Fl Emt Rpt

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  • Fl Emt Rpt

    1. 1. TASER – EMERGENCY DEPT. PERSPECTIVES <ul><li>Daniel F. Brennan, MD, FACEP, FAAEM </li></ul><ul><li>Emergency Physicians of Central Florida </li></ul><ul><li>Orlando Regional Medical Center </li></ul><ul><li>Emergency Medicine Residency Program </li></ul><ul><li>July 2004 </li></ul>
    2. 2. Electrical Units Charge Volts Amperes: Total electrons per second Volts: “Pressure” pushing electrons Energy (Joules): Energy in single pulse Power (Watts): Energy per second (sum of pulses)
    3. 3. Comparison of Lightning to High-Voltage Electrical Injuries Fontanarosa PB, in Tintinalli JE Emergency Medicine , 4 th edition1996, pp. 905-14.
    4. 4. Voltage Misperceptions <ul><li>HIGH VOLTAGE </li></ul><ul><li>Static electricity </li></ul><ul><ul><li>>1000V – 50,000V </li></ul></ul>http://www.amasci.com/emotor/stmiscon.html#one
    5. 5. TASER <ul><li>High Voltage (50,000 V) </li></ul><ul><li>Low current (amperage) (<4 milliamps) </li></ul><ul><li>Short Duration (microsecs) </li></ul><ul><li>Repetitive pulses (5-30/sec) </li></ul><ul><li>Energy – 1.76J (Defibrillators 50-360J) </li></ul><ul><li>Power = Energy/time – 26-35 Watts </li></ul><ul><li>“ Myocardial (heart) stimulation extremely unlikely with darts striking the skin” </li></ul><ul><li>“ Clear that TASERS are less likely than guns to cause injury and death or the target (and the officer)” </li></ul><ul><li>Generally more effective than other means of restraint </li></ul>Fish RM, Geddes LA. Lancet. 2001;358:687-8.
    6. 6. ED Literature - TASERS <ul><li>TASER vs. use of lethal force </li></ul><ul><ul><li>218 TASER patients vs. 22 .38 caliber GSW </li></ul></ul><ul><ul><li>Long-term effects 0% TASER / 50% GSW </li></ul></ul><ul><ul><li>Mortality TASER 1.4% / GSW 50% </li></ul></ul><ul><ul><ul><li>3 deaths – all PCP (one also with heart disease) </li></ul></ul></ul><ul><ul><ul><li>Arrests all remote from TASER (25, 15, 5 minutes) </li></ul></ul></ul><ul><ul><li>TASER Complications – 38% </li></ul></ul><ul><ul><ul><li>Lacerations, abrasions, contusions, mild rhabdomyolysis (1%), testicular torsion (0.5%) </li></ul></ul></ul><ul><ul><li>48% Hospitalized (pre-existing injury, psychiatric) </li></ul></ul>Ordog GJ. Annals Emergency Medicine . 1987;16:73-8.
    7. 7. ED Literature - TASERS <ul><li>Portland OR experience – M26 May 2002 </li></ul><ul><li>227 TASER deployments </li></ul><ul><ul><li>32% direct, 68% projectile </li></ul></ul><ul><ul><li>No deaths, cardiac rhythm problems / complaints </li></ul></ul><ul><ul><li>63% No injury </li></ul></ul><ul><ul><li>28% Minor injuries </li></ul></ul><ul><ul><ul><li>Hematomas, lacerations, contusions </li></ul></ul></ul><ul><ul><li>9% self-inflicted / unrelated </li></ul></ul><ul><li>ORMC experience – anecdotal </li></ul>McManus JG. Academic Emergency Medicine . 2004;11:587.
    8. 8. FORENSIC Literature - TASERS <ul><li>16 TASER related deaths </li></ul><ul><ul><li>8 PCP, 1 amphetamines, 6 cocaine </li></ul></ul><ul><ul><li>Those without drugs had trauma, e.g. GSW </li></ul></ul><ul><ul><li>One case – TASER possibly contributed </li></ul></ul><ul><ul><ul><li>Disputed - Allen TB. J Forensic Science 1992;37:956-85. </li></ul></ul></ul><ul><ul><li>More likely contributors – </li></ul></ul><ul><ul><ul><li>Agitation / aggression </li></ul></ul></ul><ul><ul><ul><ul><li>Drug cardiac irritability, acidosis </li></ul></ul></ul></ul>Kornblum RN. J Forensic Science . 1991;36:434-48.

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