Conducted energy device: Difference between revisions

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==Background==
==Background==
* Conducted Energy Device, Conducted Energy Weapon, Electronic Control Device, Electrical Control Device, and Electronic Control Weapon all refer to same thing
* Conducted Energy Device, Conducted Energy Weapon, Electronic Control Device, Electrical Control Device, and Electronic Control Weapon all refer to same thing
*Commonly referred to as Tasers by lay public
* Purpose of a Conducted Energy Device (CED) is to provide law enforcement officers with broader choices on use of force spectrum
* Purpose of a Conducted Energy Device (CED) is to provide law enforcement officers with broader choices on use of force spectrum
* CEDs assist law enforcement officers with securing and controlling combative individuals
* Used to control combative individuals
* Use of Force by law enforcement should be least amount necessary to accomplish objective then escalate as needed by situation
* Every other force option (impact weapons (baton), chemical weapon (pepper spray), etc.) also uses pain/discomfort for compliance and has associated risks of traumatic injury to suspect to facilitate capture, control, or restraint.
* 99.75% of time no significant injury as result of using device per Department of Justice (DOJ) study <ref> Bozeman, W, et al. Safety and Injury Profile of Conducted Energy Weapons Used by Law Enforcement Officers Against Criminal Suspects, Annals of Emerg. Med. 2009. </ref>
* 99.75% of time no significant injury as result of using device per Department of Justice (DOJ) study <ref> Bozeman, W, et al. Safety and Injury Profile of Conducted Energy Weapons Used by Law Enforcement Officers Against Criminal Suspects, Annals of Emerg. Med. 2009. </ref>


===Mechanism of Action===
===Mechanism of Action===
* Either through direct contact or with fired probes which penetrate up to 1/2 inch into body a current is delivered which causes neuromuscular interference resulting in temporary paralysis for seconds which often results in uncontrolled fall.  
* Either through direct contact or with fired probes, which penetrate up to 1/2 inch into body a [[electric shock|current]] is delivered which causes neuromuscular interference resulting in temporary [[weakness|paralysis]] for seconds which often results in uncontrolled fall.  
** Electrical current captures skeletal muscle and tends to stay on outside of muscle
** Electrical current captures skeletal muscle and tends to stay on outside of muscle
** Immediate relief occurs after application of energy ceases.
** Immediate relief occurs after application of energy ceases.
** Pulse has less peak current than strong static shock.
** Less than half current allowed in use of electric fence and less current than some pain blocking stimulators.
===Advantages===
* CEDs reduce injuries to officers and suspects
* CEDs effective in facilitating capture, control and restraint
* CEDs are generally as safe or safer than other use of force options except deadly force
* CEDs can prevent confrontations in escalating to use of deadly force
===Disadvantages===
* CEDs are less accurate and reliable than a firearm
* More than trivial force but less than deadly force when used
* Uncontrolled fall associated with use of device can cause injury
* Some individuals fail to react and continue to resist (thick clothing is known to sometimes block penetration of darts)
* Probes may be dislodged when suspect is actively resisting, fleeing or engaging in excessive movement


==Clinical Features==
==Clinical Features==
* Consider underlying reason why CEDs was used i.e. medical crisis, serious physiological distress, drug/alcohol abuse, altered mental status, combative individual
* Consider underlying reason why CEDs was used i.e. medical crisis, serious physiological distress, [[substance abuse|drug]]/[[alcohol intoxication]], [[altered mental status]], combative individual
*[[Myalgia|Pain]] secondary to induced forceful muscle contracture
*[[laceration|Puncture]] wound and often minor [[burn]] from barbs
* +/- signs/symptoms of [[trauma]] from uncontrolled fall
* No clinically relevant changes in ventilation, acid-base status, electrolyte concentrations, troponin I level or EKG noted <ref> Vilke, GM, Sloane CM, Bouton KD, et al. Physiological Effects of a Conducted Electrical Weapon on Human Subjects. Annals of Emergency Medicine. 2007; 50(5) 569-575. </ref>
* No clinically relevant changes in ventilation, acid-base status, electrolyte concentrations, troponin I level or EKG noted <ref> Vilke, GM, Sloane CM, Bouton KD, et al. Physiological Effects of a Conducted Electrical Weapon on Human Subjects. Annals of Emergency Medicine. 2007; 50(5) 569-575. </ref>


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[[Category:EMS]]
[[Category:EMS]]
[[Category:Trauma]]

Latest revision as of 15:57, 9 October 2019

Background

  • Conducted Energy Device, Conducted Energy Weapon, Electronic Control Device, Electrical Control Device, and Electronic Control Weapon all refer to same thing
  • Commonly referred to as Tasers by lay public
  • Purpose of a Conducted Energy Device (CED) is to provide law enforcement officers with broader choices on use of force spectrum
  • Used to control combative individuals
  • 99.75% of time no significant injury as result of using device per Department of Justice (DOJ) study [1]

Mechanism of Action

  • Either through direct contact or with fired probes, which penetrate up to 1/2 inch into body a current is delivered which causes neuromuscular interference resulting in temporary paralysis for seconds which often results in uncontrolled fall.
    • Electrical current captures skeletal muscle and tends to stay on outside of muscle
    • Immediate relief occurs after application of energy ceases.

Clinical Features

  • Consider underlying reason why CEDs was used i.e. medical crisis, serious physiological distress, drug/alcohol intoxication, altered mental status, combative individual
  • Pain secondary to induced forceful muscle contracture
  • Puncture wound and often minor burn from barbs
  • +/- signs/symptoms of trauma from uncontrolled fall
  • No clinically relevant changes in ventilation, acid-base status, electrolyte concentrations, troponin I level or EKG noted [2]

Differential Diagnosis

Evaluation

  • Routine history and physical examination
    • Consider history of cardiac disease
    • Consider history of pacemaker/defibrillator
    • Consider drug or alcohol intoxication, psychiatric disturbance, altered mental status
  • Look for direct injury from barb and indirect injury from fall
  • No need for routine performance of labs, EKGs, or prolonged observation after CED exposure in otherwise awake and alert patient
  • More extensive testing and evaluation may be appropriate in individual cases based on history and physical examination i.e. EKG if chest pain, palpitations, or cardiac history

Management

  • Barb removal then wound care for small puncture wound and minor burn at barb site

Disposition

  • Most healthy individuals may be discharged (often to the custody of law enforcement) after barb removal
  • Appropriate medical intervention/consultation if barb in vulnerable area such as mouth, eyes, neck, groin

See Also

External Links

References

  1. ↑ Bozeman, W, et al. Safety and Injury Profile of Conducted Energy Weapons Used by Law Enforcement Officers Against Criminal Suspects, Annals of Emerg. Med. 2009.
  2. ↑ Vilke, GM, Sloane CM, Bouton KD, et al. Physiological Effects of a Conducted Electrical Weapon on Human Subjects. Annals of Emergency Medicine. 2007; 50(5) 569-575.
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