Electronic Gun (Taser ) Injuries

Transcription

1 if7 nne r! "" ' r...'. Olll(j"~ALLU liluu UN laser" irljufies SECTON : p. 1 Electronic Gun (Taser ) njuries The 1l1.'lcr K is m dcctrical weapolj l.'w1 lor immohilizmicm. 1\vo huhdn.j cil!lltetm Ulliems who were ~hot hy police with t 11scr"' for \!iolelll or ('fujii J11 l1elwvwr were compared simihlt wticnts shot hy police with..in Sl'ccillJs. The Ollx ternj tllofhidity rutc was signijiclmtly dif!ercjjt iof "(/ ""ed" victims (11%) lind for l"e lvitlll"dlel lvouuds (50%) ('.<.15). 'J1" OJldlily rate was "so significantly different between "ltlsered" \';clim. (1.4'ru). mh guwsjwt wound victims (5()%) (p < OS). Possi/Jc colj/jliccltioljs assw.:idled with 7lm!fJl. wounds indw/ed ('(J111S;ons. lhwsiolls. dllt/ldee' lols (38 f r.d; mild r}wbdolj}yo!ysis (l'yuj; dlldtcsticllhlf torsioll (O.5%J. Although 48% of "losered" patiellls ree/hired wspiu}izelliojj. tl ml oue \\'ih for u preexisting injury or Oxic or psychiauic prohlem. \V~ COlJdlldc tlhll 7h..ersl> lrc rej"u\'ejy safe when compared to shooting with more com'cui 0tlflildl well/ons. Oulog G W"sserberger Schlater t BaltlsulnamdlliwJJ S: f.ft!ctnjllic gull (1hser-JS) injuries. Alln Emerg Med lanuary 191:J7;16:7l7~.f :(' j. NTRODUCTON. f Taser" Thomas A Swift's Elecrric Rifle) guns' have been used by lawenfnrcement ufficers for immobilizing violent suspects and those on ~rugs especially PCP phencyclidine phenyl-cycjohexyl-piperidinell. 1..\ Simi"... electric rifles have been used by private citizens for self-protection. The Taser'" gun is used because it is claimed to have the advantage of not pennanently harming the victim while at the same time immobilizing the victim ilnd controlling violent behavior. 4 This prevents injury to others and alleviates the need to use physical force and bullets which obviously produce more serious cunsequences. The Taser" is generally used when there is no immediate lethal threat to the police or bystanders and when proximity to and control of the suspect is required. f the suspect prescnts an immedi.lte danger to others such as threateniog with a gun or knife a.38 Spedal may be used according to established police protocols. 4 The Tase... is an electrical gull that shoots darrs (usually two or fourl up lu i range of 15 feet. The dans arc connected to the gun by wires that deliver up lu 5ll()(Xl v"hs 13 mal to the victim. For maximum effect the shah shuulj penetrate lilt: skin wherc because of barhs the dans arc not easily removed unle~ the skin is lacerated or ripped open. mmobilization of lhe vil:tim occurs when the trigger of the gun is squeezed and current flows through the suspect's skin. Due to tetanic contraction of the muscles the victim usually falls. The trigger can be squeezed as rc4uin:d to maintain immuhilizaliull. The barbs do not have to penetrate the skin for immobilization; only Cl)ma..:t with the victim's clothing is rcquircd and one barb is usually effective. After Taser.all immobilization the victim is physically restrained the wires to the dans arc Cllt and the victim is taken to the hospital for removal of the dans The batb is like a fishhook and re4uires surgical removal. The mechanics and ballistic pro~r!ies of the Taser-6' have been di~cussej Vtlly by KoSCOVC5 but to date no chmcal study has shown the df~cllvc1~ss and safety of the Taser. ~ '- MATERALS AND METHODS We conducted a prospective case study of all patil:nts brought to the emergency department of the King/Drew Medical Center in L<u; Angeles whtl had been shot with a Taser~ gun between July 1980 and Pecember 19M5. nfllfma Gilly J Ooog Mil. FACE'. raac JOll<ilhan W;j5~efbcU(: MD f\clp lllt::odole SClllillet: MO f-acs Sub'amanldrn Bakuubta' Ji.JrUl MD. facs los Angeles Caillolllid From tile OepulHlBnl of Eml:luency MulhClnc KinD Ol;W Mcdll~dl CtJllh~" eulj llle DlewlJCLA MedlCdl Silul Lo:> Angele:>. CdlllwlHd Received lor publication J~llllJWy ReVision received May 27 19till Accepkd lor puljllcaholl JUlle Address for repollls; Gary J Of(jog Mil face'. faac1. lox Wlhlunglon AVl~ntl~. Cdhloffllil 90W)U l05 AllUelc~.~... v.

2 ' ;;.E.-.'.'M.7.n!!!..iii~5i_'i'.! E1" NJ Jm s Ordog ' ~ SECTON : p. 2 F<;lJHE 1. 1l\lf'()/f.~\ o( 'lst'ed /'(1';('".. \"" 11 'Ct'"t pill'"(td;tli 11(' alms('. n \r""" 2J homs '\' "istm\': ) S'''''11 'nq';\'t' jlll' or 1'''(11' (Tditlin. 1"\"('/ tl/1d lin" /t'n'ls in l'it;/ \\-ho lit'd:.11 Ph"<;icfll ;~1J.<; of 'hcnc.' '." i' heitil'.\" ;ctll;em. incruung "."qll.l.!l11s. 1nlle /"""('/10";"_ ".'"'CTtJl'ill. /111'''01('.'\;... luel df"'tlled Nom/ 'W"<;f/1(':.' '.'( 1''.1 ~ 41 N.n"lgmrrs wih h" hm;::o11al and \'erticdl n ml'ohfnls!1t'sf''.? 'th. "'. ] F1<;[HlE 2. An"tn"'.l of <'ubedded Ttscr ~ dfln.'\. -~_ "' 0- Z w ;= <~ ~ an ' "- _0 ' 0 " '!! 1 linn WilS l:olhtll'd 011 "'~l' ~l X:. race who shot thl' Wl':lrOn whether fl" ~n:1ints Wl'fl' lst...t medic1 t1i:trjlosis compliciltions of laser t 'U1topsy re ~ults 1lH.thod of h;nh removal and as soci:httj hl';1tml'nt. The patients who died l1:hl ftlll autopsies l'l'fot111l'd hy the Los An~de" County nlloller's f (ice to t1ctl'lmine thl' cause of death. P:ltit'nts included in the stutly were:tll thosl' shot with a Taser ll who prescnted to the Kin~/J)rew emer~ency der:ntnh.'1lt. None was excluded. These data wcrc comparcd to similar data on r.1tients who were shot with.~r Spc:cial h:1ld~lns hy police officers for the control of either vin lent or crimin;11 hl'1l:lvior and who Wl'n' hml1~ht fllr tre:lnu"n to the Kill~/1 hew Ml'tlicll Ccnter t1uril1~ the pt'rintl from l;lll1:lry 19RO to Dccemhcr 19H21 Only pa'ients who were sho' hy police officers were incluclt'd This was usually verified hy the acc()mpanyin~ officer. All patients mcetin~ these criteria were included except those for whom only ht';h5:1y evhll-nce indicated that it was 3n officer-related shootin~ :md those not hroll~ht to the hospit11 :lftt'r hl'in~ shot hy police who llay havc hl'cn hamlle\1 hy the coroller's office with no m{'dical treatml'nf. P;Hit'llls were 1l1t ;W41ft' that they were heing studit'd :lml consent was Tlllt rcqllih'd hccaust' treatment W:1S lel1dt'cd :1ct'md;n~ to ('siahli~h{'d plot(ll:ol~ of st:hlmd l11l'\lical practice. No hlilhlit1~ \\':1<: lsed; foto% of c1inic:!1 Oh...l'r\ ;liol1s w('le malic hy rhe pincip;11 ;mlhol :mel the u'f1l:1indcr wcre m;he n' t'nwlcl'1c\' medicine lesident ""ff. 1 S;ltic.;tic.1 :llwly...is indtl{lnt caleul:!- lio1 of st:lhbld deviation chi-squall' :mll ANOVA lromp<ltison of uncqu:l1 gllltl1''' usi1l1~ :111 \M-PC" :llld Sial' gt;ll'hir" ~ 1'11.Ct:l o ra.ct=: HSTORY( 1) ClUTEAl (12.0~) SCA.lP (2.0"') (lo~) t.ower 11MB (2J.O~) LEVElS(2) -- SGNS(J) UETMOO OF DAGNOSS OF PCP._.:'"P~~RllVlJlj~J'n) " MH CHfsr (4.0Y.) NYSTAGUUS(4) MT A800M~N (12.5::) HESUJ;J'S laser" njuries Two hlllh.hcd l'ightt't'n p.lil'lls who \\'l'h'...hot wilh -(:1Sl'S M were inclu\kd. Thl' 111\;111 <l1~e dl'\ j:ltiol1 '.H; 1;11~l' W:S l.r Yl'ars st:111t!;htl f) to 4H. Ninl' ty-fi\'l' 1'l'l'<':l'llt werc men All werc shot hy 'olkt officers. n all C:1SCl" the guns w:;ed were tll.11l1lf<lcturt'd hy laser" ndl1slf'ic... lnt"flrl'oratt'd le 1hl'O (-;llilllllli'll. Nincty-nine percent of p:ltit'lll... W('ll' hrought in hy police. Sixty l''htll \\"{'l' hlot~ht in with no p:;1 l11edic til \'lll'l.\!l'1l:y llctlk;11 tl'dllli \'jall H.. n ('(llt;lcl ThirtY'nine pe fent t'p:hkl1fs wert' hmll~hl in hy 1'!Mnl;tirs with police in t'seort :1l1d '~ \\";llknl in on their own J'rt'Stll11 ;hh- :~J.('1' ht'inc "t:"'net!" hy the polke POST CHEST (J9.0~) and thl'n csclpin~. Of those hrou~ht in hy rolice 46% were in h:tu rcstr:lints fie thick leather hinders on all limhs with key locksj. lwcnty pt'rn'nl Wl'rt' shot hecause thl'y exhihitcd violcnt heh;1villr hut were no lon~cr restrained :lud 7'X were in custody for criminal offenses and werc handcuffed. S('venty-~ix percent of all patients were "taserel!" for hizaln~ and uncontrol1:1hle hch:lvior junusl:11 hut not nccessarily dirccled violenceli 4f1'Y" for hiz:lfre :!ntl extrcnll'ly colnhativt l\'h:lvilll jwifh tli rected violencel; :1nd S'X" for hizane and 11lcontrollalJle h(:havillr with 1'''' nudism)' f'jahle Sixty'ei~hl cent of patients were put on a 71-hour psychi:ltric hold; h:11f (f them \\''rc

3 rs 7"' 'urt: SECTON : p. 3 \ MEDCAL (14.9'1) JAL (5.9'1) PSYCH (29.7'1) HOME (46.0"')... GUUE 3. '1f.~ef.:d l't1licljl (/~P() ~;;ljlj. lullle disdltlfgt.:d home hom llc ellh1/~cjc)' tlcl'iul111:ut a;lel tl\'cl' dge ~ld}' u; ~ix 1l()1l.~; J~) ( l. b)'chi dltic utlmi~.\wu W.WJl)'V" u ' im'o!uutdry hold; M.:dil.:;JJ. ct/milled Ju the mc.j("j ~en'j(c (i llw W':pittl} fo {luther l1ctltm..:lll; jji}. rd":ij')..:d to police CU:SCJl/)' ;tel' l..:u went in the cmergency l:ptutmelll; dl1(/ CO(()JJcr. /llwliew:) who i..:d l'ct:t:i\'c(/ duwp sics l)y the l.o!') Angdc:s Coullty Coru la's Ofiit'e to delam;llc cause o{ '/Ctlth. FGURE 4. Office 'llse tll fie 1l!)C'. laler n:lc<.l~ed from the emergency dc pallment to go homc. Tuxiculogy < Eighty six percent of patients had a tory of recent jsame oayl PCP ~sei 70% had positive levels of PCP j 64% had signs of PCP imoxica llllll; ami 4~% hal! bulh vertical an! h~lrizontal nystagmus jstrong evidence ol PCP ahuscl.l >1 TWenty-six percent of patients had positive ethanol levels.11t1 4'Y. hau <. hislory.mu physic'll tv 4 CORONER (1.5"') idence of recent cocaine usc.a five percent of patiellls hal! a psychiatric disorder unrelatel! to!rug use alll! hal! negative drug screens (Figure 11. Associated Diseases Fifteen percent of patients had pre existing diseases including psychiatric disorder sickle cell trait. mitral valve prolapse cardiac arrhythmia. and sick sinus syndrome. The one patient with a previous history of cardiac disease had mitral valve prolapse cardiac arrhythmia and sick sinus syndrome. Thirty-eight percelll of patiellls hal! associated injuries usually associated with the violent behavior fwll 'C' intoxication. These injuries included multiple abrasions in 4~ patiellls. stab wounds in 11 patients am multiple lacerations not due to knivesl in seven patients. There were no hone fractures. Darts The number of dans firel! by the pulice officers ranged from two to lour with a mean of 2.6 S1..l1 per patiell. The number of dans present in he patients' skin 011 admission to the emergency dcpanmcl rall~ed from onc to four whh OJ mean uf 2.3 (SD G.Y31 per patient. The anawmkal distribution of the embel!del! ans is shown Figure 21. Vital Signs> The average bluod prcssure uf ta sered" patients'fjll admh;sion lo the ED was :utlbo SD wilh a 3 r'lll~e ot Ot!70 lu 160/ too. The 'lvera~c pube rate \\'J~ Y6min lsd 211 wilh a ran~c of xu to 160. A~idc twill the three "useretl" p;llicnt~ wilh asyswle no mhe!" c'lhhh.: <uhythmi.ls were repuned. Othcr Trcatment Electrocardiography was perjormed on 3H U /u of patients. All were normal for rhythm except the chrcc patients who had asyswle. forly-five perccnt of patients rcluirej tetanus prophylaxis. All dans were removed hy incising tlie skin at lhe base uf the shaft with a # sl:alpcl blade. No suturing was required. Complications The Olouality rate Jssociatcd with Taser usc WolS 1.4 }~. All three of these patients olrrivetf at the ED in asystole. "laser'" darb were emhedded in the anterior thigh hullocks and back in these patients. All three hal! high levels uf PCP in bulh serum to 0.43 'g/mll.ml! liver (0.44 to 0.76 'g/mll. One hal! a previuus cardiac his(ury. including c.:ardiac arrhythmias sick sinus ~yndrol1lc wilh mitral valve prolapse' and \VdS 011 diguxin. All three patients went into cardiac.nesl aller being "tascrcd." Two jljlicnt:s with no previous history went into cardiac anest 5.md 15 minutes aha being "taserell".. ld the third wclll illlil le~pjr.llt1ry ane~c fulluwed by l:ardi...t'le:t 2S UlJlute~ &leter hdll~ "tasered." None rc:pomled 10 AClS resuscit..tiunj The l:omncr's repun tor e..ch uf he tillce p.illicnts stjlcd th.ilt death WJ~ due lu phcucyclidinc Uxidty with 110 M~S ol myul.:ardial djmage.invay uhstl'lll: tiun or uthcl' path(llo~y. l1liny dght pcu.:clll ut patients had & e..._... _.

4 77.5 '.7.'.;;! mp? 7[ ;mm T 't' it: tww'l'_.i... _ laser' NJlfllFS Ordog el H SECTON : p. 4 FGlH~ 5. 1J;l1g'Uf of i\cr... ilssnd;lll'd inilllit''' lelart.'(1 til their vio )cnt hl'h;wiot :ud 110t to lise of tilt.' l:'sl'r". Eightet'll of the!';nil'nls n' luirc.. d suturing of \\'Olllllis ;lh.) 1.% of ' nil 1'1ilit'lS "'t''''' :ulmitll'd 10 the msflit:' fo jl1illrit'~!"l~:il1t:d du' 10 tltdr Vililcilt ll'ha\'iflr primarily 'll'cxi:'itin~!'tnh wounds The :llhniu<>d patients spent an avl'r;~(" of two days in the h"pial Mild rhahd"my"lyi.nd my" Jtlohil1uria o(tunl'd in 1% (l't p:uient; and rt'lluin'll hospital trc..'afl11l'nt. No renal complications Wl'rc Sl'cn. Whether the hll'akllown of muscle ell' curred duc to PCP ao\ls(" \ or to the tct;lnic contractions ilssociatcd with the l:'ser lt could not he determined hut each of tlll'~c pi1ticnt~ h:lll positive levels of rc! One p:nient developed a te~ticular torsion immediately after hcin~ "t:lsl'red." He denied prt'existin:; scrot;1 p.l1n or SWt'lin~ hut it eoulll not he dctl'rmim'll Whl'tht'f the tor sion W:l~ a result (f the Ta~erll wound. This patient W1S "tasercd" fof criminal activity and not for psychiatric or dml( rdated hell.vim Hi' PCP creen was nl'~ntivc. Ollt' patient statt f.1 that he hecame sterile after ll'in~ "tasered" in the 5 Reason CONTACTS Bizarre and uncontrollable behavior Bizarre and extremely combative behavior Criminal aclivity not inloxlcaled Clinical Correlation Phencyclidine abuse - Ethanol intoxication - Cocaine intoxication ~ TABLE. Reason for patients being "tasered" by history or drug screen by history and serum tevels t HANon 2. Et[CTAC RELEASE BAR (lell.nd Righ) 3 SAFElY.. MCHARG[ lnocatoo :~~ 5 BATTER\' CHARGE PLUG 6 FlASHLGHT SWlCH 1 flashlght 8. CASSfTTE CHAMBERS % of Patients i f i \ scrotum. Wfu. thcr thc sterility W;Hi preexistin~ could not hc llt-rcrminclt n:.hlc 11. TARLE 2. Complication. of 7aser'" use " i ljispositio" ""1:1st'rcd" patients spent :111 avera~e of (5 hours lsd 411 in till' ED The disf\ljsition of patknt~ aftl'r treatment in thl' ED j~ shown ffi~11l' JJ. Sixty two pefcrnt of p:ltients h;lll :l psychi atric l"':llu:u;ol while in tht ED. Half of thl'sc l((i patients1 well' illlrnittl'd to the hospit:ll psychi;nric unit on a 72 hour illvohmt:uy hoht. These p:ltil..'nts srent :111 :1'...r<1l-:l of (our t1ys in the fildjity hefon' hcit1~ rclc;1<::ed. Ahnost half (f illl p:1til'nts \\"t'r(' llcitl en(jl~h to hl' disch;ll~t tl. Other Ohsef\'alinns A lucid intet":l1 W;lS fl.'po (l d hy the police in ""~ of patient... \"hile the prcvinus)y psydwtk p;lit'lts h"t {'Ufn'nt flowing fhrcmgh their hodies they lll'l':1tt'ntly hl'l';11l' hkid 1mf urientet!. nnly ttl Mer...'t t to disori l'nt('d <1lll vioh'nt heh;1viof "J hi~ W;1S strictly a lay oh"'ef\'ation anti W;l~ not l"onfhl11etl hy Tll'tHell or ps)'t'hil1tric Jll fs(11l1ll 1. Nil1l'ty-tWll pl'n"'t of ra Complication s'alcd th.t he had f r H.~ eve ml'l11 r lell1~ Htasered n total ami n't re % of Patients Contusions' abrasions lacerations (probably preexistent and related to phencyclidine abuse) 38 Mild rhabdomyolysis (probably relaled 10 phencyclidineinduced hyperactivity) 1 Testicular torsion 05 Sierilily in men (not proven) 05 Mortalily 15 Wuuud C.re \\'o\ll1d t'arc follow up W;Hi very poor. Nonr tt'turned for wnuml cht'ck clinic :tprointmcnts. All patients were tcl'pl"e" 1m lolluw up hut only )';~~ el\.ld he re.ched The 48% of pa tints who were admitted to either the 11clHcal or flsychi:ltric hospital were w<1tfhtlll'l an a"cra~ of four days and hatt no wound infections. The 2 to 4 mm wnunds were not fo;utured hut were cleaned with Retadine t :"olmion.nd dre"ed. All he.led satif.c'orily...lienls Shot With.3R Speci.ls Datil were collected on 22 patit-nts hmtl~ht hy paramedics for tn':ttmcnt.fter heink shul hy p"lice wilh.18 Spccial h."dkuns Thc me.n 'KC 01 hese patien" w.s J8 years ra"ke 14 to.181.nd.11 were men The.veraKe numhc. ul hullet wound was L

5 f J.JUldV llh SECTON : p. 5. range to \venty five percent of the patients had physical or laboratory evidence of recent usc of PC~ ethanol ur col..:ainc. The mortality ratc was 50'1..; de J patients who survived suiklcd pcnnancnt morbidity im..:luliing pjrjly~is brain d.tmagc and loss of limb. The operative rate was 82% which indujcd ED thoracotomy whcli the patient Mrivcd in cxtrcmi.'). AVL'rage lospitalization for those paticnts who survived \Vas 41 Jays /r;llge 12 til ( Lllarison of Victims Then: \\las a st.uislil:ally significant dilkrellcc (' ".(111 between the PCl' llallent morbidity rates of "tascrcj" pat kilts 10'1.".U1J 11105c shot hy polkc wllh a.. X Special halhlgnn (50%1. Tlu:rc was also.1 btatisth.:ally signifi- cant difference P <.01) belween he mortality rates of "tasercd" patients 11.4%1 and those shot by pulice wilh a.3m Special handgun whu received treatment at the hospital jsttytj. Although the two groups 19unshot wound and "teasered" victimsl au: not equivalent it would be impossihle h) establish a true comparison ~rolip in (cnns ot m;alioll of injury Hllllll..'l' of injuries and reason for llh:..:h.mil:.&1 immobilization. DSCUSSON The Tascr'" is lscd by pulice w minimize the 31110lUU of forl'c m:ccss.lry to nmtrol violent' suspects" lpcrsollill communicaliol1s wilh Sgt Jilll Kcll) and Sgt Jllck SchmiJa l.os Angeles Pulice J)cpartmcllt~l\:rsonncl illlj l1jiniug lureau.tieplemher 10 HiXol. They HGlJlU: 7. "J'J-S..'( W(JR. -like huh elld / ~ h.jft. Medical Trealmeltl tll1jl.'iitj\\'llg ii.h may be lsed when a klhal 'on.:c sw.:h as th.1t fwl OJ..iN SpL.'ciJ halj~t11 is nm justifiahle and whcli l:onvclliollj tactics oi YC'h~llizati(ll :.ch dl.'j-'bc finn grip l:olltwl Jnd othcn:i do not suhdue the bllbjlecl. The 'a:.er h temporarily immobilize:. hy using clcl: uic.:ity Jt SO(XN) yuhs 10.M juuk's JWJll1 scl:onj:..- t This del:uil:ity is pub-'d ill a r.le of 10 tj S impubl. :' pel' scl:onj and is suilidcll to l:jlbe tetank l:ontraction oj the budy's mll.:tt.:lcs. Thus the ~uspct.:t is il1volul1jlily pal'.)'zed as long as he current jh)\\s Whcn the Taser ~ release har is JepresseJ two darts arc lwpclled from the gun over a rang~ uf hum two tj 15 leel jrigures 4-61.~ The J.lrtS Figure 71 pull two fine cundul:ting wires from a L:J:.scU.. The dans l:<ln alt.ll:h either 10 lhe susp""l:'s clothing ur 10 he skin. The L:lnent will dfectivdy pass hrough two inches oi clothing and need not penctrate the skin hlr inl1110hilizatiun: t A person Whl) is "tascred" is immobilized with just twu to three se..:onds of applied ~)wec. 4 Th"' power may he repeated as required tu maintain immobilizaliull. Continwlus appliglti(m of cuncnt is nm ajvis""d for it cuuld result in respiratory arrest. T.lsers'" have been shown til he efiective in immobilizing suspects H2% the time. 4!l Recovery frum being shot with a Tascr~ repullcuy is rapid. 4 The Tas~r 1\ was designed as a nunlethal control device. Bel:ausc the victim usually falls when paralyzed many need medical treatment for minor trauma MOM arc seen in the emcrgency llepanmehl jor removal of lite dans fwm he skm. ~ Th~ major problems h:l.luirillg 11""diL:J tlc.llment appcar to he holl precxistillg iuimics and toxic conditions that Jl:CuJlly led to thc palil..'1l hell1~ "t;~c.-ej." This was usu.)' due to the toxic psydjusis of PCP ami h) injuries slblalllej ihlm the violent hehavlur a~stjdj'nl with it. Ahhou~h the huspu.11 adlllismon rate \'is high tollowing Taser wounds t~w;;d lly ulle paticnt cc \llil'ed JJllssiun ht.'t.:.jusc ui il lilel:( illju')' lu.' to the las~lh. All uthel patients r~'luired aju:.slon lor pn:cxisting (()X.: psydloses psychiatril: disorders and injuries.bs(j(ialcj with

6 T 'm '!!!? r t 'tmt!nt?tu. - /ls~w NJUlill S 0'<10(1 el al SECTON : p. 6 : : ; i :! " ~!./ " Vi411l'1t xh:1\i;u. Thn'l' "il1kllt!" -lil'd pmh'lhly due to l'lrdi:u: nrrhythl11i; in il prl'l'xistil1l: irritahlt hemt.!' 1\11 tlm.'t' r:1til'nt!'i who (it'd :"l!i'tl1incd toxic 1l'\"t'~ of PC~ OlC had i history of c:mlirlc lli-scasc anti c:udinc 1rrhythmi;lS :l1d :111 died scv. crill l11inutl's :1ftl'r hcin.l: "tascrcll." TlliS he l~ls('r ~ Ci111ot ht' hdd solely rt'l"ronsihlc (or tlwit dt aths. There is very little in the litt'raturc ahollt mortality rates for 'ht'ncyclidine ahusc hut McCarron (.'t :11l'l showed ;1-0.1% mortality o\'rmll with a 1% mortality rate 11/106 r.1.il'llls! for severely inrox. lciltt.'d p:nil-nls (which our ~rnllp repn'senft'tll and ;1 S'X mortality {l/20 pl1 tit'nlsl for sl'vl'rt'ly COf11:1tosc "Atit'nts. Otlll'r potential inillfits not St'cn in this clinical study included penetration of maior hlmlll VCSSt'!s. mpturc of thl' ~ohet; inlcrff.'rcncc with a cnr. dial' pact'm:lker" dl'ctricallr induced nt'urolo~kal ami renal injury"" D myo. cardial infarction u 11 cardiac arrhyth. mias " lind fr:l.:tlift's." The incidcl1tt ()f rhahdolllyolysis '.~;) W:S consistt'nt \vith if not lower h:1l1/ that in the litt'r:1turc lr:11ge 0.2 to 11'~:"1"ucJ(.17 CONCLUSON When coml':m:d to police shootings with h;1fulguns to iml1lnhili:c people with \'ioll'll hl'll.1viol' tht're is a l11:hkt'd nnd st:listic.11y 1(1\\'l'r 11101'- t:1lity nnd morhidity ratc when the laser'" is used Another way.of view. illg these datn is tn say that the l:1ser1l' \Wg associ:ttt'd with a 1.4'X mortality mtt'/ and prohahly saved the 48.6% of patients who may have otherwise heen sl". with.1 ~R Speci.11 hal1llj(uo. The nt1thm~ thank Sgt Jack Schmida and S~tlim Kelly of.he los Angele. Police Department fur information and reference sourn'~ nn the laser'll; Los Angeles Police Department Chief Darryl Gates for his rdt'rl'ncl' on the rolice usc of the Tascr'Jr; OHiccr Rilly Holland for posing fbr photo ~r41rhs and lise of his Taser for this Mudy and Cindy Ordog for editing and typinj: the manuscript. REFERENCES. Zylich N: li.~t r - evltllllttinn ltnd analyliill Unilt'd l\laft ~ Cnn"illloc.'r l'rlklucl Sall'tY Cllm. mi"l..inl1 Mt:mmantlllln 'eference No.!j.1tt9.';Y: 7f. N ' Z.lid: Ft 14 1'17(. 1 1\1t'Carron MM Schulze U\Y Thomp~on GA. l't : ACtltl' r1lt'nq'c1idint intnxicatinn: nd. lll'nn' clinical fjthtin~~ in.uno cues. Ann rlllt'r.1!.'t'd WU;l1:H7.142.\. llilttnll Cit. Stt.'rlin~ ML V;lzari ND: rhellcrdi1lint' inlmdc:ltinn: Clinical cll.peri~ncc in 27 l"/'''lcc; confirmcd hy urinc a~5ay. Am Emerg M"d Jl~ldf1:14\.246. ' C;ltt'.. DF: the ( furce: Ta~r c1cctmnic cnn dl'\ il'l'. Tminil1J: hlllnin of the Los AllJtde~ 'olin' krartl11l'llt. 19R4 Volume XV is5tlc 4 r f._ :". f<l'''l'n\'(' F.r-.l: Thl' lit'ier- Weapon: A new 1 l11t".!:t'w\' mnlidl1l' rruhlt'm Am Enter!': M'd 1911';14: my-ll. t. Rntlll'nhcrJt R: Cncaitw #:rul'rx('/tt Akdic'fll $en ict'.~ : "'"wril'an 'h':ut A!'lfmdatinl1: Siantbul!'l :ul Jtuidclim'" {lr cardinrulmnnary rt'c;u!ilcilalinn CPR find cmer~ncy cardiac care ECe). lama 1980 j 244:4's1. " ft McCarron MM-Schllb:e my Thomp~on GA. el al: Acule phencyclidine intoxicaliun: Clinic. paltern" compliclllinns.nd trcalment. Ann Erner/( Med 19ftl j 10: '9; DiVcncenti Fe Moncrief la "mh RA: Elcc. rical iniurie~: A rt.'vicw uf "i cl1"e". 1'tlllmfJ 19699:497-'sU Sulc1l1 L Fi"Cher R: Stmll' tg: The..' l10lllltlll hi5tmy nf dectrical injury t "i Y77 i 17: Dixon GF: The cv.llation and ml1najt.'ntcnt of electrical injuries. eri' Care Med 1981 :.lrqr Kohernick M: Electrical iniurie": 'a. thnphv"ioluky and emcrjtency manajteml'nl. Am 1:'lJl'r~ M'" 19M2 j ll:f..\:j.(;\m 1.1 tnhmll'n.e Nl'wlun cn: Myucardial in. fan'tilln fllllnwin~ dl'ctrical!'hnck. 'S Ar"'d -'l1c('_' Med t lys2r-1:497.lifl Kinm'y 1"1: Myncardial infarclinl1 follnwinj: dcctrical iniut}.. Ann Em('f~ Mt'1119R2:11: S. S Kirclun:tir \Y DienM F: 15 c:trdiac munitur. ink rcquir("d after electrical injllrk!l? 1J'~ch Ml'd WscJr 19R2;107:SS7-R.'l9. 16 fatd R!)as M PalaZZlliu M C' al: Mvo :lohinuric ncutl.' rennl failure.' in phcncyclitlinc ovenltl~e: Ref'url f nh~erv:tlihn"l in ei~ht C:1<:CS. An" fnll'rj( M"t/ 19R1J9:S4Y.';Sl 17 hnn~ RS Lerner SE <':nrr:1d:t fla: 'hell' cyclidine: ~tatc~ tlf acute intoxicatilln ami. ralitic!'l \\{~ 1!off'" 1975;11.1:14';..\49. " ' 1" 7R