T.C. Chan, Annals of Emergency Medicine, October 2006 (Vol. 48, Issue 4, Pages 23-24).
(10/06) 340: Cardiac Effects of the Taser Conducted Energy Weapon, D.G. Barnes, J.E. Winslow, R.L. Alson, J. Johnson, W.P. Bozeman, Annals of Emergency Medicine, October 2006 (Vol. 48, Issue 4, Page 102).
Conclusion: Taser shocks produced no detectable dysrhythmias and a statistically significant increase in heart rate. A dose response relationship was not demonstrated. This study more than doubles the previously reported human subject experience of Taser shock during EKG monitoring and includes a significant number of full 5 second exposures. Overall, Taser exposure appears to be safe and in this population well tolerated from a cardiovascular standpoint.
(09/06) Long Beach, California: Less-lethal Weaponry Case Study. By Chief Anthony W. Batts and Sergeant Susanne Steiner, Long Beach Police Department, California, and Data Collection and Analysis by Lieutenant John Lembi, Long Beach Police Department, California, The Police Chief, vol. 73, no. 9, September 2006.
(09/06) Taser use in restraint-related deaths, 10 (4) Prehospital Emergency Care 447-50 (Oct-Dec. 2006) Strote Jared; Range Hutson H Division of Emergency Medicine, Department of Medicine, University of Washington Medical Center, Seattle, WA.
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