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Aaem Evaluations Needed Er Patients After Tasing July 2010

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Clinical Practice Statement:
What Evaluations Are Needed in Emergency Department Patients after a
TASER Device Activation? (7/12/10)
Reviewed and approved by the AAEM Clinical Practice Committee.
Chair:

Steven Rosenbaum, MD

Authors:

Gary M. Vilke, MD
Theodore C. Chan, MD
William P. Bozeman, MD

Reviewer:

Eric Bruno, MD
Jack Perkins, MD
Arasi Thangavelu, MD
Donald Dawes, MD
Mitch Heller, MD
Jeffrey Ho, MD

Reviewed and approved by the AAEM Board of Directors 1/11/2010.
Authors Who Have Disclosed No Conflict of Interest
Gary M. Vilke, MD
Theodore C. Chan, MD
William P. Bozeman, MD

Use of Conducted Energy Weapons (CEW) such as the TASER includes delivery of a
series of brief electrical pulses, which result in pain and muscular contractions. The
pulses may be delivered via a pair of sharp metal probes fired from the device,
commonly referred to as “probe mode”, or by direct contact with the front of the device,
commonly referred to as “drive stun” or “touch stun” mode.
The current human literature has not found evidence of dangerous laboratory
abnormalities, physiologic changes, or immediate or delayed cardiac ischemia or
dysrhythmias after exposure to CEW electrical discharges of up to 15 seconds.
Therefore the current medical literature does not support routine performance of
laboratory studies, EKGs, or prolonged Emergency Department (ED) observation or
hospitalization for ongoing cardiac monitoring after CEW exposure in an otherwise
asymptomatic awake and alert patient.
Testing for cardiac conduction or injury, or other physiologic effects of CEWs may be
appropriate in individual cases based on medical history such as cardiac problems or
symptoms like chest discomfort, shortness of breath or palpitations suggestive of
cardiac issues, pain suggesting muscle contraction injuries, or prolonged CEW
exposure >15 seconds. Coexisting conditions like intoxication, prolonged struggling,
altered mental status, or symptoms of excited delirium syndrome may also be present in
patients exposed to CEWs, although the CEW does not appear to be the precipitating
factor. Presence of these findings should prompt additional evaluation or treatment per
physician discretion.

For CEW activations in the probe mode, patients should be screened for injuries related
to the dart penetration or surface burns due to CEW use, as well as injuries associated
with falls and muscle contractions. Among patients who had a CEW activation in drive
stun or touch stun mode, evaluation should focus on skin manifestations, which are
typically limited to surface burns, also called signature marks.