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.
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