Physiological Effects of a Spit Restraint Device Saturated With Artificial Saliva.

BACKGROUND: Spit restraint devices, also referred to as spit hoods, spit masks, or spit socks, are used by law enforcement and medical personnel to minimize transmission of communicable disease from bodily fluids from agitated individuals. Several lawsuits have implicated spit restraint devices as contributing to the death of individuals who are physically restrained by means of asphyxiation due to saturation of the mesh restraint device with saliva. OBJECTIVES: This study aims to evaluate whether a saturated spit restraint device has any clinically significant effects on the ventilatory or circulatory parameters of healthy adult subjects. METHODS: Subjects wore a spit restraint device dampened with 0.5% carboxymethylcellulose, an artificial saliva. Baseline vitals were taken, and a wet spit restraint device was then placed over the subject's head, and repeat measurements were taken at 10, 20, 30, and 45 min. A second spit restraint device was placed 15 min after the first. Measurements at 10, 20, 30, and 45 min were compared with baseline using paired t-tests. RESULTS: The mean age of 10 subjects was 33.8 years, and 50% were female. There was no significant difference between baseline and while wearing the spit sock for 10, 20, 30, and 45 min for the measured parameters including heart rate, oxygen saturation, end-tidal CO2, respiratory rate, or blood pressure. No subject indicated respiratory distress or had to terminate the study. CONCLUSIONS: In healthy adult subjects, there were no statistically or clinically significant differences in ventilatory or circulatory parameters while wearing the saturated spit restraint.

Physiological effects of a spit sock.

OBJECTIVES: Healthcare providers and law enforcement utilize spit socks to prevent exposure to communicable diseases transmitted by bodily fluid projection from agitated individuals. There are cases in which death is reported due to breathing being limited by a spit sock. There are no formally published studies on their use and safety. The aim of this study was to evaluate whether wearing a spit sock causes a clinically significant impact on breathing. METHODS: Subjects sat with the spit mask over their heads for 15 min and their vital signs and ventilatory parameters were recorded after 5 min, 10 min and 15 min. Data were compared to baseline using Student's t-test with 95% confidence intervals using SPSS. RESULTS: The median age of the 15 subjects was 28 years and 53% were male. There was no significant difference between baseline and wearing the spit sock for 5, 10 or 15 min for heart rate (p = 0.250, p = 0.181, p = 0.546), oxygen saturation (p = 0.334, p = 1.00, p = 0.173), end-tidal pCO2 (p = 0.135, p = 0.384, p = 0.187), and diastolic blood pressure (p = 0.485, p = 0.508, p = 0.915). The respiratory rate was not significantly different after 5 and 10 min (p = 0.898, p = 0.583), but decreased at 15 min (p = 0.048). The systolic blood pressure was lower after 5 and 10 min (p = 0.028, p = 0.045), but not significantly different at 15 min (p = 0.146). No subject indicated distress nor did the study need to be terminated due to pre-determined concerning vital signs or ventilatory parameters. CONCLUSIONS: In healthy subjects there were no clinically significant changes in the physiologic parameters of breathing while wearing a spit sock.

Physiologic effects of the TASER after exercise.

OBJECTIVES: Incidents of sudden death following TASER exposure are poorly studied, and substantive links between TASER exposure and sudden death are minimal. The authors studied the effects of a single TASER exposure on markers of physiologic stress in humans. METHODS: This prospective, controlled study evaluated the effects of a TASER exposure on healthy police volunteers after vigorous exercise, compared to a subsequent, identical exercise session that was not followed by TASER exposure. Subjects exercised to 85% of predicted heart rate (HR) on an ergometer and then were given a standard 5-second TASER activation. Measures before and for 60 minutes after the TASER activation included minute ventilation, tidal volume, respiratory rate, end-tidal pCO(2), oxygen saturation, HR, blood pressure (systolic BP/diastolic BP), 12-lead electrocardiogram, and arterialized blood for pH, pO(2), pCO(2), and lactate. Each subject repeated the exercise and data collection session on a subsequent data, without TASER activation. Data were analyzed using paired Student's t-tests with differences and 95% confidence intervals (CIs). Statistical significance was adjusted for multiple comparisons. RESULTS: A total of 25 officers (21 men and 4 women) completed both portions of the study. After adjusting for multiple comparisons, the TASER group was significantly higher for systolic BP at baseline (difference of 14.1, 95% CI = 8.7 to 19.5, p < 0.001) and HR at 5, 30, and 60 minutes with the largest difference at 30 minutes (difference of 7.0, 95% CI = 2.5 to 11.5, p = 0.004). There were no other significant differences between the two groups in any other measure at any time. CONCLUSIONS: A 5-second exposure of a TASER following vigorous exercise to healthy law enforcement personnel does not result in clinically significant changes in ventilatory or blood parameters of physiologic stress.

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.

Thoracic spine compression fracture after TASER activation.

The TASER is a less lethal weapon seeing increased use by police jurisdictions across the country. As a result, subjects of TASER use are being seen with increasing frequency in emergency departments across the country. The potential injury patterns of the device are important for emergency physicians to understand. This report describes the case of an officer who complained of back pain after a single 5-s TASER discharge during a routine training exercise. Subsequent evaluation led to the diagnosis of an acute thoracic vertebral compression fracture. We discuss the potential mechanisms of injury in this case. Because we were unable to find any cases like this in our review of TASER-related injuries, we liken it to compression fractures that have been documented after seizures. We recommend that physicians consider obtaining back radiographs to rule out a vertebral compression fracture in any individual who has sustained a TASER discharge and has ongoing or persistent back pain.

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.