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Taser Injury - The Stunning Truth

Taser injury often happens in prisons and the correctional nurse should deal with the effects. Here is the truth about taser injury.

Joyce is working at the local county jail on Friday night when a man-down code is called for the booking area. She arrives to find an obese disheveled male lying face-down on the floor being cuffed by one of the deputies. The booking hall looks as disheveled as the man, who is now the center of activity. Another deputy tells you that the individual had ‘freaked out’ during the intake process and after attempts to de-escalate the situation; a Taser was used on him. No health screening has been completed.

Tasers, or ‘stun guns’, are used by many law enforcement agencies to temporarily incapacitate individuals when other, lesser, de-escalation or uses of force are ineffective. Guidelines for officers and for clinicians have been published that can help correctional nurses, like Joyce, determine an assessment and plan of care for Taser activation.

Tasers, also called Electronic Control Weapons (ECW), are battery-operated hand-held units that fire two barbed electrodes up to 35 feet. These electrodes are connected to the unit by copper wires and deliver a pulse of up to 50,000 volts of electricity that temporarily disrupts electrical conduction in the body. Once jolted, the individual falls to the ground and is unable to think or move for a short period of time.

Assessing the Taser Effect

As with any medical condition, nurses need to assess the immediate and ongoing effect of the Taser shock. Disrupted electrical conduction affects all muscles causing uncontrolled contraction during the time of the impulse. Heart and brain activity should be considered.
  • Assess airway, breathing, and circulation at the scene. Joyce’s patient is face down with officer’s weight on his back as he is cuffed. Positional asphyxia is a concern.
  • Consider injuries due to the de-escalation process and any other uses of force during the event. For example, Joyce needs to evaluate for trauma caused by the fall and hear a review of the pre-Taser interventions. Get as much information as possible about the context of the event to help interpret assessment findings. For example, find out if there was extensive physical struggling with the individual prior or during the use of the Taser.
  • Locate the Taser barb entry points – there will be at least 2 – and determine if any vital areas are affected. Special concern is needed if the barb entry is near an eye, on the face or neck, or in the breast, axilla or genital areas.
  • Find out how long and how many stuns were used in the incident. Increased risk of after effects are found with a cumulative use of over 15 seconds.
  • Discover as much about the individuals medical history as possible. Joyce did not have a medical chart in this situation, but another patient might have a chart indicating any past medical history important to the evaluation such as mental illness, heart condition, or current drug and alcohol use.
Treating the Taser Wound

Superficial skin injury and surface burns are the most frequent direct injury of Taser activation. Before making contact with your patient, be sure the Taser device is no longer active. Wear gloves and expose the two or more barbs attached to the skin. If these barbs are in any of the sensitive areas indicated above, it is strongly advised that they be removed by medical providers in an emergency room setting.
  • Disconnect the darts from the Taser cartridge by bending and snapping the copper wire.
  • Next, grasp the frame of the dart between your thumb and index finder and pull directly up from the skin surface. This will minimize any further skin damage.
  • Carefully dispose of the dart as a sharp in standard sharps container or, if needed for evidence, possibly thread the dart into the Taser cartridge and provide to the appropriate security individual.
  • Inspect the wound, clean with an alcohol pad, and apply a sterile dressing. A Band-Aid is acceptable.
Monitoring At-Risk Patients

Generally speaking, healthy individuals recover quickly from a stun-gun experience without lasting effect. However, a National Institute of Justice Study found that Taser use was implicated in the death of 200 individuals. Ongoing monitoring is recommended for several high risk categories of patients:
  • Cardiac Disease: A weakened cardiac system may not withstand a Taser shock. Take all reports of chest pain and shortness of breath seriously. EKG monitoring may be advisable for those with a history of arrhythmias.
  • Pregnancy: Pregnant or potentially pregnant females need added attention. In the former, obstetric evaluation soon after the event is warranted. In the latter, pregnancy testing should be performed.
  • Medical/Mental Health Crisis: The electrical voltage of Taser activation can exacerbate a crisis situation. An individual in active crisis due to amphetamine drug use, asthma, or excited delirium can tip over the edge after this intervention.
The use of Tasers has decreased officer and suspect injury but is not without risk. Correctional nurses who work in facilities that employ this technology are called upon to assess and treat the physical results of deployment. Joyce had a busy Friday night but her patient pulled through the experience without incident due to her assessment and interventions.

Have you had an experience assessing and treating a patient after a Taser device activation? Do you have a written treatment protocol? Share your experiences in the comments section of this post.

Special thanks to Margaret Collatt, Training and Development Specialist with the Oregon Department of Corrections, for sharing ODOC Taser Dart Removal protocols.

Photo Credit: © aijohn784 – Fotolia.com

This post originally appeared in CorrectionalNurse.Net

Guest post by Dr. Lorry Schoenly nurse author and educator specializing in the field of correctional health care. She has written 6 continuing education courses especially for the Correctional Healthcare Campus.

Correctional Healthcare Processes
Safety in the Correctional Setting
The Correctional Healthcare Patient and Environment
Medication Administration in the Correctional Setting
Risk and Documentation in the Correctional Setting
Special Issues in Corrections

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Posted: 6/14/2016 11:01:00 PM
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