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

- Rogue Medic

TASER or Glock – Which treatment do you choose?

 

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.

Footnotes:

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

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

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

[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

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

[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

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

[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.

[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.

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

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Comments

  1. If I had to choose a Taser or a Glock.I personally opt for the Taser.I can get over being shot by the Taser.But the likely hood of recovery from the Glock shot,are not so good.I found you through A.D.

  2. RM, In light of your recent post there are swirling rumors that the committee of OLMC Physicians is considering an emergency revision to protocol banning the very dangerous oxygen.

  3. There are some things that are better than others. In breathing, oxygen is better than water. In circulation, blood is better than air. In subduing EDP patients, tasers are better than glocks as you point out.Of course those of a different opinion are usually looking at the EDPs from behind a glass window like in a zoo. I say remove the critics from the comfy environments, drop them into the PJs for a minute, and let’s see just how long they maintain that opinion.I give them 45 seconds.

  4. NYC Watchdog,That is part of the message I try to communicate in The Joy of Naloxone (Narcan).

  5. I have been shot by a taser. I did not like it. I will ABSOLUTELY do it again. The effects are gone immediately after the taser has finished its cycle or is turned off. I have shot two dogs with tasers. I would utterly have been in the right to have shot them with my pistol. Instead, I tazed them. Doing so did more than save the lives of the dogs– it kept me from sending bullets downrange while standing in a residential neighborhood. We have to think of the vicarious liability, as well.

  6. Oh, and here’s a question: why are NONE of the deaths proximal to all of the police officers that are voluntarily tazed every year? That’s a huge sample of uses, many of which are on video, yet NO training deaths have occured from Tasers, to the best of my knowledge? If it were so dangerous on its own basis, wouldn’t we be seeing the odd cop keel over dead?

  7. One reason given for the lack of proximal LEO deaths is that they are expected to be healthier than the average person.Many of the proximal deaths are in people who have drugs on board.It is probably not the best plan to consume enough cocaine that you act in a crazed fashion if you are about to be TASED.What is an expected LEO response to being told you are to be shocked with a TASER as a part of the job?Go out and get high?Not with your typical police officer.The police are not often shocked with the TASER except when it is a part of training and in a controlled environment.Used on less healthy people, under less controlled circumstances, and with a variety of pharmaceuticals on board (legal or not or both) should produce results that are not as positive for the recipient of the shock.This is no reason to avoid using the TASER.There are many people who die in custody. If similar numbers of LEOs were subjected to the same custody conditions, it would be expected that there would NOT be deaths in the LEO group.Should police be prevented from taking people into custody because some die while in custody?Should the police only be permitted to take those able to pass the police physical into custody?How far do we go to prevent people from taking responsibility for their own behavior?Does this do anything other than endanger responsible people?

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