The physiologic effects of a new generation conducted electrical weapon on human volunteers at rest

[Conducted energy weapons (CEW)]

BACKGROUND

Conducted energy weapons (CEW, TASER) are increasingly used by law enforcement agencies in Germany. The CEWs are intended to reduce violence against police officers and to reduce moderate to severe injuries of police officers and aggressors. The delivery of repetitive electrical impulses causes neuromuscular paralysis and incapacitation; however, there are safety concerns due to deaths related to CEWs.

OBJECTIVE

The aim of this article is to provide an overview of the medical risks associated with the use of CEWs.

METHODS

A literature search was carried out using relevant databases.

RESULTS

The CEWs offer a good overall safety profile but in rare cases can have serious or life-threatening health risks. These include injuries to vulnerable body regions and falls. Myocardial capture and malignant arrhythmia can be triggered in animal experiments. The cause of death following the use of a conducted energy device (CED) can often not be clearly attributed due to competing causes; however, in studies with volunteers arrhythmia has not been observed so far. Overall, the risk of life-threatening cardiac arrhythmia in humans appears to be low, although still present. Particularly vulnerable risk groups include children, people with a history of mental illness or with intoxication, pregnant women and cardiac device wearers.

CONCLUSION

Even though in principle CEWs can trigger malignant arrhythmia, the risk is low and the causality of death after CEW deployment often remains unclear. In the medical care of patients after CEW use, comorbidities such as intoxication or mental illness must be considered.

Restraint asphyxia. An analysis of the circumstances and mechanism of death in agitated, physically restrained individuals

W ostatnich latach media coraz częściej poruszane są przypadkami śmierci młodych zazwyczaj osób, w trakcie zatrzymywania przez policję. Śmierć w tych przypadkach dotyka zazwyczaj osoby pobudzone psychoruchowo, obezwładniane z użyciem siły, a badania pośmiertne nie wykazują jednoznacznej urazowej przyczyny zgonu. Celem pracy jest próba ustalenia mechanizmu i okoliczności zgonów w trakcie obezwładniania osób pobudzonych psychoruchowo. Analizie poddano przypadki opiniowane od 2010 roku, zarówno jako sekcje zwłok, jak i oceniane na podstawie materiału aktowego. W analizowanym okresie ZMS w Krakowie wydał opinie w 10 tego typu przypadkach, w dziewięciu na podstawie własnych sekcji zwłok, w jednym na podstawie materiału aktowego. We wszystkich nastąpiło nagłe zatrzymanie krążenia lub utrata przytomności, a resuscytacja okazywała się nieskuteczna. W sześciu przyczyną pobudzenia była ostra psychoza, w czterech działanie narkotyków, zazwyczaj w wysokim stężeniu. Tylko w pięciu przypadkach stwierdzono obecność wybroczyn w spojówkach. Najbardziej prawdopodobną przyczyną śmierci było współistnienie nasilonego wysiłku fizycznego spowodowanego patologicznym pobudzeniem psychoruchowym, z przymusowym unieruchomieniem pogarszającym funkcjonowanie układu oddechowego. Mechanizm ten jest określany jako asfiksja restrykcyjna. Restraint asphyxia. An analysis of the circumstances and mechanism of death in agitated, physically restrained individuals Recent years saw frequent media reports of young people who die while they are being arrested by the police. Death in these circumstances affects people who are agitated and restrained with the use of force, with their autopsies indicating no unequivocally traumatic cause of death. The goal of this study was to identify the mechanism and circumstances of sudden deaths in agitated individuals who are being restrained. Ten cases evaluated at our center since 2010 were included in this study: nine involved forensic postmortem examination and one involved casefile analysis. In each case there was sudden cardiac arrest or at least a loss of consciousness, and the cardiopulmonary resuscitation proved ineffective. In six cases the cause of agitation was acute psychosis, in four it was an effect of narcotics, usually in high concentration. Conjunctival petechiae were detected in only five cases. The most probable cause of death in the evaluated cases was the combination of physical exertion caused by pathological psychomotor agitation and forcible restraint, hindering the function of the respiratory system. This mechanism is known as restraint asphyxia.

Elektroschockdistanzwaffen Taser® X2 und T7

Die medizinische Beurteilung von Verletzungen und potenzieller todesursächlicher Relevanz einer Stromexposition durch eine Elektroschockdistanzwaffe beschränkt sich nicht allein auf die situativen Gegebenheiten und die morphologische Befunderhebung, sondern beinhaltet auch eine intensive Analyse polizeilicher Ermittlungen und die Auswertung von Zeugenaussagen sowie vorangegangener medizinischer Maßnahmen. Insbesondere bei zeitlich relevanter Nähe zwischen Exposition und Todeseintritt muss die Wirkung der übertragenen Stromimpulse in Zusammenhang mit der meist komplexen Einsatzsituation und der medizinischen Vorgeschichte des Geschädigten beurteilt werden. Ein detailliertes Wissen über die konkrete und auch abstrakte Wirkungsweise, Wirksamkeit und Risiken von Elektroschockdistanzwaffen ist hierfür unabdingbar.

Medical Care in a Police Intervention with Conducted Electrical Weapons: Zaragoza (Spain) Fire Department Protocol

In the last decade, conducted electrical weapons (CEWs) have become a new tool for law enforcement agencies as an alternative to firearms. They provide security in the intervention for both the police and the citizen and try to cause the least possible harm to the subject to immobilize.The health care providers who perform in joint actions with the police in which CEWs are used should be aware of how they work, risk groups, as well as the most frequent clinical effects associated with the application of electrical discharge, and the complications that can be produced according to the area of impact of the electrodes.For this purpose, the current medical literature was reviewed by consulting the main health care sciences database (PubMed) to determine the medical measures to be taken before, during, and after the use of these weapons. Also presented and shared is the Zaragoza (Spain) Fire Department protocol.