AT our service EMT-B's do remove the probes. Here is the link to adobe formatted state EMS document from our state EMS, designed for BLS providers, that is based on our own protocol we developed about 2 years ago:
http://www.idahoems.org/ems_guidelines/gen_taser.pdf
In addition I have included the text from our SWO's that concerns the subject the only thing its missing is the photos of the taser device. I believe we based our protocol on a protocol from Austin-Travis County EMS, but its been at least 2 years so I don’t remember right now.
A few Quick comments:
We have a set of pliers, Neosporin, and band aids on every EMS unit for "taser removal".
While the taser has gotten a little bad press with the five supposed deaths, and I am not saying one way or the other on that...but for our department in general, and my self in particular, our experience has been very very positive. It is used in lieu of chemical agents which as often as not cause as many problems for PD and EMS as they do for the "victim". In addition the taser does not leave a residual in the ambulance or on the medic that may cause problems for respiratory pt's later in the shift. In short...war stories aside, Its a good thing, just like RSI for us, a good tool when it goes hand in hand with training.
Also: I have heard..ancedotaly mind you, had at least two episodes of when the taser did not work to full effectiveness in other services. Both of these incidents involved heavy hyper-dynamic drug use (meth and crack respectfully), agitated deleirum, and extreeme combativeness. Other more traditional methods had to be used (i.e. either chemicial agents and/or the old fashions dog pile).
SO like any tool, it doesn’t work all the time, just most of it. The Taser only actively restrains the victim when it is being actively discharged. We have had cases of "rowdy" victims after the prongs were removed and the pt was in the back of the rig onthe way to the hospital (ie when PD wasn’t in close proximity). As a result we went back to having a cop ride in with us instead of just following us in.
When training your medics up on this, I would include training on proper restraint of the combative pt, proper chemical restraint, dealing with hyperdynamic states, and other less lethal devices as well. Make it a package deal. I don’t know if you do one on one, off duty, or onn line training, but I really recommend at least briefly discussing it all. Especially restraint issues, as they often go hand in hand with the tasers. Positional asphyxia is always a big issue to consider. I have some ppt's I can send you on some of these subjects when I get back to my office next week, if you would like.
I hope this has been of some help. Please feel free to contact me as needed for anything I can do to assist. Really! I mean it!
My email is:
colemedic@hotmail.com
Robert S. Cole
Paramedic, CCEMTP
Boise, Idaho
"...Not all who wander are lost"
J.R.R. Tolkien
APPENDIX DD: TASER PROTOCOL
Scene Safety Consideration:
Before touching any patient who has been subdued using a Taser ensure that the officer/deputy has disconnected the wires from the hand held unit.
Taser and Probe:
Assessment of a Patient who has been Tasered:
Identify the location of the probes on the patient’s body. If any of the probes are embedded in the following areas do not remove them and transport the patient to an Emergency Department:
1. Face
2. Neck
3. Groin
4. Spinal Column
Confer with the officer/deputy and determine the patient’s condition from the time of the Taser discharge until EMS arrival.
Assess vital signs, including ECG monitoring for potential cardiac abnormalities. If greater than or equal to 35 years old consider a 12 Lead evaluation.
Determine from the patient:
1. Date of Last Tetanus
2. Any Cardiac History
3. Any ingestion of a mind-altering stimulant (Phencyclidine (PCP), meth, etc.)
All of these assessment findings should be documented thoroughly in the Patient Care Report.
Removal of Probe by EMS System providers:
If the probe are located in an area not specified above it can be removed by a Paramedic or EMT. To remove the probe:
Place one hand on the patient in the area where the probe is embedded and stabilize the skin surrounding the puncture site. Place your other hand firmly around the probe.
In one fluid motion pull the probe straight out from the puncture site.
Repeat procedure with second probe.
Removed probes should be handled like contaminated sharps and should be placed in a urine specimen container to be provided by the officer/deputy. They will likely log the probes into evidence.
Treatment and Follow Up Instructions:
Cleanse puncture sites and bandage as appropriate.
Place triple antibiotic ointment on the puncture sites.
If patient has not had a tetanus shot in the last five (5) years they should be advised to acquire one.
If the patient is combative and needs to be chemical restrained, then they must be transported to the Emergency Department.
All patients with altered mental status require a full assessment and Emergency Department evaluation.
