A Primer on Tasers

Last weekend, I attended the annual meeting of my medical specialty society in New York.  My medical specialty is occupational medicine, and I signed up to attend a half-day long seminar on occupational health issues for public safety professionals.  One of the presentations-- unexpectedly and paradoxically-- was on the subject of tasers.  It was a gripping presentation, and a video was shown of the taser being used.  (I wish to acknowledge Dr. Fabrice Czarnecki who gave the presentation I attended.)

While use of the taser may have been shown on television previously, I had not seen it.

Considerable local and national discussion, of course, has focused on the appropriateness of this law enforcement tool.  I learned some things I did not know about the taser, and I suspect some other folks may not know either.

First, the taser does not shock someone with an invisible beam like a "ray gun" as seen in science fiction.  It does not work like a "stun gun", in which the gun is pressed against the body of the assailant to deliver a shock (which apparently does not work well).  Instead, the taser shoots "darts", each of which has a sharp end intended to penetrate the skin of the assailant. 

Second, what the assailant perceives is not merely a shock.  Instead, there is intense pain as the shock is delivered, and it lasts as long as it is being applied.  The taser is very effective because the assailant falls, immobilized in severe pain until handcuffs can be placed.

Third, the use of the taser is not without after-effects.  The site of skin penetration where the "dart" enters can become significantly burned.  Because the dart penetrates about 0.5 - 1.5 cm below the skin, the burn encircles the entrance point to a mild extent, but tends to be fairly deep.

Fourth, there is a "standard of practice" for police professionals that the electric shock not be discharged for more than 5 seconds, and no more than three times.   There  have been instances when the shock has been delivered for up to a couple of minutes, and obviously this increases the risk of complications.

Fifth,  there are animal studies on the adverse effects of the taser, but little good peer-reviewed human data.  And there is very little information on what level of taser electric exposure causes what level of response.  There have been 270 taser-related deaths in the US out of 600,000 field exposures.  Some of these deaths, however, may not have been directly caused by the taser.  For instance, drugs, "excited delirium", or heart disease may have been the cause. 

Sixth, the darts need to be removed.  They become "stuck" in the skin and underlying tissue, not unlike a fishhook, and removing them can be tricky.  Sometimes the assailant has to be brought to the ER for removal of the dart.  Medical personnel should remove it if it enters the head, neck, or groin regions, for instance.  The police officer, of course, should avoid hitting these areas-- and also avoid hitting the chest.

The heart speeds up with certain taser exposures, and in unusual cases a rhythm called ventricular fibrillation is seen.  This rhythm usually results in cardiac arrest and death, unless promptly treated.

There have been case reports of other types of injuries with taser use: the dart penetrating through the skull and then through the surface of the brain; fractured vertebrae, even when no fall has occurred; seizures; eye injuries leading to blindness; trauma due to the fall that takes place; and drowning if the assailant falls into water.

One of the circumstances in which tasers are used is when the assailant demonstrates "excited delirium."  This is when the individual is profoundly agitated and out of control.  This can be caused by illicit drug abuse or withdrawal; or by psychiatric problems.  Some of these individuals will develop various medical complications, or will die because of them.

It is felt that limiting the number of times tasers are used for any one individual,  and limiting the time during which electricity is discharged, will reduce the risk of complications.  There is little benefit seen with subjecting police trainees to taser exposure.  Police, however, must be trained how to use them properly.

Who is at high risk with taser exposures? Young children, the elderly, pregnant women, frail individuals and short people.  It has been suggested to avoid using it in these populations.

The use of the taser should be restricted to assailants who are felt to be at risk of hurting themselves or hurting others.  In some cases, use of a baton or a firearm might be a better option, and should be considered.  When deciding to use the taser, the risk of NOT using it also needs to be evaluated.

If any police are reading this article, you are welcome to offer your thoughts.

 

Comments

[Fred Gregory]

Joe,

Thanks for sharing. All I got to say is " Don't tase me bro ".

Oh, this is a hoot. Ann Coulter on the taser,

http://www.humanevents.com/article.php?print=yes&id=22596

[Matt Lojko, Jr.]

Determining what method to use to take a resisting person into physical custody by a law enforcement officer has been and will continue to be a perplexing question open to much speculation and individual opinion. In the past 30+ years, I have seen law enforcement make great strides in this area.

Verbal techniques, such as Verbal Judo, developed and taught nationally by Dr. George Thompson are effective in some situations. However, much depends upon the state of mind of the offender.

Hands-on techniques have improved significantly and are required skills taught in basic law enforcement training academies throughout the state. However, the downside to most hands-on techniques is that it requires officers to come in close physical contact with the arrestee that creates significant safety issues and the potential of injury both to the officer and the arrestee. Another downside is the necessity for officers to continually practice the techniques to maintain proficiency. To attempt such techniques in a haphazard manner can potentially create significant safety issues for both the officer and the arrestee.

Chemical irritants, such as mace and more recently, OC spray, have been a significant development that has dramatically reduced injuries both for officers and arrestees alike. However, these weapons are often not effective against persons who are under the influence of alcohol or drugs.

Striking weapons have changed over time as well. Law enforcement has gone from the Billy club to the nightstick/baton to the PR-24 to a collapsible baton. Again, these instruments are effective in some situations but the public perception and PR nightmare created by officers “beating” someone with such a device is often not worth the benefit. We only have to remember the Rodney King situation and the horrific images of that video.

Recent technology has produced other non-lethal weapons. Examples of these are rubber bullets, beanbag round, capture nets, etc. The problem with such weapons is the expense and availability. These weapons are expensive and when they are purchased, frequently they are not put into the hands of the officers that most need them due to the costs involved.

Obviously, the firearm is the weapon of last resort for law enforcement and the one that has the most potentially devastating consequences for its use.

The Taser presents a non-lethal alternative that is effective and while expensive, an affordable option for most law enforcement agencies. It offers several advantages over other techniques mentioned above.
• It does not require the officer to come into physical contact with the arrestee, thereby minimizing potential injury to the officer and arrestee through a physical confrontation.
• It does not require any specialized skill or proficiency level to administer as required in most hands-on techniques.
• It works when chemical irritants don’t, particularly with persons who are under the influence of alcohol or drugs.
• It does not present the PR issues of a striking weapon.
• It is accessible to officers as it is worn on the utility belt.
• It is non-lethal when used appropriately.

The Taser seems to be undergoing a scrutiny similar to that of OC spray when it was first implemented by law enforcement. I remember attending a training session at Baptist Hospital in 1990 regarding OC spray following the death of an arrestee in Concord. While the OC spray had an exacerbating effect on the arrestee, it was determined that cocaine intoxication and positional asphyxiation was the proximate cause of his death. Just as OC spray withstood the scrutiny and became an accepted tool of law enforcement, I feel the Taser will as well as long as good policies and procedures are developed for its use and officers are held accountable.

We should remember that virtually anything could be used as a weapon if it is used inappropriately. Pillows have murdered persons. We should also be aware that certain factors inherent to particular arrestees could affect any technique used by law enforcement to affect an arrest. But more than that, we need to realize that law enforcement has a job to do and much of the decision regarding how an arrest occurs resides with the arrestee. All he or she has to do is submit to the arrest and no force is used.

I believe the Taser is an effective and needed tool for law enforcement and one that will lessen the potential injuries to both officers and arrestees alike. When that occurs, it’s a success.

Matthew A. Lojko, Jr.
Captain (Retired)
Greensboro Police Department

[Joe Guarino]

Matt, thanks for helping fill in the gaps with this discussion. As you suggest, it appears the risk/benefit of using the taser has to be weighed against the risk/benefit of using other techniques. And the safety of the officer has to loom large in the overall equation.

I suppose Dr. Czarnecki's presentation opened my eyes to the reality that the use of this modality is fairly serious in a number of ways of which I was unaware. While he was not making the case that it should not be used, he did suggest that it needs to be used in a certain way. Incidentally, Czarnecki himself had been tasered several times to learn what it was like.

And we need to remember that billy clubs can lead to serious complications as well, for instance due to internal bleeding. I have seen a gentleman with profound neurologic impairments-- paralysis, etc.-- because of head injuries incurred with a billy club. And some head injuries, of course, can lead to death if severe enough.

And firearms, even when they do not kill the assailant, can lead to certain other types of permanent impairment-- for instance, when bones are shattered by bullets, when vital organs are penetrated, etc.

[Matt Lojko, Jr.]

Joe:

The following press release culminates an independent study done by Wake Forest University School of Medicine on the Taser. The results of this study cleared the way for many law enforcement agencies who were riding the fence on whether to purchase Taser for their respective agencies.

For Immediate Release 10/08/2007

Nationwide Independent Taser® Study Results Suggest Devices are Safe

WINSTON-SALEM, N.C. – A nationwide study examining the safety of Tasers® used by law enforcement agencies suggests the devices are safe, causing a low occurrence of serious injuries.
“This study is the first large, independent study of injuries associated with Tasers. It is the first injury epidemiology study to review every Taser deployment and to reliably assess the overall risk and severity of injuries in real world conditions,” said William Bozeman, M.D., the lead investigator and an emergency medicine specialist at Wake Forest University School of Medicine. “The injury rate is low and most injuries appear to be minor. These results support the safety of the devices.”
Bozeman will present the study results at the American College of Emergency Physicians’ Research Forum in Seattle, Wash., Oct. 8. In a review of nearly 1,000 cases, 99.7 per cent of those subjected to a Taser 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 use. A third subject was admitted to a hospital two days after arrest with a medical condition of unclear relationship to the Taser. Two subjects died, but autopsy reports indicate that neither death was related to the Taser. Earlier partial results involving 597 cases were published in the September issue of Annals of Emergency Medicine.
The independent prospective study was funded by the National Institute of Justice and included six law enforcement agencies across the United States. A tactical physician at each participating agency reviewed police and medical records after each successful application of a Taser. Injuries were identified and classified as mild, moderate, or severe and their relationship to the Taser was classified as direct, indirect, or uncertain.
Tasers are used by many police departments in the United States and are credited with decreasing police officer and suspect injuries and deaths due to police use of force. However, the devices have been surrounded with controversy.
“This is the largest independent study to date, and the first to detail the medical effects of Tasers under real-world conditions,” said Bozeman. “With physician review of 100 percent of Taser uses, this study promises to give us the best information yet on the medical risks of these weapons.”
Bozeman said results from previous studies were limited by the use of animal models and of healthy police volunteers in training settings, not criminal suspects in real-world conditions.
“The Taser is a weapon and it can clearly cause injuries and even deaths in some cases,” Bozeman said. “The question is ‘how likely is it to cause a significant injury” and whether that risk of injury outweighs the benefits it brings.”
Co-researchers were J. Tripp Winslow, M.D., M.P.H.; Derrel Graham, M.D.; Brian Martin, M.D.; Joseph J. Heck, D.O.; all of the Department of Emergency Medicine at Wake Forest University; Louisiana State University, Inova Fairfax Hospital (Va.), and University Medical Center (Nev.).

# # #
Media contact: Bonnie Davis, bdavis@wfubmc.edu, (336) 716-4977; Karen Richardson, krchrdsn@wfubmc.edu, or Shannon Koontz, shkoontz@wfubmc.edu, (336) 716-4587.

[Brenda Bowers]

Thank you both for good information on the taser. Of course having police officers in my family I am seriously interested in anything that will contribute to the officers safety ( I don't have any problems with inflicting pain on anyone breaking the law or fighting a police officer). And as a military wife with military personnel also in my family I have advocated that tasers be made a part of the soldier's basic equipment. Too many soldiers have died when they were reluctant to use their rifles but had to subdue an enemy soldier. And a taser most certainly would be more useful in the type of guerrilla warfare that is becoming the norm. The soldier must always keep the safety of civilians in mind because if a mistake is made it is 1) it becomes a greater trauma for the soldier to mentally deal with and 2) there is the very real unfair danger of being arrested and court marshaled for murder if a split second decision happens to be wrong. Brenda Bowers

[Fred Gregory]

Matt,

Thank you for the valuable data on the taser which has been focused on officer and arrestee saftey.

Turning to the ordinary person's self protection short of CCW what are your thoughts on pepper spray v. taser v. stun guns. Are all legal for non-sworn citizens when flight is not an option? I imagine your answer will depend upon whether the bad guy is armed and with what.

[Joe Guarino]

Brenda, thanks for the comments. I had not previously considered military use of the taser.

Matt, some reviewers might have criticisms of the study you cited from a number of standpoints-- methodology, study design, conclusions drawn, etc.; and it is unclear whether the study has yet undergone formal peer review. But I think the take-home message is probably valid-- the risks of developing serious health consequences from being "tasered" are probably very small, especially if proper technique is used, but measurable.

[Joe Guarino]

Good questions, Fred. And just a clarification for readers: OC spray is the same thing as pepper spray. And Czarnecki made the statement that stun guns don't work well. Is this true?

[Matt Lojko, Jr.]

Fred, since I'm not an attorney I won’t attempt to offer a legal opinion on the right of self-defense by citizens. Certainly, there is significant case law that exists on this topic. Wilkpeida has information that speaks directly to this topic under "the right of self defense".

Please don’t hold me to this belief because it has been quite a while since I “worked the streets” but I think both pepper spray and stun guns are legal for private citizens to own in North Carolina. However, the statutes on carrying concealed weapons may be applicable to one or both of these devices. I’m not quite sure. Please, someone correct me if I am wrong.

Joe, in regards to the Wake Forest Taser Study, I am by no means an authority on medical studies. I bring this up only to show what research has apparently been done in the area of Tasers in real life situations. Obviously, I will leave it to the medical and research experts to judge its validity.

[Joe Guarino]

Sometimes decisions have to be made even though there may be an incomplete scientific data base.

It would be very difficult, from an ethical standpoint, to conduct true prospective or experimental studies in large numbers-- thousands-- of people testing responses to different levels and duration of exposure to the taser; and also testing what the response is according to the body part shocked.

So the "field" type of research you cited, Matt, may be the best that can be achieved. It seems that the study Wake did was retrospective-- meaning it looked backward at old cases-- it should be possible to do prospective research on future police cases. Departments being studied, however, would likely be controlling tightly how the taser is being used.

So again, we are left with the need to make decisions with incomplete scientific knowledge-- but this is not uncommon.

[Fred Gregory]

Taser sets man on fire....

http://thespec.com/News/Local/article/356763