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Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
Medical implications of Force
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Medical implications of Force

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  • Transcript

    • 1. TASER
    • 2. <ul><li>Police have the following force options for dealing with criminal or mental health issues: </li></ul><ul><ul><li>Verbal commands </li></ul></ul><ul><ul><li>Pepper Spray </li></ul></ul><ul><ul><li>Defensive Tactics </li></ul></ul><ul><ul><li>Expandable Batons </li></ul></ul><ul><ul><li>Pepperball Launcher </li></ul></ul><ul><ul><li>Firearms </li></ul></ul>
    • 3. Verbal De-escalation <ul><li>Aim: To effect a peaceful arrest without further incident </li></ul><ul><li>Initial approach is to properly use verbal commands and clearly communicate. </li></ul><ul><li>Voice is a powerful tool that we use in conjunction with all other force options </li></ul>
    • 4. Pepper Spray <ul><li>When verbal commands do not suffice </li></ul><ul><li>Pepper spray is a second line ‘force option’. </li></ul>
    • 5. Pepper Spray <ul><li>Oleoresin capsicum (OC) is an oily extract of pepper plants of the genus Capsicum </li></ul><ul><ul><li>Spice in salsa, chili, curries </li></ul></ul><ul><ul><li>Pharmacologic agent in topical anaesthetic and analgesic creams </li></ul></ul><ul><ul><li>Principal active ingredient in Pepper Spray </li></ul></ul><ul><li>Complex mixture of </li></ul><ul><ul><li>Fat soluble phenols (Capsaicinoids) </li></ul></ul><ul><ul><li>Capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide) </li></ul></ul><ul><ul><li>Dihydrocapsaicin </li></ul></ul><ul><li>Capsaicinoid content determines the &quot;hotness&quot; of the extract </li></ul><ul><ul><li>Relative hotness is measured in Scoville units </li></ul></ul><ul><ul><ul><li>The greatest dilution of pepper extract that can be detected by the human tongue </li></ul></ul></ul>
    • 6. <ul><li>Advantages </li></ul><ul><li>Fear Compliance </li></ul><ul><ul><li>People are afraid of being sprayed and will often cease resistant behavior at the mention of pepper spray. </li></ul></ul><ul><li>Pain Compliance </li></ul><ul><ul><li>Most people not under the influence of drugs are susceptible to pepper spray, and will feel respiratory and eye pain when sprayed; often gaining compliance. </li></ul></ul><ul><li>Covers Large Area </li></ul><ul><ul><li>Even if pepper spray is not a direct hit it can still have an effect on a subject. </li></ul></ul>Pepper Spray
    • 7. <ul><li>Disadvantages : </li></ul><ul><li>Long decontamination process </li></ul><ul><ul><li>Up to an hour or more for pain from pepper spray to subside </li></ul></ul><ul><li>Collateral Damage </li></ul><ul><ul><li>Many Officers do not like to use pepper spray because it often effects bystanders (including officers) as well as the target. </li></ul></ul><ul><li>Does not work on everyone </li></ul><ul><ul><li>Highly determined people can overcome effects. </li></ul></ul><ul><ul><li>Some drugs such as angel dust and methamphetamine negate the effect </li></ul></ul><ul><li>Not an instant stop </li></ul><ul><li>Close Proximity required </li></ul>Pepper Spray
    • 8.  
    • 9. Medical Implications <ul><li>Potential risks of pepper Spray </li></ul><ul><ul><li>Capsaicinoid exposure </li></ul></ul><ul><ul><ul><li>May vary by as much as 30-fold among brands </li></ul></ul></ul><ul><ul><li>Diluents </li></ul></ul><ul><ul><ul><li>Alcohols, organic solvents </li></ul></ul></ul><ul><ul><li>Propellants </li></ul></ul><ul><ul><ul><li>Halogenated hydrocarbons </li></ul></ul></ul>
    • 10. Medical Implications - Dermal <ul><li>Dermal </li></ul><ul><ul><li>Burning, itching, erythema and severe dermatitis (Hunan Hand) </li></ul></ul><ul><ul><li>Exaggerated response secondary to </li></ul></ul><ul><ul><ul><li>Repeated contact </li></ul></ul></ul><ul><ul><ul><li>Diminished sensitivity to heat- or chemical-induced pain </li></ul></ul></ul><ul><ul><ul><li>Augmentation of allergic dermatitis </li></ul></ul></ul><ul><ul><li>Reflex vasodilatation and sweating mediating hypothalamus induced cooling </li></ul></ul><ul><ul><ul><li>Risk of hypothermia if decontaminated with cold water </li></ul></ul></ul>
    • 11. Medical Implications - Respiratory <ul><li>Respiratory </li></ul><ul><ul><li>Broncho-constriction </li></ul></ul><ul><ul><ul><li>Wheeze, dry cough, SOB </li></ul></ul></ul><ul><ul><li>Release of Substance P </li></ul></ul><ul><ul><ul><li>Increased vascular permeability/pul oedema </li></ul></ul></ul><ul><ul><li>Rarely Laryngeal spasm/laryngeal paralysis </li></ul></ul><ul><ul><ul><li>Cyanosis, apnoea </li></ul></ul></ul><ul><ul><ul><li>Respiratory arrest </li></ul></ul></ul>
    • 12. <ul><li>Eye Symptoms </li></ul><ul><ul><li>Redness, swelling, burning pain </li></ul></ul><ul><ul><li>Conjunctival inflammation </li></ul></ul><ul><ul><li>Blepharospasm </li></ul></ul><ul><ul><li>Loss of blink reflex with corneal abrasion </li></ul></ul><ul><ul><li>Keratitis </li></ul></ul>Medical Implications - Ocular
    • 13. Treatment <ul><li>Dermal </li></ul><ul><ul><li>Decontamination with warm water (shower) </li></ul></ul><ul><ul><ul><li>Pat dry with clean towel – do no rub </li></ul></ul></ul><ul><ul><ul><li>Wet towel/ice packs useful to reduce inflammation </li></ul></ul></ul><ul><ul><li>Do not use lotion or creams on affected areas </li></ul></ul><ul><ul><ul><li>These trap the active ingredient against the skin </li></ul></ul></ul>
    • 14. <ul><li>Respiratory </li></ul><ul><ul><li>Remove from enclosed space - Fresh air </li></ul></ul><ul><ul><li>Oxygen and Ventolin nebs for broncho-constriction </li></ul></ul>Treatment
    • 15. <ul><li>Ocular </li></ul><ul><ul><li>Remove contact lens </li></ul></ul><ul><ul><li>Decontamination with irrigation (15 minutes saline/water) </li></ul></ul><ul><ul><li>Prevent patient from rubbing eyes </li></ul></ul>Treatment
    • 16. Expandable Baton
    • 17. Expandable Baton <ul><li>Advantages : </li></ul><ul><li>Carried on officer’s person </li></ul><ul><ul><li>Rapid Deployment </li></ul></ul><ul><li>Pain and fear response </li></ul><ul><li>No cross contamination </li></ul><ul><ul><li>target of baton strike is typically who is hit </li></ul></ul>
    • 18. <ul><li>Disadvantages : </li></ul><ul><li>Expandable Baton strikes can cause severe and or lasting injuries </li></ul><ul><li>Public perception of striking someone with a hard object is not positive </li></ul>Expandable Baton
    • 19. 21 Foot Rule <ul><li>If a subject is within 21 feet of an officer with a weapon: </li></ul><ul><ul><li>Studies show that they can reach the officer and harm them before the officer can draw and fire their weapon </li></ul></ul>
    • 20.  
    • 21.  
    • 22. TASER <ul><li>A TASER is an electronic control device that uses propelled wires, or direct contact, to conduct energy to affect the sensory and motor functions of the nervous system </li></ul><ul><li>T homas A. S wift's E lectric R ifle </li></ul>
    • 23. TASER advantages <ul><li>Carried on officer’s belt for immediate deployment </li></ul><ul><li>Affects only those who are hit with probes. </li></ul><ul><li>Almost immediate effect upon deployment. </li></ul><ul><li>Fear, pain and motor function response </li></ul><ul><li>Control a subject/situation from a safer distance </li></ul><ul><li>Integrated camera allows for added accountability </li></ul>
    • 24. From
    • 25. TASER
    • 26. TASER Introduced <ul><li>2002: At risk of being privately un-insurable </li></ul><ul><li>TASER as part of 3 element plan eliminated injuries for 2 years </li></ul><ul><li>(through Sept 17, 2004) </li></ul>
    • 27.  
    • 28. Traditional “Blunt” Pulse High Energy, “Brute Force” Approach 90% Energy Loss Traditional “Blunt” Pulse New Shaped Pulse ™ Arc Phase Stim Phase New Shaped Pulse ™ Full Energy Penetration
    • 29. Shaped Pulse Tech
    • 30. 60% SMALLER
    • 31.  
    • 32.  
    • 33. Medical Safety Fibrillation Results, 5 Second Burst
    • 34. Lower Pulse Rates Increase Safety Margin
    • 35. X26: Digital Pulse Controller (DPC) <ul><li>Digitally controls pulse rate </li></ul><ul><li>Consistent performance </li></ul><ul><li>-4  F to +122  F </li></ul><ul><li>-20 C to +50 C </li></ul><ul><li>5-second burst </li></ul><ul><ul><li>0-2 sec @ 19 pps </li></ul></ul><ul><ul><li>2-5 sec @ 15 pps </li></ul></ul><ul><ul><li>If trigger held beyond 5-second cycle @15 pps </li></ul></ul><ul><li>Initial “punch” to drop </li></ul><ul><ul><li>Increases effectiveness </li></ul></ul><ul><ul><li>Enhances safety </li></ul></ul><ul><ul><li>Extends battery life </li></ul></ul><ul><li>Standard Procedure </li></ul><ul><ul><li>Maximum 5 second pulse </li></ul></ul><ul><ul><li>Maximum of 3 shocks </li></ul></ul>
    • 36. <ul><li>Taser-use by RCMP </li></ul><ul><ul><li>2002 to 2007 </li></ul></ul><ul><ul><li>28 per cent, or 910 of the 3,226 people who were shot, had to go to a medical facility </li></ul></ul>Medical Implications - Potential Injuries
    • 37. Medical Implications - Potential Injuries <ul><li>Local </li></ul><ul><ul><li>Taser penetration – laceration (0.5-1cm subdermis) </li></ul></ul><ul><ul><li>Secondary electric burn at entry point </li></ul></ul><ul><ul><li>Require ED and medical removal from head, neck and groin </li></ul></ul><ul><li>Other recorded injuries </li></ul><ul><ul><li>dart penetrating through the skull </li></ul></ul><ul><ul><li>Fractured vertebrae, even when no fall has occurred </li></ul></ul><ul><ul><li>Seizures </li></ul></ul><ul><ul><li>Eye injuries leading to blindness </li></ul></ul><ul><ul><li>Trauma secondary to fall </li></ul></ul><ul><ul><li>Drowning if the assailant falls into water. </li></ul></ul>
    • 38. Unknown 162 N.A. None / Minor 1,852 98.09% (Puncture wounds from probes, abrasions) Moderate 23 1.2% (Abrasion, skinned knee, carpet burn, testicle shot, penis shot, cut to mouth, cuts from falling onto glass) Severe 13 0.69% (Dog bites, self-infliction, officer battle) Field Data Injuries to Subjects
    • 39. Unknown 114 N.A. None / Minor 1,927 99.54% (Officers involved with fighting suspects or arresting them) Moderate 7 0.4% (Knife thrown at officer cutting arm, knee injury officer ran into obstacle, struggle prior to TASER use, officer fell during chase & fractured arm, groin kick prior to TASER) Severe 2 0.1% (Officer attacked by 6-8 juveniles, M26/X26 used in stun gun mode - suspect poor batteries) Field Data Injuries to Officers
    • 40. Excited delirium <ul><li>Not officially recognised as medical condition </li></ul><ul><ul><li>Studies always done on healthy police volunteers (Vilke) </li></ul></ul><ul><ul><li>Animal studies (pigs on speed) </li></ul></ul><ul><li>Pre-disposition </li></ul><ul><ul><li>Increased occurrence with illicit drug use/withdrawal </li></ul></ul><ul><ul><li>Psychosis or psychiatric problems.  </li></ul></ul><ul><li>Symptoms </li></ul><ul><ul><li>Profound agitation excitable behaviour </li></ul></ul><ul><li>Effect </li></ul><ul><ul><li>Seizures, AF, VF, CHF, cardiac arrest </li></ul></ul><ul><ul><li>Most common coroner finding at Taser related autopsy </li></ul></ul>
    • 41. Source: Study of Use of Force at Los Angeles Police Department, Capt. Greg Meyer. Statistics are for TASER technology deployed at LAPD in the TASER TE-86, a 7-Watt TASER. However, human volunteer studies of over 100,000 volunteers have confirmed a 0% injury rate for the 26-Watt ADVANCED TASER and 5-Watt TASER X26 .
    • 42. <ul><li>Jared Feuer - reported 277 fatalities </li></ul><ul><ul><li>From 675,000 Taser related incidents from June 2001 and October 2007 in the US </li></ul></ul><ul><li>YouTube and other videos record Taser deaths </li></ul><ul><li>However fatalities form Firearms has reduced </li></ul><ul><ul><li>Of those fatally wounded with firearms 76% had a lethal weapon in hand </li></ul></ul><ul><ul><li>82% of those fatally wounded with Taser were unarmed </li></ul></ul>Medical Implications - Fatalities
    • 43. <ul><li>October and November 2007 – Canada </li></ul><ul><ul><li>Four individuals died after being tasered </li></ul></ul><ul><ul><li>Robert Dziekański </li></ul></ul><ul><ul><ul><li>Non-English speaking man from Poland who died in less than two minutes after being tasered at the Vancouver International Airport </li></ul></ul></ul><ul><li>Emily Marie Delafield </li></ul><ul><ul><li>April 2006 a 56 year old, wheelchair-bound woman, died after being shocked at least 10 times. </li></ul></ul><ul><ul><li>The death was ruled justified homicide </li></ul></ul>Medical Implications - Fatalities
    • 44. Phoenix PD Field Results First Top-10 City to Deploy to All Patrol Officers <ul><li>Suspect Injuries </li></ul>67% Lethal Force 50%
    • 45.  
    • 46. Times are changing <ul><li>June 2008 </li></ul><ul><ul><li>Federal jury ordered Taser International to pay $6 million in punitive and compensatory damages for the 2005 death of the man who died a day after being shocked repeatedly by officers using Tasers </li></ul></ul><ul><ul><li>The jury found that Taser International should have “more effectively warned police that Taser shocks were potentially dangerous” </li></ul></ul>
    • 47. … .so following Taser <ul><li>Remove Taser darts </li></ul><ul><li>Treat local wounds/burns </li></ul><ul><li>Perform ECG </li></ul><ul><li>Note lactate continues dropping for up to 60 minutes </li></ul><ul><li>Beware excited delirium </li></ul><ul><li>Observe patients with </li></ul><ul><ul><li>>3 shocks >5 seconds each </li></ul></ul><ul><ul><li>Female, short people, aged<16 </li></ul></ul><ul><li>if patient arrests…….. </li></ul>
    • 48.  

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