How to Work Up TASER Shocks

October 2, 2019

Written by Clay Smith

Spoon Feed
Patients who have been shocked with a conducted energy device (i.e. TASER) need a careful exam to rule out injury from the electrical probe and to screen for trauma from muscular contraction, fall, etc. If none, no ECG, monitoring, or lab evaluation is indicated.

Why does this matter?
Conducted energy weapons, such as TASERs, give a jolt of 50,000 volts. That seems like a lot. The question is, do we need to do a medical workup after a weapon like this has been used on a patient?

A stunning review
This was a review of the literature on conducted energy weapons to answer these questions.

1. Do these patients need cardiac monitoring, ECG, or troponin measurement after a shock under 15 seconds? If a patient is awake, alert, and had a <15 second shock, there is no indication for ECG, prolonged cardiac monitoring, or measurement of troponin.

2. What about checking other labs? There have been no studies that found electrolyte abnormalities. Some have found clinically insignificant elevations of lactate and CK. So, the answer is no.

3. Anything to be done with a shock in “drive stun” or touch stun mode (directly applied to person)? No, it may cause minor skin irritation or small burns at the contact sites that do not require intervention.

4. What about when the probe is fired at a patient (“probe mode”)? This is where most of the problems arise. The probe may cause eye injury, vascular puncture, or nerve injury. In addition, spinal compression fracture or other soft tissue injury from forceful muscle contractions or fall with blunt trauma occurs rarely, 0.5% in real world use.

Source
Emergency Department Evaluation After Conducted Energy Weapon Use: Review of the Literature for the Clinician. J Emerg Med. 2019 Sep 6. pii: S0736-4679(19)30553-0. doi: 10.1016/j.jemermed.2019.06.037. [Epub ahead of print]

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Reviewed by Thomas Davis