Tasers and Gurneys

[IsraelEMS]

Yesterday I had a not so lovely situations where a police offer almost had to taser an pt in the back of the ambulance on the way to the hospital. The pt was handcuffed to the gurney which is metal. How much electricity do tasers use and would the handcuffs/gurney have conducted it? I assume it is less than the defi but would it have been dangerous to the crew had he done so?

 

[ErikWeeWoo]

I won't address the tasering a person cuffed to the cot. Taser requires three conditions to be fully effective:

1. Penetration of clothes & skin to reach more conductive tissue, as both skin & clothes are insulators at the dose of electricity that is used

2. Both probes to have a conductive path to each other, as they form an alternating current circut & both probes are required to make a circuit

3. That path needs to be through a muscle that would cause incapacitation.

There is the possibility of minescule leakage maybe if you're grabbing the patient between the probes, but it wouldn't be incapacitating. There would be at least 2 barriers (your skin & patients skin) preventing the cot or cuffs from being an effective source of a shock, excluding the paint etc on the cot. So no, not really a risk.

 

[IsraelEMS]

I did not provide all the details but the officer's actions in this specific case would have been warranted as the pt was posing a danger to our crew and had one hand cuffed and the other not. Thankfully the officer was able to subdue the pt in the end without the taser but there was a reason we had an officer riding with us on this call.

However, my real questions revolve around the taser. I'm glad to know it would not have injured the crew. What kind of injuries can be expected from a taser? I have never treated anyone after they were tasered (is that a word?). How incapacitating is it? Does it cause injuries like an electrocution or just local burns?

 

[DrParasite]

However, my real questions revolve around the taser. I'm glad to know it would not have injured the crew. What kind of injuries can be expected from a taser? I have never treated anyone after they were tasered (is that a word?). How incapacitating is it? Does it cause injuries like an electrocution or just local burns?

according to this study, you aren't alone:

Emergency Medical Services Experience With Barb Removal After Taser Use By Law Enforcement: A Descriptive National Study - PubMed

At present, EMS activations with documented TASER barb removal are rare. Routine care by EMS is expected, and life-threatening emergencies are not common. All EMS providers should be familiar with local policies and procedures related to TASER use and barb removal.El SayedM, El TawilC, TamimH...

pubmed.ncbi.nlm.nih.gov

as for injuries to expect and how to treat (always follow your local protocols and what your medical director recommends, but if you want to read more):

How the Taser Affects Humans - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

Review of: Levin SD, Sloane CM, Chan TC, et al: "Cardiac Monitoring of Human Subjects Exposed to the Taser." The Journal of Emergency Medicine. 33(2):113-117, 2007.

www.jems.com

Taser Treatment | Joint EMS Protocols

www.jointemsprotocols.com

http://www.emsonline.net/assets/Taser-Guidelines_2011.pdf

https://www.acep.org/globalassets/uploads/uploaded-files/acep/membership/sections-of-membership/tact/literature/management-of-the-tasered-patient-word.doc

https://www.vchca.org/images/public_health/EMS/Policies/0725-TASER_Jun22.pdf

and in some places, EMS can carry tasers?

https://www.reddit.com/r/RPClipsGTA/comments/f1siqt

 

[ErikWeeWoo]

I did not provide all the details but the officer's actions in this specific case would have been warranted as the pt was posing a danger to our crew and had one hand cuffed and the other not. Thankfully the officer was able to subdue the pt in the end without the taser but there was a reason we had an officer riding with us on this call.

However, my real questions revolve around the taser. I'm glad to know it would not have injured the crew. What kind of injuries can be expected from a taser? I have never treated anyone after they were tasered (is that a word?). How incapacitating is it? Does it cause injuries like an electrocution or just local burns?

I've personally been tasered (for funsies) - it is completely incapacitating for the 7 seconds the electricity is going, you turn into a limp noodle assuming all the conditions above are met... but pretty much as soon as that 7 seconds is over, you have complete control again. It's quite painful while it's happening, but again once it's done nothing but mild soreness. Very unpleasant but so much better than pepper spray.

You generally aren't seeing very much injury associated with the actual zap, if they're standing it's the fall that causes the trauma. No burns generally. Barbs are little straightened fishhooks, they can be removed pretty easily. Per our protocol, as long as they aren't in a sensitive area (ie neck/genitalia/axilla/face/nipples) they can be yanked with gloved hand or kelly clamp etc - check your local protocols. Extent of wound care we do is quick irrigation and a bandaid.

There is a slight concern of cardiac effects in some susceptible individuals, so we do a 12 lead on our taser removals. Never seen anything directly attributable to the taser, but have caught incidentally interesting finds before. I'll get vitals, do a quick assessment for any head/other trauma, ask the officer how they fell, assess mental status, etc. I've never seen any burns, and it isn't like a typical electrocution. I have seen rhabdo & metabolic derangements in people who've been tasered multiple times, but this isn't something I've seen with 1-2 7 second cycles.

All of that was associated with the barbs. There's a second feature called drivestun where the taser is pressed against the skin directly to shock. This occasionally does cause minor burns, especially when repeated for multiple cycles in the same area.

 

[HardKnocks]

I won't address the tasering a person cuffed to the cot. Taser requires three conditions to be fully effective:

1. Penetration of clothes & skin to reach more conductive tissue, as both skin & clothes are insulators at the dose of electricity that is used

2. Both probes to have a conductive path to each other, as they form an alternating current circut & both probes are required to make a circuit

3. That path needs to be through a muscle that would cause incapacitation.

There is the possibility of minescule leakage maybe if you're grabbing the patient between the probes, but it wouldn't be incapacitating. There would be at least 2 barriers (your skin & patients skin) preventing the cot or cuffs from being an effective source of a shock, excluding the paint etc on the cot. So no, not really a risk.

Statistically, Tasers or Conducted Energy Devices have a relatively safe track records for adverse events. Unfortunately the Media sensationalizes the few, infrequent tragic events.

Taser Probe/Dart insertions into the skin are not required, in some Taser models, to deliver a shock.

Some Taser models have a "Drive-Stun" option that is usually used as a follow up application of voltage after the initial Taser deployment and is at a lower power setting used for follow up Pain Compliance.

To answer the OP;

Contact Burns from a Taser Dart are almost all non-existent during effective Taser Deployments, (if the probe/dart is sufficiently embedded and remains in the body).

Most of the time when a Person experiences a residual "Contact Mark" from the application of a Taser it is usually from a "Contact Application" at full power and the Person is trashing around causing the Taser to lose full contact with the body which produces a small electrical arc from the Taser to the skin, (a Contact Application is Taser to Body contact vs using the Probes/Darts). The other possible causes of a Contact Mark can involve a flammable substance/item on the body, such as alcohol, fuel etc).

Your risk from being electrocuted via a secondary connection to a person being Tasered is very slim, (unless a person has a comorbidity or other underlying heath issue etc).

I'm more concerned about the effects of an inadvertent shock from an AED than a Taser.

Electrocution by definition is the application of High Amperage and/or High Voltage electrical current to the body. In theory, a Taser applies low amperage via high voltage to immediately contract large muscle groups and induce pain.

An AED application of current has a much higher risk in injuring a crew member than a Taser application, (as the AED delivers a MUCH higher Amperage than a Taser. Taser = 3-4 Milliamps vs. an average AED delivers up to 360 Joules @ 3000 volts @ 16 Amps).

Have people died after the application of a high voltage charge from a Taser? Yes, but its very infrequent and usually involves multiple adverse health issues/events at the time of the shock application, (such as Drug/Alcohol Intoxication, Comorbidities, etc).

Note: A Medical Triage item that Public Safety Personnel frequently overlook after a taser deployment is the possibility of Rhabdomyolysis, especially after a Patient has been involved in a prolonged foot pursuit, assault or other physical activities during an event.

If anyone would like to "Ride the Lightning" we can arrange a brief training session, just bring the IPA for recovery..lol

Eric Wee Weo and I were typing at the same time...Good info Sir!

Btw, I have 4 "Personal Training Rides" logged so far...

 

[IsraelEMS]

Thanks everyone. This is great info. Taser use here is relatively infrequent and therefore we recieve almost no training on it (mostly stay out of the way and let the cops handle it).

How does alcohol/drug intoxication change change the effects os a taser? Why remove the barbs in the field and not at the hospital? What happens if both barbs dont embed?

 

[IsraelEMS]

I've personally been tasered (for funsies) - it is completely incapacitating for the 7 seconds the electricity is going, you turn into a limp noodle assuming all the conditions above are met... but pretty much as soon as that 7 seconds is over, you have complete control again. It's quite painful while it's happening, but again once it's done nothing but mild soreness. Very unpleasant but so much better than pepper spray.

Wait! This is something people do for fun?!

 

[FiremanMike]

Do you guys not have chemical restraint?

I’m not judging the handcuffed part, sometimes that just happens, just curious if you could have put him down as he was obviously continuing to be an issue?

 

[IsraelEMS]

Do you guys not have chemical restraint?

I’m not judging the handcuffed part, sometimes that just happens, just curious if you could have put him down as he was obviously continuing to be an issue?

I was on a BLS unit when this happened so we could not use chemical restraint and once we got to the ER he was given haldol. Took two huge cops and two more massive security guards, 1 larger than average male nurse, 1 regular size doctor and 5mgs of haldol to get him to stop fighting. We didn't know what he was on and the answer we got (just one glass of whiskey) was obviously a lie. His bp was 220/110, hr 100. He would not let us take his sugar. At one point he tried to roll into traffic. The ER was closer than an ALS unit (none where available anyway) and the cops where insistent that he be taken in. (I don't know what the law is in the US but here once a person is under arrest the cops can either force or refuse medical treatment on his behalf). Since we were a block away from the hospital we transported. Once a person is under arrest an officer is required to ride in the back with us and his partner follows in the police car (do you do that in the US?)

When I asked the guy for his id number (everyone here has a national id number) he responded that he wanted to murder the cop. I told him that was nice but I really wanted to open a file for him at the hospital so could I please have his id number. He gave me part of it then went back to threatening to kill the cop's whole immediate and extended family one by one. That was followed by some crying, apologizing, and then he started to take swings at everyone again.

On a separate note, I did some checking today and apparently this is so rare here that we don't even have an official protocol for it. It is treated the same as electrocution. We have about 1000 EMTs and paramedics in our region. The only person I could find who ever treated someone after a taser said the officers removed the barbs themselves (!). His pt was tasered after trying to stab the EMT. The EMT then treated the pt and took him to the hospital.

 

[HardKnocks]

Wait! This is something people do for fun?!

For most people its not for fun

Receiving/Experiencing a Taser Deployment is required part of the Taser training. It gives the person, carrying/deploying the Taser personal knowledge of the physical effects of the Taser and if needed, they can testify in Court that they've experienced the total Taser experience.

 

[johnrsemt]

Yes we remove the taser darts; then bandage (usually just a 2cm x 4cm little bandaid) if needed. Very seldom are they needed. Just grab the wires and pull. I have had a couple patients tell me that hurts more than getting tasered, (tased?) in the first place. Then we turn them over to the police to go to jail if needed.
We do it in the field because we are 45 minutes to 2 hours from the hospital and no reason to take an ambulance out of service for that. Even if they are in a sensitive spot we usually call the hospital talk to a doctor and then pull them.

If both barbs don't embed into the patient then they don't get tasered, because it doesn't work.

Check You Tube videos about people (usually police) being tasered: in the US they have to be tasered to be able to do it to others. Usually it is done while 2 other officers are holding them up (so they don't fall down and get hurt). It doesn't hurt the ones holding them.

 

[johnrsemt]

All the patients that I have had that have had barbs in sensitive places that should have been transported to the hospital (and I was going to take them to the hospital) pulled them out on their own. Including 1 guy that was in his scrotum., and 1 lady that was in her eyelid. Then they refused transport (they can do that in most places in the US) and unless they are under arrest we can't make them go to the hospital.