Cardiac stimulation with high voltage discharge from stun guns

Snakebite: When the Human Touch Becomes a Bad Touch

Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood. Tens of thousands of lives are lost to snakebites each year and hundreds of thousands of people will survive with some form of permanent damage and reduced work capacity. These numbers are well recognized as being gross underestimations due to poor to non-existent record keeping in some of the most affected areas. These underestimations complicate achieving the proper recognition of snakebite’s socioeconomic impact and thus securing foreign aid to help alleviate this global crisis. Antivenoms are expensive and hospitals are few and far between, leaving people to seek help from traditional healers or use other forms of ineffective treatment. In some cases, cheaper, inappropriately manufactured antivenom from other regions is used despite no evidence for their efficacy, with often robust data demonstrating they are woefully ineffective in neutralizing many venoms for which they are marketed for. Inappropriate first-aid and treatments include cutting the wound, tourniquets, electrical shock, immersion in ice water, and use of ineffective herbal remedies by traditional healers. Even in the developed world, there are fundamental controversies including fasciotomy, pressure bandages, antivenom dosage, premedication such as adrenalin, and lack of antivenom for exotic snakebites in the pet trade. This review explores the myriad of human-origin factors that influence the trajectory of global snakebite causes and treatment failures and illustrate that snakebite is as much a sociological and economic problem as it is a medical one. Reducing the incidence and frequency of such controllable factors are therefore realistic targets to help alleviate the global snakebite burden as incremental improvements across several areas will have a strong cumulative effect.

Acute pathophysiological influences of conducted electrical weapons in humans: A review of current literature

Conducted electrical weapons (CEWs) deliver short high-voltage, low current energy pulses to temporarily paralyze a person by causing muscular contraction. The narrative of this article is a methodical analysis on acute pathophysiological changes within the central nervous system, cardiovascular, neuroendocrine, sympatho-adrenergic and muskuloskeletal system which can occur after application of conducted electrical weapons on human subjects. The results are based on wide-ranging literature analysis and source studies. The majority of the recent scientific publications on humans classify the health risks of an appropriate use of the CEWs device as minor. However, there still is an uncertainty about possible side-effects of these devices. Therefore medical supervision with human application is advised.

Cardiac fibrillation risk of TASER X-26 dart mode application

In view of reported fatalities there are still controversial discussions on whether electronic stun law enforcement weapons can cause cardiac fibrillation. Experimental data are contradictory. Simplified theoretical estimations led to a negligible low risk of 8.10(-7). With a detailed numerical-anatomical model of an adult man (NORMAN) cardiac exposure to Taser X26 high-tension pulses was quantitatively assessed and the fibrillation risk estimated by accounting for its dependence on excited volume based on 3D cardiac exposure patterns. For distance mode and worst case dart hits it could be demonstrated that cardiac exposure can reach the 30% fibrillation risk level. Risk reduces considerably if direct current flow across the heart is prevented. The overall fibrillation risk of Taser application is further reduced by the limited probability of critical hits. However, in agreement with experimental findings it is demonstrated that cardiac fibrillation risk of Taser X26 dart mode application is small, however, not negligible.

Numerically simulated cardiac exposure to electric current densities induced by TASER X-26 pulses in adult men

There is still an ongoing debate whether or not electronic stun devices (ESDs) induce cardiac fibrillation. To assess the ventricular fibrillation risk of law enforcing electronic control devices, quantitative estimates of cardiac electric current densities induced by delivered electric pulses are essential. Numerical simulations were performed with the finite integration technique and the anatomical model of a standardized European man (NORMAN) segmented into 2 mm voxels and 35 different tissues. The load-dependent delivery of TASER X-26 pulses has been taken into account. Cardiac exposure to electric current densities of vertically and horizontally aligned dart electrodes was quantified and different hit scenarios compared. Since fibrillation thresholds critically depend on exposed volume, the provided quantitative data are essential for risk assessment. The maximum cardiac rms current densities amounted to 7730 A m(-2). Such high current densities and exposed cardiac volumes do not exclude ventricular fibrillation.

TASER conducted electrical weapons and implanted pacemakers and defibrillators

INTRODUCTION

Conducted electrical weapons (CEW) have generated controversy in recent years regarding their effect on heart rhythm and on their suspected interaction with implanted devices such as the pacemakers and ICDs (implantable cardioverter defibrillators). We review the current evidence available on device interactions and pre-sent a new case series of 6 patients.

LITERATURE

We used the available case reports and animal studies on TASER or CEW related publications in PubMed.

CONCLUSION

Oversensing of TASER CEW discharges may cause noise reversion pacing in pacemakers and inappropriate detection of VF in ICDs. The nominal 5-second discharge is sufficiently short that neither clinically significant inhibition of bradycardia pacing nor inappropriate ICD shocks have been reported. Current evidence indicates that CEW discharges do not have adverse effects on pacemakers and ICDs.

Generalized tonic-clonic seizure after a taser shot to the head

During a police chase on foot, a previously well police officer was hit mistakenly by a taser shot meant for the suspect. The taser gun had been fired once, sending 2 barbed darts into his upper back and occiput. Within seconds, the officer collapsed and experienced a generalized tonic-clonic seizure with loss of consciousness and postictal confusion. Subsequent magnetic resonance imaging scans of the head and electroencephalograms were normal. The patient has experienced no recurrence of seizure over more than a year of follow-up. This report shows that a taser shot to the head may result in a brain-specific complication such as generalized tonic-clonic seizure. It also suggests that seizure should be considered an adverse event related to taser use.