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Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

TASER or Glock, addendum

Tue, 18 Mar 2008 19:06:00 -0400 by
 

I was not suggesting that the TASER be used to manage inconveniences.

The TASER should be used when the option (in the mind of the peace officer) is shooting the misbehaving person or allowing the misbehaving person to injure someone (civilian, police, or themselves).

As for the suggestion that the police “just shoot them in the leg,” there are plenty of sites that explain clearly what is required for police to use of deadly force. Unfortunately, I am not familiar with them. If you know of any good sites, please mention them in the comments to one of these posts.

I also wrote about this here:
 

TASER or Glock – Which treatment do you choose?

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Filed Under: Heresy, TASER

TASER or Glock – Which treatment do you choose?

Tue, 18 Mar 2008 07:14:00 -0400 by
 

Ambulance Driver is trying to dispel the misinformation about firearms and GSWs[1]. I figured it was a good time to vent a few things that have been bugging me about TASER coverage in the media. It seems to be an area rife with misinformation.

Recently, on the The Diane Rehm Show, the topic of discussion was the TASER[2]. The guests on the show were Thomas P. Smith, chairman of the board and co-founder, Taser International; Dalia Hashad, director of Amnesty International USA’s domestic human rights program; Lorie Fridell, associate professor of criminology, University of South Florida; Michael Berkow, Chief of Police, Savannah, Georgia (by telephone).

The show began with a discussion of a recent death that was proximate to use of a TASER. Diane Rehm stated that recently:
 

the United Nations Committee Against Torture[3] expressed concern that TASERs cause extreme pain, constitute a form of torture, and could cause death.[4]

 

Here is the main objection that seems to be leveled at TASERs – they can be misused.

Jeepers! Is there anything that cannot be misused?

What about water (wet stuff, makes up most of the human body, without it we would die)?

Water cannot be misused!
 

With recent emphasis on increased water intake during exercise for the prevention of dehydration and exertional heat illness, there has been an increase in cases of hyponatremia related to excessive water intake. This article reviews several recent military cases and three deaths that have occurred as a result of overhydration, with resultant hyponatremia and cerebral edema.[5]

 

So, the obvious response must have been to prohibit the use of water by military personnel.

No, they adjusted their training to include better education about proper hydration.

They seem to be capable of learning from their mistakes.

But what about oxygen (20 – 21% of the air at sea level, without it we die)?

Oxygen cannot be misused!

In one study, with high concentrations of oxygen the activity of the patients:
 

closely resemble those of grand mal epilepsy, and show similar electroencephalogram (EEG) patterns. If the excess PO2 exposure is not quickly ended, severe convulsions can lead to death.[6]

 

The effects of aging are often due to oxidative stress. Also, some diseases such as atherosclerosis, Alzheimer’s disease, Parkinson’s disease, and others have been linked to oxidative stress and free radical induction. Thus, the evolving thought is that, in some conditions, high concentrations of oxygen can be harmful.[7]

 

So, oxygen is not completely safe, either.

I think that I am beginning to understand – nothing can be made completely safe.

OK, but we still need to avoid creating dangerous situations; giving the jack-booted thugs these TASERs is clearly asking for trouble.

Regardless of foot wear, the police have a good record of protecting the public. Giving them one more tool to avoid using lethal force is helping to protect the public.

One famous case from New York City in 1984 is a perfect example of where a person died because the police did not have TASERs.
 

In 1984, a 66-year-old woman named Eleanor Bumpurs, four months behind in the $98.65 rent at her Bronx apartment, threatened housing workers who came to evict her that she would hurl boiling lye at the next face at her door. Officers arrived with shields and a special Y-shaped bar used to pin people to the wall, but the woman, almost 300 pounds and naked, fought her way free, waving a knife and trying to slash an officer. His partner shot her twice with a shotgun, once in the hand and once, fatally, in the chest.[8]

 

A little background. At the time the police would use nets and shields to corner and restrain violent people considered crazy. When EMS calls for help we expect the police to show up; when the police call for help they expect ESU (Emergency Services Unit) to show up. ESU was called for by the housing police. ESU are the most experienced at dealing with violence in NYPD.

The right people?

Yes.

As an EMS provider, if she is violent and armed she is not receiving medical care from me until she is restrained.

If someone is close enough to stab me with a knife – the 10″ knife she had, or a little paring knife – please shoot her to keep her from stabbing me. If I am close enough to get stabbed it is probably my fault, but that doesn’t mean she shouldn’t get shot and I should get stabbed.

One way to avoid this problem is to use the TASER or similar devices.

If I am experiencing agitated delirium and am perceived as a threat to those around me –

Please, TASE me, Bro!

Do not shoot me with a gun.

Based on my experience treating patients, being shot by bullets is not preferable to being shocked with a TASER or any similar device.

What part of this is hard to understand?

If you attack the police with a knife, you should expect to be shot.

The entertaining part of the Diane Rehm Show came when Dalia Hashad stated that the proof that TASERs are misused is

* (Danger – stupidity’s going to sneak up on you warning) *
 

of all the cases we have seen of people who have died after being shot with the TASER, none of them had a firearm.[4]

WTF?

If someone is pointing a gun at a civilian, or at the police, the police should use a gun to shoot the person with the gun.

In the movies people point guns at each other, but don’t shoot right away. If you do this without a script do not expect to be talking about it afterward.

Someone has a gun in his hand.

You run a bunch of electricity through the person.

The muscles contract.

If the person with the gun has a finger on the trigger and the muscles contract . . . .

Have we done a good thing?

Another of Dalia Hashad’s foolish statements was that a police officer used a TASER on someone who was in a swamp. The statement was:
 

That’s not a good thing to do, to shoot 50,000 volts of electricity into an individual who is in water.[4]

 

Is the water going to increase the voltage? The TASER is designed to deliver a lot of electricity into the person. My only concern – no it isn’t that the current will disable me if, I am in the water – is that the person may fall in a way that his/her airway ends up under the water, but that should be relatively easy to manage.

The person standing in the water is probably less affected by the electricity, since it may disperse more than desired for optimal use. This is not at all like dropping a hair dryer in a tub of water, while there is a person in the water.

Again Dalia Hashad:
 

I think what we need to concentrate on is where TASER is used inappropriately – and that is the vast majority of cases.

In Houston, the study that went on that reviewed the first thousand cases of the TASER being deployed out in the field; out of that, the first 900 people, on whom TASERs were used, were never convicted of any crime. Now, that’s really serious.[4]

 

If the problem is psychiatric, should the person be convicted of a crime?

If the problem is psychiatric, does that mean the person is harmless and TASER use is wrong?

Many of the problems are from use on people who are passively resisting the police – just sitting there, not getting up to walk with the police to the police car or away from the scene.

Everyone seemed to agree that this is not appropriate use.

So, the biggest problem, other than the deaths in custody, is due to misunderstanding of appropriate use, poor training, or willful misuse.

This is pretty much the same problem we have with any other tool that can be misused (e.g. all tools).

Rules of use should be based on when it is likely to make a difference by improving the outcome, training should be improved, and willful misuse should be punished; the same as with anything else.

And one study that would be conclusive, if any IRB were to approve it:
 

An observational study of the effects of TASER vs Glock.

The subjects in the TASER group stated that they were grateful that they were not in the Glock group. The subjects in the Glock group did not respond, representatives of the estates of the Glock subjects expressed some displeasure with the methodology employed and with the results of the study. They really thought that their family members would be better off being saved from the TASER.

CONCLUSION: Please, TASE me, Bro!
Medic, R., Peel, D.
Journal of Lambasted Leather, 5150, pp. 10-13.

 

TASER responded to the UN torture statement with their own statement.[9]

Popular Mechanics published their own story on the hub-bub.[10]

These arguments to ban TASERs are similar to the ones that are made to avoid having EMS chemically sedate combative patient or to avoid managing pain appropriately – too much emphasis on the side effects and an illogical refusal to consider the benefits.

I also wrote about this here:

TASER or Glock, addendum

Due to dead links, this page was updated 7/31/09.

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Footnotes:

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[1] Calling All Gun Bloggers and Med Bloggers
A Day in the life of an Ambulance Driver
Article

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[2] TASER.org
Web site
TASER stands for “Tom A. Swift’s Electric Rifle.”

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[3] United Nations Committee Against Torture
Committee Against Torture Hears Responses Of Portugal
15 November 2007
UN Press Release

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[4] TASER Debate
12/05/2007
The Diane Rehm Show
NPR (National Public Radio)
The guests on the show were:
Thomas P. Smith, chairman of the board and co-founder, Taser International; Dalia Hashad, director of Amnesty International USA’s domestic human rights program; Lorie Fridell, associate professor of criminology, University of South Florida; Michael Berkow, Chief of Police, Savannah, Georgia (by telephone).
Audio
Web page

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[5] Death by water intoxication
Gardner JW.
Mil Med. 2002 May;167(5):432-4.
PMID: 12053855 [PubMed – indexed for MEDLINE]

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[6] Patty’s Toxicology Volumes 1-9 5th ed.
Bingham, E.; Cohrssen, B.; Powell, C.H.;
John Wiley & Sons.
New York, N.Y. (2001).,
p. 3:672

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[7] The Oxygen Myth?
Bryan E. Bledsoe, DO, FACEP
JEMS.com Another Perspective
2009 Mar 5
Article

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[8] When Mental Illness Meets Police Firepower; Shift in Training for Officers Reflects Lessons of Encounters Gone Awry
NY Times
By Michael Wilson
Sunday, December 28, 2003
Article

This article contains many other examples of people who would probably be alive if a TASER had been used.

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[9] TASER: UN Committee Against Torture is Out of Touch With Law Enforcement Worldwide
TASER
Nov 28, 2007
Press releases – the original press release is no longer available on the web site.

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[10] Taser Fires Back at U.N. Anti-Torture Committee: Analysis
By Erik Sofge
November 28, 2007
Popular Mechanics
Article

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Filed Under: Excited Delirium, Heresy, Irrational Government Oversight, Sedation, TASER
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