Do Saliva-Saturated Spit Hoods Interfere With Ventilation?

ABSTRACT: Spit hoods are used by law enforcement, officers in correctional facilities, and medical personnel during the restraint of agitated subjects that are actively spitting to prevent the transmission of droplet-transmitted pathogens. We could find no studies reporting on the time course of normal breathing to clear saliva from such a saturated spit hood. We purchased samples of 3 popular spit hood models and applied a section over the output of a pneumatic test system. We used a digital anemometer, digital manometer, and an inline controllable fan for back pressure and flow. The pressure was 3 mm Hg to match quiet breathing. The tested area was saturated with artificial saliva, and air pressure was applied while we recorded the pressure and airflow. Within 5 seconds, the spit hoods all cleared sufficient artificial saliva to allow 1 m/s of airflow, which exceeds that of an N95 mask with similar pressure. Commonly used spit hoods offer very low resistance to breathing even after being initially saturated with artificial saliva. Our results do not support the hypothesis that a saliva-filled spit hood might contribute to death.

Confusion between firearms and electrical weapons as a factor in police shootings.

Conducted electrical weapons (CEW) have risks including trauma associated with uncontrolled falls, probes penetrating the eye, and fume ignition. A lesser-known risk is weapon-confusion error with officers mistakenly discharging their firearm when they intended to deploy their electrical weapon. We searched for incidents of possible weapon confusion with the TASER® brand CEWs via open-source media, litigation filings, and a survey of CEW law enforcement master instructors. We found 19 incidents of possible CEW weapon confusion in law enforcement field uses from January 2001 to April 2021. We eliminated a case as not meeting our criteria for probable weapons confusion leaving 18 cases, thus giving a demonstrated CEW discharge risk of 3.9 per million with confidence limits (2.4-6.2 per million) by Wilson score interval. Ipsilateral carry of the weapons was historically correlated with increased risk vs. contralateral carry. Officer gender was not a predictor of weapon confusion. The psychological issues behind weapon confusion under stress are discussed. The concurrent carry of electrical weapons and firearms presents a very small but real risk of injury and death from confusion between an electrical weapon and a firearm.

Pneumatic Impedance of Spit Socks and N95 Masks: The Applicability to Death Investigation.

INTRODUCTION: Restrained subjects often spit on law enforcement and corrections officers and medical responders. Based on the droplet-transmitted risk of COVID-19, such spitting could be considered a potentially life-threatening assault. Officers commonly use "spit socks" over the head and neck of spitting subjects to reduce this risk. The pneumatic impedance of such socks has not been published, so this remains an open issue for arrest-related death investigation. METHODS: We purchased samples of 3 popular spit sock models, 3 insect-protecting "bug" socks and hats, 3 N95 masks, a standard 3-ply surgical mask, and a common dust mask. We used a BTmeter model BTN8468 digital anemometer, an HTI model HT-1890 digital manometer, and an AC Infinity Cloudline model S6 inline controllable fan to measure air flow versus pressure drop. We compared the curves graphically and also calculated a pneumatic pseudo-impedance by dividing the pressure drop by the air velocity. RESULTS: The spit and bug socks allowed nearly maximum airflow with minimal pressure (≤1 mm Hg), whereas none of the masks allowed greater than 2 m/s of airflow at maximum pressure of 3 mm Hg. All of the spit and bug masks were grouped together with the lowest pneumatic impedances, whereas all of the N95 masks were grouped together with the highest values. The dust mask and surgical mask were in between with the dust mask closer to the spit and bug masks, whereas the surgical mask was closer to the N95 masks in impedance. CONCLUSIONS: Commonly used spit socks offer nearly zero resistance to breathing. The highest resistance spit sock was still 100 times better than the best N95 mask for airflow during inhalation. Our results do not support the occasional hypothesis that spit socks might contribute to an arrest-related death.

Estimation of Physiological Impedance from Neuromuscular Pulse Data.

INTRODUCTION: A Conducted Electrical Weapon (CEW) deploys 2, or more, probes to conduct current via the body to induce motor-nerve mediated muscle contractions, but the inter-probe resistances can vary and this can affect charge delivery. For this reason, newer generation CEWs such as the TASER® X3, X2 and X26P models have feed-forward control circuits to keep the delivered charge constant regardless of impedance. Our main goal was to explore the load limits for this "charge metering" system. A secondary goal was to evaluate the reliability of the "Pulse Log" stored data to estimate the load resistance. METHODS: We tested 10 units each of the X2 (double shot), X26P, and X26P+ (single-shot) CEW models. We used non-inductive high-voltage resistor assemblies of 50, 200, 400, 600, 1k, 2.5k, 3.5k, 5k, and 10k Ω, a shorted output (nominal 0 Ω), and arcing open-circuits. The Pulse Log data were downloaded to provide the charge value and stimulation and arc voltages for each of the pulses in a 5 s standard discharge cycle. RESULTS: The average reported raw charge was 65.4 ± 0.2 µC for load resistances < 1 kΩ consistent with specifications for the operation of the feed-forward design. At load resistances ≥ 1 kΩ, the raw charge decreased with increasing load values. Analyses of the Pulse Logs, using a 2-piece multiple regression model, were used to predict all resistances. For the resistance range of 0 - 1 kΩ the average error was 53 Ω; for 1 kΩ - 10 kΩ it was 16%. Muzzle arcing can be detected with a model combining parameter variability and arcing voltage. CONCLUSIONS: The X2, X26P, and X26P+ electrical weapons deliver an average charge of 65 µC with a load resistance < 1 kΩ. For loads ≥ 1 kΩ, the metered charge decreased with increasing loads. The stored pulse-log data for the delivered charge and arc voltage allowed for methodologically-reliable forensic analysis of the load resistance with useful accuracy.

Detection of Arcing and High Impedance with Electrical Weapons.

INTRODUCTION: Conducted electrical weapons are primarily designed to stop subjects from endangering themselves or others by deploying 2, or more, probes to conduct current via the body to induce motor-nerve mediated muscle contractions, but probe impedance can vary significantly including open circuits from probes failing to complete or maintain a circuit. METHODS: We tested 10 units of the TASER® 7 model with a range of impedances and open circuit conditions. Pulse data (stored in the device's memory) were used to predict the load resistances and detect arcing conditions. Acoustical data (recorded externally) was evaluated on an exploratory basis as a secondary goal. RESULTS: The average error of predicted resistance, over the physiological load range of 400-1000 Ω, was 8%. Arcing conditions was predicted with an accuracy of 97%. An arcing condition increases the duration of the sound generation. CONCLUSIONS: The TASER 7 electronic control device stored pulse-log data for charge and arc voltage yielded forensic analysis of the load resistance with reliable accuracy.

Output of Electronic Muscle Stimulators: Physical Therapy and Police Models Compared.

INTRODUCTION: Both physical therapists and police officers use electrical muscle stimulation. The typical physical therapist unit is attached with adhesive patches while the police models use needle-based electrodes to penetrate clothing. There have been very few papers describing the outputs of these physical therapy EMS (electrical muscle stimulator) units. METHODS: We purchased 6 TENS/EMS units at retail and tested them with loads of 500 Ω, 2 kΩ, and 10 kΩ. RESULTS: For the typical impedance of 500 Ω, the EMS units delivered the most current followed by the electrical weapons; TENS units delivered the least current. At higher im-pedances (> 2 kΩ) the electrical weapons delivered more current than the EMS units, which is explained by the higher voltage-compliance of their circuits. Some multi channel EMS units deliver more calculated muscle stimula tion than the multi-channel weapons. CONCLUSION: Present therapeutic electrical muscle stimula-tors can deliver more current than present law-enforcement muscle stimulators.

Police shootings after electrical weapon seizure: homicide or suicide-by-cop.

PURPOSE: Risks of handheld electrical weapons include head impact trauma associated with uncontrolled falls, ocular probe penetration injuries, thermal injuries from the ignition of volatile fumes, and weapon confusion police-involved shooting. There is also an uncommon but critical risk of a shooting after a subject gained control of an officer's electrical weapons. METHODS: The authors searched for police shooting incidents involving loss of control of TASER® weapons via open-source media reports, crowd-sourced internet sites, litigation filings, and a survey of Axon law-enforcement master instructors. RESULTS: The authors report 131 incidents of subjects attempting to or gaining control of an officer's electrical weapon from 2004 to 2020, 53 of which resulting in a shooting. These incidents demonstrated a risk of 11.8 shootings per million electrical weapon discharges (95% confidence limits of 9.0 to 15.1 per million by Wilson score interval). CONCLUSIONS: The use of electrical weapons presents a rare but real risk of injury and death from a shooting following a subject's attempts to gain control of the weapon.

Eye injury from electrical weapon probes: Mechanisms and treatment.

PURPOSE: While generally reducing morbidity and mortality, TASER® electrical weapons have risks associated with their usage, including burn injuries and head and cervical trauma associated with uncontrolled falls. The primary non-fatal complications appear to be significant eye injury but no analysis of the mechanisms or suggested treatments has been published. METHODS: We used a biomechanical model to predict the risk of eye injury as a function of distance from the weapon muzzle to the eye. We compared our model results to recently published epidemiological findings. We also describe the typical presentation and suggest treatment options. RESULTS: The globe rupture model predicted that a globe rupture can be expected (50% risk) when the eye is within 6 m of the muzzle and decreases rapidly beyond that. This critical distance is 9 m for lens and retinal damage which is approximately the range of the most common probe cartridges. Beyond 9 m, hyphema is expected along with a perforation by the dart portion of the probe. Our prediction of globe rupture out to 6 m (out of a typical range of 9 m) is consistent with the published risk of enucleation or unilateral blindness being 69 ±â€¯18%, with an eye penetration. CONCLUSIONS: Significant eye injury is expected from a penetration by an electrical weapon probe at close range. The risk decreases rapidly at extended distances from the muzzle. Not all penetrating globe injuries from electrical weapon probes will result in blindness.

Applied Force During Prone Restraint: Is Officer Weight a Factor?

INTRODUCTION: It has been suggested that law enforcement officer (LEO) weight on the backs of prone subjects may cause asphyxia. METHODS: Law enforcement officers used their agency-trained "local" single- and double-knee techniques, the "Wisconsin" 3-Point Ground Stabilization, and the Human Factor Research Group Inc single-knee tactical handcuffing techniques, and the weight force was measured. RESULTS: Forty-one LEOs (36 men, 5 women) participated, aged 38.4 ± 8.3 years, and weighing 96.2 ± 19.4 kg. The double-knee technique transmitted more weight than single knee (P < 0.0001). Wisconsin technique force was lower than other single-knee techniques (P < 0.0001). Double-knee weight was 23.3 kg plus 24% of LEO's body weight. Mean values for local and Human Factor Research Group Inc single-knee were 30.9 and 32.9 kg, respectively. The Wisconsin single knee weight force was given by 15.4 kg plus 9.5 kg for a male. CONCLUSIONS: A double-knee technique applies more weight force than single-knee techniques. The Wisconsin single-knee technique provides the least weight force of single-knee techniques. Law enforcement officer body weight is irrelevant to prone-force weight with single-knee techniques. With double-knee restraint, it has a modest influence. Our data do not support the hypothesis of restraint asphyxia.

Electrical Weapon Charge Delivery With Arcing.

INTRODUCTION: Human electronic control with the Conducted Electrical Weapon (CEW) has gained widespread acceptance as the preferred law enforcement force option technology due to its dramatic injury and fatal shooting reduction. However, with bulky or baggy clothing, a CEW probe may fail to make direct skin contact and thus arcing is critical to complete the circuit. The goal of the study was to evaluate the ability of modern CEWs to deliver their pulse charges across typical required arcing distances. METHODS: Popular TASER® CEW models X26E (openloop output), and the X2 and X26P (with closed-loop outputs) were activated using a cartridge connected to a custom polymer air-gap fixture. For each model 5 units were tested. The raw and normalized charge delivery were evaluated according to ANSI-CPLSO-17. RESULTS: All 5 units of each model satisfied ANSICPLSO-17 even at maximum arcing length. The X26P CEW had the greatest arcing gap capability. CONCLUSIONS: The stabilized closed-loop charge output feedback of modern electrical weapons (X2 and X26P CEWs) provides a significantly improved output consistency under arcing conditions. With arc lengths of 10-20 mm per probe, the X2 CEW normalized output charge exceeds that of some units of the older higher output X26E CEW model.

Eye injuries from electrical weapon probes: Incidents, prevalence, and legal implications.

PURPOSE: While generally reducing morbidity and mortality, electrical weapons have risks associated with their usage, including burn injuries and trauma associated with uncontrolled fall impacts. However, the prevalence of significant eye injury has not been investigated. METHODS: We searched for incidents of penetrating eye injury from TASER® conducted electrical weapon (CEW) probes via open source media, litigation filings, and a survey of CEW law-enforcement master instructors. RESULTS: We report 20 previously-unpublished cases of penetrating eye injury from electrical weapon probes in law-enforcement field uses. Together with the 8 previously published cases, there are a total of 28 cases out of 3.44 million field uses, giving a demonstrated CEW field-use risk of penetrating eye injury of approximately 1:123 000. Confidence limits [85 000, 178 000] by Wilson score interval. There have been 18 cases of total unilateral blindness or enucleation. We also present legal decisions on this topic. CONCLUSIONS: The use of electrical weapons presents a rare but real risk of total or partial unilateral blindness from electrical weapon probes. Catastrophic eye injuries appear to be the dominant non-fatal complication of electronic control.

New conducted electrical weapons: Finite element modeling of safety margins.

Introduction-We have previously published on the ventricular fibrillation (VF) risk with TASER® X26 conducted electrical weapon (CEW). Our risk model accounted for realistic body mass index distributions, modeled the effects of partial or oblique dart penetration, and used epidemiological CEW statistics. As new CEWs have become available to law enforcement, their cardiac safety profile was not quantified. Therefore, we applied our VF probability model to evaluate their cardiac risk. Methods and Results-An eXperimental Rotating-Field (XRF) waveform CEW and the X2 CEW are new 2-shot electrical weapon models designed to target a precise amount of delivered charge per pulse, 64 µC and 62 µC, respectively. They can deploy 1 or 2 probe pairs, delivered by 2 separate cartridges. New Smart Probes (SP), which carry 11.5 mm long CEW darts, can be used with XRF and X2 CEWs. Finite element modeling (FEM) was used to approximate the current and charge densities produced by XRF and X2 CEWs in tissues located in the vicinity of darts, including accounting for the effects of fat, anisotropic skeletal muscles, sternum, ribs, and lungs. Using our previous cardiac risk probabilistic model, the new XRF and X2 CEWs operated with 11.5 mm SPs, had an estimated overall theoretical VF risk of less than 1 in 1 300 000 and 1 in 1 490 000 cases, respectively. We also found that the XRF and X2 CEWs had increased cardiac safety margins with respect to those previously reported for the X26 CEWs when all three CEW models were operated with 9 mm CEW darts. Lastly, the cardiac risk of these new CEWs (<; 0.76 ppm) was found to be much lower than reported levels of CEW non-cardiac fatal injuries (e.g. falls and burns, > 7.2 ppm). Conclusions-While not risk-free, the new TASER XRF and X2 CEWs offer increased cardiac safety margins and extremely low cardiac risk profiles.

New conducted electrical weapons: Electrical safety relative to relevant standards.

INTRODUCTION: We have previously published about TASER® conducted electrical weapons (CEW) compliance with international standards. CEWs deliver electrical pulses that can inhibit a person's neuromuscular control or temporarily incapacitate. An eXperimental Rotating-Field (XRF) waveform CEW and the X2 CEW are new 2-shot electrical weapon models designed to target a precise amount of delivered charge per pulse. They both can deploy 1 or 2 dart pairs, delivered by 2 separate cartridges. Additionally, the XRF controls delivery of incapacitating pulses over 4 field vectors, in a rotating sequence. As in our previous study, we were motivated by the need to understand the cardiac safety profile of these new CEWs. The goal of this paper is to analyze the nominal electrical outputs of TASER XRF and X2 CEWs in reference to provisions of all relevant international standards that specify safety requirements for electrical medical devices and electrical fences. Although these standards do not specifically mention CEWs, they are the closest electrical safety standards and hence give very relevant guidance. METHODS: The outputs of several TASER XRF and X2 CEWs were measured under normal operating conditions. The measurements were compared against manufacturer specifications. CEWs electrical output parameters were reviewed against relevant safety requirements of UL 69, IEC 60335-2-76 Ed 2.1, IEC 60479-1, IEC 60479-2, AS/NZS 60479.1, AS/NZS 60479.2, IEC 60601-1 and BS EN 60601-1. RESULTS AND CONCLUSION: Our study confirmed that the nominal electrical outputs of TASER XRF and X2 CEWs lie within safety bounds specified by relevant standards.

New conducted electrical weapons: Thoracic cage shielding effects.

INTRODUCTION: The TASER® conducted electrical weapon (CEW) delivers electrical pulses that can temporarily incapacitate subjects. For existing CEW models, we have previously presented the distribution of currents in tissues posterior to the sternum and their likelihood of triggering cardiac arrhythmias. New models, the eXperimental Rotating-Field (XRF) waveform CEW (in development) and the X2 CEW (released) have not been investigated. Both the XRF and X2 CEWs target a precise amount of delivered charge per pulse, 64 µC and 62 µC, respectively. The goal of this study was to numerically model the thoracic cage attenuation of currents and electric fields delivered by the new CEWs and to find whether the heart is shielded from the induction of any dangerous arrhythmias. METHODS AND RESULTS: Finite element modeling (FEM) was used to approximate the current density and electric field strength in tissues around the thoracic cage. FEM boundary conditions were set to correspond to output waveforms of the new CEWs, the XRF and the X2. We analyzed a CEW dart deployment scenario that had both darts located over the anterior aspect of the sternum. We found that the sternum and thoracic cage provided significant attenuation of currents and electrical fields. CONCLUSION: The sternum and the thoracic cage significantly attenuated currents and electric fields delivered by XRF and X2 CEWs. These tissues `shielded' the heart against potentially dangerous cardiac arrhythmias. The shorter durations and reduced amount of charged delivered by the XRF and the X2 CEWs resulted in increased cardiac safety margins.

Validity of the small swine model for human electrical safety risks.

Small swine are the most common model now used for electrical safety studies. Because of the significant anatomical and electrophysiological differences and the effect of animal size on the ventricular fibrillation (VF) threshold, there are concerns that these differences may exaggerate the risks of electrical devices to humans. We chose, as an illustrative and relevant example, swine studies of the TASER® conducted electrical weapon (CEW) as it has numerous published VF studies. We reviewed the published electrical swine safety studies for CEWs and compared them to finite element modeling studies, electrical safety standards, and epidemiological experience from field usage. We also compared the body weights of the swine to those of law enforcement arrest-related deaths. Studies of small swine exaggerate the risks of CEWs to humans. This conclusion may be extrapolated to suggest that the use of small swine for electrical safety studies should be questioned in general.

The neurocognitive effects of simulated use-of-force scenarios.

While the physiologic effects of modern conducted electrical weapons (CEW) have been the subject of numerous studies, their effects on neurocognitive functioning, both short-term and long-term, are less well understood. It is also unclear how these effects compare to other use-of-force options or other arrest-related stressors. We compared the neurocognitive effects of an exposure to a TASER(®) (TASER International, Inc, Scottsdale, AZ) X26™ CEW to four other use-of-force scenarios during a training exercise using a well-established neurocognitive metric administered repeatedly over 1 h. Overall, we found that there was a decline in neurocognitive performance immediately post-scenario in all groups, but this effect was transient, of questionable clinical significance, and returned to baseline by 1 h post-scenario.