Electrical weapons and rhabdomyolysis.

It has been suggested that an application of a conducted electrical weapon (CEW) might cause muscle injury such as rhabdomyolysis and an acute inflammatory response. We explored this hypothesis by testing the effects of electrical weapons on circulating markers of inflammation and muscle damage. In a prospective study, 29 volunteers received a full-trunk 5-s TASER® X26(E) CEW exposure. Venous blood samples were taken before, 5 min after, and at 24 h following the discharge. We tested for changes in serum levels of C-reactive protein (CRP), alkaline phosphatase (ALP), myoglobin, albumin, globulin, albumin/globulin ratio, aspartate and alanine aminotransferase, creatine kinase, total protein, bilirubin, and lactic acid dehydrogenase. Uncorrected CRP and myoglobin levels were lower in the immediate post exposure period (CRP levels 1.44 ± 1.39 v 1.43 ± 1.32 mg/L; p = 0.046 and myoglobin 36.8 ± 11.9 v 36.1 ± 13.9 µg/L; p = 0.0019) but these changes were not significant after correction for multiple comparisons. There were no changes in other biomarkers. At 24 h, CRP levels had decreased by 30% to 1.01 ± 0.80 mg/L (p = 0.001 from baseline). ALP was unchanged immediately after the CEW application but was reduced by 5% from baseline (66.2 ± 16.1 to 62.7 ± 16.1 IU/L; p = 0.0003) at 24 h. No other biomarkers were different from baseline at 24 h. A full-trunk electrical weapon exposure did not lead to clinically significant changes in the acute phase protein levels or changes in measures of muscle cellular injury. We found no biomarker evidence of rhabdomyolysis.

Perceived Electrical Injury: Misleading Symptomology Due to Multisensory Stimuli.

BACKGROUND: An electrical accident victim's recollection is often distorted by Bayesian inference in multisensory integration. For example, hearing the sound and seeing the bright flash of an electrical arc can create the false impression that someone had experienced an electrical shock. These subjects will often present to an emergency department seeking either treatment or reassurance. CASE REPORTS: We present seven cases in which the subjects were startled by an electrical shock (real or perceived) and injury was reported. Calculations of the current and path were used to allocate causality between the shock and a history of chronic disease or previous trauma. In all seven cases, our analysis suggests that no current was passed through the body. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Symptomology seen as corroborating may actually be confounding. Witness and survivor descriptions of electrical shocks are fraught with subjectivity and misunderstanding. Available current is usually irrelevant and overemphasized, such as stress on a 100-ampere welding source, which is orders of magnitude beyond lethal limits. History can also be biased for a number of reasons. Bayesian inference in multisensory perception can lead to a subject sincerely believing they had experienced an electrical shock. Determination of the current pathway and calculations of the amplitude and duration of the shock can be critical for understanding the limits and potential causation of electrical injury.

Eye injury from electrical weapon probes: Mechanisms and treatment.

PURPOSE: While generally reducing morbidity and mortality, TASER® electrical weapons have risks associated with their usage, including burn injuries and head and cervical trauma associated with uncontrolled falls. The primary non-fatal complications appear to be significant eye injury but no analysis of the mechanisms or suggested treatments has been published. METHODS: We used a biomechanical model to predict the risk of eye injury as a function of distance from the weapon muzzle to the eye. We compared our model results to recently published epidemiological findings. We also describe the typical presentation and suggest treatment options. RESULTS: The globe rupture model predicted that a globe rupture can be expected (50% risk) when the eye is within 6 m of the muzzle and decreases rapidly beyond that. This critical distance is 9 m for lens and retinal damage which is approximately the range of the most common probe cartridges. Beyond 9 m, hyphema is expected along with a perforation by the dart portion of the probe. Our prediction of globe rupture out to 6 m (out of a typical range of 9 m) is consistent with the published risk of enucleation or unilateral blindness being 69 ±â€¯18%, with an eye penetration. CONCLUSIONS: Significant eye injury is expected from a penetration by an electrical weapon probe at close range. The risk decreases rapidly at extended distances from the muzzle. Not all penetrating globe injuries from electrical weapon probes will result in blindness.

Applied Force During Prone Restraint: Is Officer Weight a Factor?

INTRODUCTION: It has been suggested that law enforcement officer (LEO) weight on the backs of prone subjects may cause asphyxia. METHODS: Law enforcement officers used their agency-trained "local" single- and double-knee techniques, the "Wisconsin" 3-Point Ground Stabilization, and the Human Factor Research Group Inc single-knee tactical handcuffing techniques, and the weight force was measured. RESULTS: Forty-one LEOs (36 men, 5 women) participated, aged 38.4 ± 8.3 years, and weighing 96.2 ± 19.4 kg. The double-knee technique transmitted more weight than single knee (P < 0.0001). Wisconsin technique force was lower than other single-knee techniques (P < 0.0001). Double-knee weight was 23.3 kg plus 24% of LEO's body weight. Mean values for local and Human Factor Research Group Inc single-knee were 30.9 and 32.9 kg, respectively. The Wisconsin single knee weight force was given by 15.4 kg plus 9.5 kg for a male. CONCLUSIONS: A double-knee technique applies more weight force than single-knee techniques. The Wisconsin single-knee technique provides the least weight force of single-knee techniques. Law enforcement officer body weight is irrelevant to prone-force weight with single-knee techniques. With double-knee restraint, it has a modest influence. Our data do not support the hypothesis of restraint asphyxia.

Eye injuries from electrical weapon probes: Incidents, prevalence, and legal implications.

PURPOSE: While generally reducing morbidity and mortality, electrical weapons have risks associated with their usage, including burn injuries and trauma associated with uncontrolled fall impacts. However, the prevalence of significant eye injury has not been investigated. METHODS: We searched for incidents of penetrating eye injury from TASER® conducted electrical weapon (CEW) probes via open source media, litigation filings, and a survey of CEW law-enforcement master instructors. RESULTS: We report 20 previously-unpublished cases of penetrating eye injury from electrical weapon probes in law-enforcement field uses. Together with the 8 previously published cases, there are a total of 28 cases out of 3.44 million field uses, giving a demonstrated CEW field-use risk of penetrating eye injury of approximately 1:123 000. Confidence limits [85 000, 178 000] by Wilson score interval. There have been 18 cases of total unilateral blindness or enucleation. We also present legal decisions on this topic. CONCLUSIONS: The use of electrical weapons presents a rare but real risk of total or partial unilateral blindness from electrical weapon probes. Catastrophic eye injuries appear to be the dominant non-fatal complication of electronic control.

Fatal and non-fatal burn injuries with electrical weapons and explosive fumes.

INTRODUCTION: While generally reducing morbidity and mortality, electrical weapons have risks associated with their usage, including eye injuries and falls. With the presence of explosive fumes or fuels there also exists the possibility of burn injury. METHODS: We searched for cases of fatal and non-fatal major burns with TASER® electrical weapon usage where there was a possibility that the weapon ignited the explosion. RESULTS: We confirmed 6 cases of fatal burn injury and 4 cases of major non-fatal burns out of 3.17 million field uses. The mean age was 35.5 ± 9.7 years which is consistent with the typical arrest-related death. Moderate, minor, and noninjurious fires - typically due to a cigarette lighters in a pocket, petrol, recreational inhalants, or body spray were also noted. CONCLUSIONS: The use of electrical weapons presents a small but real risk of death from fatal burn injury. It also presents a small risk of major non-fatal burn injury. The ignition of petrol fumes dominates these cases of major fatal and nonfatal burns.

Infection Risk From Conducted Electrical Weapon Probes: What Do We Know?

Concern has been raised over the infection risk of the TASER electrical weapon since the probes penetrate the skin. The manufacturing process produces unsterilized probes with a 5% rate of Staphylococcus aureus contamination. Voluntary recipients (n = 208) of probe exposures were surveyed and there were no self-observations of infection. With over 3.3 million probe landings, there have been 10 case reports of penetrations of sensitive tissue with no reported infections. The electrical field was modeled and found that the electrical pulses generate a field of over 1200 V/mm on the dart portion. This is sufficient to sterilize the dart via electroporation. Electrical weapon probes appear to have a very low (possibly zero) rate of infection. The factors leading to this low infection rate appear to be a manufacturing process producing a low rate of bacterial contamination and the pulses sterilizing the dart via electroporation.