Medical Management of People Subjected to Discharge from Conducted Energy Devices (‘tasers’)
Advice to Health Care Professionals

Conducted energy devices (CEDs), commonly known as ‘tasers’, exert their effects by injecting pulses of electricity into the body. While most uses appear to have benignoutcomes, a range of adverse health effects has been reported.[1] The advice in this leaflet has been adapted from TASER®: Clinical Effects and Management of Those Subjected to Taser® Discharge.[2]The leaflet is intended to complement localguidelines, which should take precedence. All persons subjected to CED discharge must ultimately be examined and assessed by a registered medical practitioner – a doctor (e.g. Forensic Physician or Emergency Medicine doctor) – who is familiar with the risks and complications associated with use of these devices. Doctors unfamiliar with these unique risks and complications must be provided with a copy of this leaflet.

In most cases, initial first aid or barb removal (if not already done) may be undertaken by any appropriate healthcare professional (e.g. nurse or paramedic) and, where barbs have not penetrated the skin, by police officers. Barbs that have penetrated the skin may be removed by stabilising the skin surrounding the barb and, while firmly grasping the barb, removing it with rapid traction,ensuring that the extracted barb is intact with no metal fragments remaining. Clean the skin around the barb exit point with an alcohol-freeantiseptic wipe. The CED used by UK police is the TASER® X26 has 9.6 mm barbs(left). Where barbs have penetrated or are near to sensitive and/or high risk areas(such as the eyes, ears, nose, mouth, face, neck, genitalia, spine, hands, feet or joints), doctors should use their clinical judgment and, when necessary, seek specialist advice on barb removal. For deeply penetrating barbs, an assessment of injury to underlying tissue (e.g. pleura) should be made.

A full history must be taken documenting any health conditions (e.g. cardiac arrhythmias, pacemaker, drug or alcohol use, epilepsy, diabetes, psychological vulnerability), the nature of the CED deployment and any other form of restraint used (taken from officers involved in the deployment) and recording any symptoms reported by the subject during or following the use of the CED.

A full external examination (including documentation and assessment of the sitesof barb penetration or drive stun application) should be undertaken to provide a record of visible injuries.A full cardiovascular, respiratory, musculoskeletal and neurological examination should also be undertaken to identify, or exclude, any CED-associated complications.

The potential effects of TASER® discharge on the fetus are unknown, and pregnant women should be referred for specialist obstetric review.

All those subjected to TASER® discharge must be advised to attend their GP or Emergency Department if they have any subsequent concerns. Electrocardiography, X-ray, ultrasound, CT or MRI scans may be indicated depending on the medical assessment. If head injury has been sustained, the UK Faculty of Forensic and Legal Medicine have produced advice on its evaluation and management in persons held in police detention. (NICE guideline CG166

It is unlikely that the TASER® would have been used in isolation from other forms of restraint. Concurrent injuries or effects arising from police use of other forms of force should also be considered during assessment of the patient. (FFLM advice on the clinical effects and management of people exposed to CS and PAVA sprays:

Immediate transfer to hospital is recommended for persons detained after a prolonged or violent struggle or in those in whom an ‘excited delirium state’ is identified or suspected.

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[1]

[2] (published by the Faculty of Forensic and Legal Medicine)