Review article
Acute pathophysiological influences of conducted electrical weapons in humans: A review of current literature

https://doi.org/10.1016/j.forsciint.2012.02.014Get rights and content

Abstract

Conducted electrical weapons (CEWs) deliver short high-voltage, low current energy pulses to temporarily paralyze a person by causing muscular contraction.

The narrative of this article is a methodical analysis on acute pathophysiological changes within the central nervous system, cardiovascular, neuroendocrine, sympatho-adrenergic and muskuloskeletal system which can occur after application of conducted electrical weapons on human subjects. The results are based on wide-ranging literature analysis and source studies. The majority of the recent scientific publications on humans classify the health risks of an appropriate use of the CEWs device as minor. However, there still is an uncertainty about possible side-effects of these devices. Therefore medical supervision with human application is advised.

Section snippets

Central nervous system

The transient high-voltage and low current waveforms of CEWs, which are transformed into the target by two darts (electrodes), over-ride the command and control system of the human body and immobilize the target (s.c. electromuscular disruption, EMD). The result is an uncoordinated muscular contraction of the majority of the skeletal muscles. According to Despa et al. [21] the reason for this phenomenon lies in the stimulation of multiple spinal reflexes. In their research on anesthetized pigs

Cardiovascular system

It is well known, that external stimulation of the heart by high voltage discharges can influence the internal electrical activity of the heart [29] and lead to cardiac arrhythmia and ventricular fibrillation [30], [31]. The effect of the electricity hereby depends on the heart's state of agitation and the current applied. The threshold for myocardial contraction current and voltage varies with impulse duration, which means that shorter pulse duration requires larger amounts of current in order

Neuroendocrine and sympatho-adrenergic system

When exposed to the electrical waveforms of CEWs, the sympathetic-adrenal-medulla axis and the hypothalamic–pituitary–adrenal axis are challenged to cope with the induced stress-reaction of the human body. There has been speculation whether an increase in catecholamines (adrenaline, noradrenaline, norepinephrine, and dopamine) could trigger ergotropic effects and influence heart contraction and metabolism and lead to a life-threatening situation such as the so called excited delirium. In this

Musculoskeletal system

On impact two harpoon-like probes penetrate the body surface and create an electric field, which does not directly activate the muscle tissue, but stimulates type A-α motoneurons [21], [22], [33]. The impulse is then forwarded to the neuromuscular junction terminal, initiating a tonic muscle contraction. The final effect of the CEW application depends on the electrophysiological characteristics of the current flow and on the localization and distance of the electrodes. Maximal tension of the

Conclusion

The majority of current medical research could not find acute clinical relevant pathophysiological effects during or after professional use of CEWs on human subjects.

However, since not every aspect of possible acute pathophysiological influences of conducted electrical weapons in humans has been evaluated yet, medical supervision of exposed patients is essential.

Limitations

In most of the current literature on CEWs, tests are done on subjects with no significant medical history and the CEW devices are applied as indicated by the company. Furthermore no testing has been done on persons intoxicated by illegal substances. Since individuals in the field often receive multiple shocks in extreme situations, which have not been discussed in this article, possible TASER conducted electrical weapon-related injuries or pathophysiological changes cannot be excluded for these

Conflicts of interest

This paper is a result of literature research, which was not funded and there is no actual or potential conflict of interest in relation to this article.

References (59)

  • M.W. Kroll

    Physiology and pathology of Taser® electronic devices

    J. Forensic Legal Med.

    (2009)
  • A. Takeuchi et al.

    Excited delirium

    West J. Emerg. Med.

    (2011)
  • J.D. Ho et al.

    Catecholamines in simulated arrest scenarios [poster]

    Am. Coll. Emerg. Phys. Sci. Assembly

    (2009)
  • R. Moscati et al.

    Physiologic effects of prolonged conducted electrical weapon discharge in ethanol-intoxicated adults

    Am. J. Emerg. Med.

    (2010)
  • R.W. Sy et al.

    Arrhythmia characterization and long-term outcomes in catecholaminergic polymorphic ventricular tachycardia

    Heart Rhythm.

    (2011)
  • M. Cerrone et al.

    Catecholaminergic polymorphic ventricular tachycardia: a paradigm to understand mechanism of arrhythmias associated to impaired Ca2+ regulation

    Heart Rhythm.

    (2009)
  • K. Kontula et al.

    Catecholaminergic polymorphic ventricular tachycardia: recent mechanistic insights

    Cardiovasc. Res.

    (2005)
  • J.D. Ho et al.

    TASER device-induced rhabdomyolysis is unlikely

    J. Emerg. Med.

    (2011)
  • R. Sinert et al.

    Exercise-induced rhabdomyolysis

    Ann. Emerg. Med.

    (1994)
  • D.M. Dawes et al.

    The effect of an electronic control device on muscle injury as determined by creatine kinase enzyme

    Forensic Sci. Int.

    (2011)
  • B. Resnick et al.

    A Guide to TASER Technology: Stun Guns, Lies and Videotape

    (1997)
  • J. Ho

    Sudden in-custody death

    Police Mag.

    (2005)
  • Amnesty International

    US Authorities Urged to Control Tasers as Official Report on Deaths Issued

    (2011)
  • Amnesty International

    Tasers – Potentially Lethal and Easy to Use

    (2008)
  • J.R. Jauchem

    Increased hematocrit after applications of conducted energy weapons (including TASER devices) to Sus scrofa

    J. Forensic Sci.

    (2011)
  • J.R. Jauchem

    Repeated or long-duration TASER electronic control device exposures: acidemia and lack of respiration

    Forensic Sci. Med. Pathol.

    (2010)
  • J.R. Jauchem et al.

    Survival of anesthetized Sus scrofa after cycling (7 s on/3 s off) exposures to a Taser® X26 electronic control device for three minutes

    Am. J. Forensic Med. Pathol.

    (2011)
  • A.J. Dennis et al.

    Acute effects of TASER X26 discharges in a swine model

    J. Trauma

    (2007)
  • D. Dawes et al.

    Commentary on: Jauchem J. Increased hematocrit after applications of conducted energy weapons (including TASER devices) to Sus scrofa

    J. Forensic Sci.

    (2011)
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