Serum troponin I measurement of subjects exposed to the Taser X-26.

The Taser is a high-voltage, low-amperage conducted energy device used by many law enforcement agencies as a less lethal force weapon. The objective of this study was to evaluate for a rise in serum troponin I level after deployment of the Taser on law enforcement training volunteers. A prospective, observational cohort study was performed evaluating serum troponin I levels in human subjects 6 h after an exposure to the Taser X-26. Outcome measures included abnormal elevation in serum troponin I level (> 0.2 ng/mL). There were 66 subjects evaluated. The mean shock duration was 4.36 s (range 1.2-5 s). None of the subjects had a positive troponin I level 6 h after exposure. It was concluded that human volunteers exposed to a single shock from the Taser did not develop an abnormal serum troponin I level 6 h after shock, suggesting that there was no myocardial necrosis or infarction.

Twelve-lead electrocardiogram monitoring of subjects before and after voluntary exposure to the Taser X26.

OBJECTIVES: The Taser (Taser International, Scottsdale, Ariz) uses high-voltage electricity to incapacitate subjects. We sought to evaluate cardiac rhythm changes during deployment of the Taser on healthy volunteers. METHODS: This prospective study was performed on 32 healthy volunteer subjects receiving a Taser X26 discharge. The subjects had baseline 12-lead electrocardiogram (ECG) monitoring performed immediately before and within 1 minute after the Taser discharge. Changes in cardiac rhythm, morphology, and interval duration were evaluated. Descriptive statistics and paired-sample t test comparisons are reported. RESULTS: All 32 subjects had an interpretable 12-lead ECG obtained before and after the Taser activation, although 1 subject's post-PR interval could not be determined. The mean age and body mass index were 33 years and 26.5 kg/m2, respectively. Overall, there was a significant increase in heart rate (2.4; 95% confidence interval [CI], 0.0-4.9) and a decrease in PR interval (-6.5; 95% CI, -9.7 to -3.3). When stratified by sex, only the PR interval in men significantly decreased (-5.9; 95% CI, -9.2 to -2.5). There were significant changes in heart rate (4.0; 95% CI, 1.3-6.7), PR interval (-6.0; 95% CI, -11.3 to -0.7), and QT interval (-18.8; 95% CI, -33.2 to -4.3) among those with a normal body mass index, and in PR interval among those who were overweight/obese (-6.7; 95% CI, -10.8 to -2.5). None of the statistically significant differences between ECG measures were clinically relevant. CONCLUSIONS: There were no cardiac dysrhythmia and interval or morphology changes in subjects who received a Taser discharge based on a 12-lead ECG performed immediately before and within 1 minute after a Taser activation.

Physiological effects of a conducted electrical weapon on human subjects.

STUDY OBJECTIVE: Sudden death after a conducted electrical weapon exposure has not been well studied. We examine the effects of a single Taser exposure on markers of physiologic stress in healthy humans. METHODS: This is a prospective trial investigating the effects of a single Taser exposure. As part of their police training, 32 healthy law enforcement officers received a 5-second Taser electrical discharge. Measures before and for 60 minutes after an exposure included minute ventilation; tidal volume; respiratory rate (RR); end-tidal PCO2; oxygen saturation, pulse rate; blood pressure (systolic blood pressure/diastolic blood pressure); arterialized blood for pH, PO2, PCO2, and lactate; and venous blood for bicarbonate and electrolytes. Troponin I was measured at 6 hours. Data were analyzed using a repeated-measures ANOVA and paired t tests. RESULTS: At 1 minute postexposure, minute ventilation increased from a mean of 16 to 29 L/minute, tidal volume increased from 0.9 to 1.4 L, and RR increased from 19 to 23 breaths/min, all returning to baseline at 10 min. Pulse rate of 102 beats/min and systolic blood pressure of 139 mm Hg were higher before Taser exposure than at anytime afterward. Blood lactate increased from 1.4 mmol/L at baseline to 2.8 mmol/L at 1 minute, returning to baseline at 30 minutes. pH And bicarbonate decreased, respectively, by 0.03 and 1.2 mEq/L at 1 minute, returning to baseline at 30 minutes. All troponin I values were normal and there were no EKG changes. Ventilation was not interrupted, and there was no hypoxemia or hypercarbia. CONCLUSION: A 5-second exposure of a Taser X26 to healthy law enforcement personnel does not result in clinically significant changes of physiologic stress.

Cardiac monitoring of human subjects exposed to the taser.

The Taser (TASER International, Scottsdale, AZ) is a high-voltage, low-amperage device used by many law enforcement agencies. Our objective in this study was to evaluate for rhythm changes utilizing cardiac monitoring during deployment of the Taser on volunteers. A prospective, observational study evaluated law enforcement personnel who had continuous electrocardiographic monitoring immediately before, during, and after having a voluntary exposure to the Taser X-26. Changes in cardiac rate, rhythm, ectopy, morphology, and conduction intervals were measured. A total of 105 subjects were evaluated. The mean shock duration was 3.0 s (range 0.9-5 s). Mean heart rate increased 15 beats/min (95% CI 12.6-18.3), from 122 beats/min before shock to 137 beats/min immediately after shock. One subject had a single premature ventricular contraction both before and after the shock, but no other subject developed ectopy or dysrhythmia. Poor inter-rater agreement prevented determination of the overall effect of shock on conduction intervals. However, several interpretable tracings demonstrated change in QT duration-either shortening or prolongation after shock. Human subjects exposed to a brief shock from the Taser developed significant increases in heart rate, but there were no cardiac dysrhythmias or morphologic changes. Alterations in the QT interval were observed in some subjects but their true incidence and clinical significance are unknown.

How well do paramedics predict admission to the hospital? A prospective study.

A study was designed to determine whether paramedics accurately predict which patients will require admission to the hospital, and in those requiring admission, whether they will need a ward bed or intensive care unit (ICU) monitoring. This prospective, cross-sectional study of consecutive Emergency Medical Service (EMS) transport patients was conducted at an urban city hospital. Paramedics were asked to predict if the patient they were transporting would require admission to the hospital, and if so, whether that patient would be admitted to a ward bed or require an ICU bed. Predictions were compared to actual patient disposition. During the study period, 1349 patients were transported to our hospital. Questionnaires were submitted in 985 cases (73%) and complete data were available for 952 (97%) of these patients. Paramedics predicted 202 (22%) patients would be admitted to the hospital, of whom 124 (61%) would go the ward and 78 (39%) would require intensive care. The actual overall admission rate was 21%, although the sensitivity of predicting any admission was 62% with a positive prediction value (PPV) of 59%. Further, the paramedics were able to predict admission to intensive care with a sensitivity of 68% and PPV of 50%. It is concluded that paramedics have very limited ability to predict whether transported patients require admission and the level of required care. In our EMS system, the prehospital diversion policies should not be based solely on paramedic determination.

A positive domestic violence screen predicts future domestic violence.

The objective of this study was to determine if a brief screen for domestic violence (DV) predicts future violence. We conducted a cohort study of adult women who presented to an inner-city emergency department during an 8-week study period. Participants were screened for DV using the Partner Violence Screen (PVS). At 4 months, follow-up telephone interviews were conducted: rates of verbal and physical violence were measured using the modified Conflict Tactics Scale. Relative risks of violent events (physical and verbal) were calculated. Of the 215 women who enrolled, 36 (16%) had an initial screen positive for DV. Ninety-six women participated in the follow-up phase; of these women, 9% had screened positive for DV. At 4 months, women with DV were 11.3 times more likely to experience physical violence and 7.3 times more likely to experience verbal aggression. The study's screen identified women at high risk for subsequent physical violence and verbal aggression.

Psychological and social aspects of resilience: a synthesis of risks and resources.

It has been conventional wisdom that early deprivation and trauma can lead unequivocally to later adult debilitation and disorder. That this is not in fact the case has become abundantly clear via a variety of recent new research. While early adversity can be a severe impediment, there is a myriad of accounts of people who have been born into lives of abject destitution, yet have grown into stable, productive, and generative adults. There are certainly personal and social factors that increase the risks of frailty and failing. By the same token, these same risk factors can contribute to the enhancement of one's life, and increase the chances of resilience and of leading fulfilling lives. There is now evidence that society has the knovi/ledge to implement prevention and early intervention programs that foster and enhance personal development; the question is, does it have the will and commitment to do so?