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International Journal of Legal Medicine

, Volume 132, Issue 5, pp 1469–1475 | Cite as

Adrenergic and metabolic effects of electrical weapons: review and meta-analysis of human data

  • S. N. Kunz
  • H. G. Calkins
  • J. Adamec
  • M. W. Kroll
Review

Abstract

Introduction

Electronic control with the CEW (conducted electrical weapon) has gained widespread acceptance as the preferred force option due to its significant injury reduction. However, a CEW application does stress the human body. In the case of the CEW, the human body response is similar to the challenge of physical exercise combined with emotional stress over a very short time interval. There has been concern whether the tension of the skeletal-muscle system together with the emotional stress of being exposed to the effects of a CEW, can lead to severe metabolic dysfunction.

Methods

A systematic and careful search of the MedLine database was performed to find publications describing pathophysiological effects of CEWs. Additional publications were collected through a manual search of reference lists in retrieved articles. After preliminary exclusions, we carefully reviewed the remaining publications and found 24 papers reporting prospective human clinical research data on adrenergic, ventilation, or metabolic effects. Where there were multiple studies on the same endpoints, we performed meta-analyses.

Results

A CEW exposure provides a clinically insignificant increase in heart rate (7.5 BPM) and a drop in both systolic and diastolic blood pressure. Alpha-amylase goes down but cortisol levels increase—both epinephrine and norepinephrine levels are increased by levels similar to mild exercise. A CEW exposure increases ventilation but does not appear to interfere with gas exchange. Lactate is increased slightly while the pH is decreased slightly with changes equivalent to mild exercise. The lactate and pH changes appear quickly and do not appear to be affected by increasing the exposure duration from 5 to 30 s.

Conclusions

Thorough review and meta-analyses show that electrical weapon exposures have mixed and mild adrenergic effects. Ventilation is increased and there are metabolic changes similar to mild exercise.

Keywords

Forensic medicine Conducted electrical weapon Metabolic effects Catecholamines Biomarkers 

Notes

Compliance with ethical standards

Conflict of interest

This paper is a result of literature research, which was not funded. Kunz SN, Calkins H, and Kroll MW are members of the scientific medical advisory board of Axon Int. (fka TASER). Kroll MW also is on Axon corporate board. Calkins H and Kroll MK have been expert witnesses in law-enforcement litigation and Calkins H has been an expert witness in cases of arrest-related death involving CEWs. Adamec J has no conflict of interest to declare.

References

  1. 1.
    MacDonald JM, Kaminski RJ, Smith MR (2009) The effect of less-lethal weapons on injuries in police use-of-force events. Am J Public Health 99(12):2268–2274.  https://doi.org/10.2105/AJPH.2009.159616 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Eastman AL, Metzger JC, Pepe PE, Benitez FL, Decker J, Rinnert KJ, Field CA, FRIESE RS (2008) Conductive electrical devices: a prospective, population-based study of the medical safety of law enforcement use. J Trauma 64(6):1567–1572.  https://doi.org/10.1097/TA.0b013e31817113b9 CrossRefPubMedGoogle Scholar
  3. 3.
    Ferdik FV, Kaminski RJ, Cooney MD, Sevigny EL (2014) The influence of agency policies on conducted energy device use and police use of lethal force. Police Quarterly 17(4):328–358.  https://doi.org/10.1177/1098611114548098 CrossRefGoogle Scholar
  4. 4.
    Strote J, Walsh M, Angelidis M, Basta A, Hutson HR (2010) Conducted electrical weapon use by law enforcement: an evaluation of safety and injury. J Trauma 68:1239–1246CrossRefPubMedGoogle Scholar
  5. 5.
    Burton AR, Fazalbhoy A, Macefield VG (2016) Sympathetic responses to noxious stimulation of muscle and skin. Front Neurol 7:109CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Finsterer J (2004) Effect of needle-EMG on blood-pressure and heart-rate. J Electromyogr Kinesiol 14(2):283–286.  https://doi.org/10.1016/j.jelekin.2003.08.002 CrossRefPubMedGoogle Scholar
  7. 7.
    Lindgren K, Miner J, McGill J (2003) Correlation of heart rate and systolic blood pressure with reported pain. Paper presented at: ANNALS OF EMERGENCY MEDICINE 2003Google Scholar
  8. 8.
    Ho JD, Dawes DM, Bultman LL, Thacker JL, Skinner LD, Bahr JM, Johnson MA, Miner JR (2007) Respiratory effect of prolonged electrical weapon application on human volunteers. Acad Emerg Med 14(3):197–201.  https://doi.org/10.1111/j.1553-2712.2007.tb01772.x CrossRefPubMedGoogle Scholar
  9. 9.
    Levine SD, Sloane CM, Chan TC, Dunford JV, Vilke GM (2007) Cardiac monitoring of human subjects exposed to the TASER. J Emerg Med 33(2):113–117.  https://doi.org/10.1016/j.jemermed.2007.02.018 CrossRefPubMedGoogle Scholar
  10. 10.
    Ho JD, Dawes DM, Reardon RF, Lapine AL, Dolan BJ, Lundin EJ, Miner JR (2008) Echocardiographic evaluation of a TASER-X26 application in the ideal human cardiac axis. Acad Emerg Med 15(9):838–844.  https://doi.org/10.1111/j.1553-2712.2008.00201.x CrossRefPubMedGoogle Scholar
  11. 11.
    Vilke GM, Sloane C, Levine S, Neuman T, Castillo E, Chan TC (2008) Twelve-lead electrocardiogram monitoring of subjects before and after voluntary exposure to the Taser X26. Am J Emerg Med 26(1):1–4.  https://doi.org/10.1016/j.ajem.2007.01.005 CrossRefPubMedGoogle Scholar
  12. 12.
    Bozeman WP, Barnes DG Jr, Winslow JE 3rd, Johnson JC 3rd, Phillips CH, Alson R (2009) Immediate cardiovascular effects of the Taser X26 conducted electrical weapon. Emerg Med J 26(8):567–570.  https://doi.org/10.1136/emj.2008.063560 CrossRefPubMedGoogle Scholar
  13. 13.
    Dawes DM, Ho JD, Reardon RF, Miner JR (2010) Echocardiographic evaluation of TASER X26 probe deployment into the chests of human volunteers. Am J Emerg Med 28(1):49–55.  https://doi.org/10.1016/j.ajem.2008.09.033 CrossRefPubMedGoogle Scholar
  14. 14.
    Ho JD, Dawes DM, Nelson RS, Lundin EJ, Ryan FJ, Overton KG, Zeiders AJ, Miner JR (2010) Acidosis and catecholamine evaluation following simulated law enforcement “use of force” encounters. Acad Emerg Med 17(7):e60–e68.  https://doi.org/10.1111/j.1553-2712.2010.00813.x CrossRefPubMedGoogle Scholar
  15. 15.
    Ho JD, Dawes DM, Reardon RF, Strote SR, Kunz SN, Nelson RS, Lundin EJ, Orzco BS, Miner JR (2011) Human cardiovascular effects of a new generation conducted electrical weapon. Forensic Sci Int 204(1-3):50–57.  https://doi.org/10.1016/j.forsciint.2010.05.003 CrossRefPubMedGoogle Scholar
  16. 16.
    Vanmeenen KM, Lavietes MH, Cherniack NS, Bergen MT, Teichman R, Servatius RJ (2013) Respiratory and cardiovascular response during electronic control device exposure in law enforcement trainees. Front Physiol 4:78.  https://doi.org/10.3389/fphys.2013.00078 CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Dawes DM, Ho JD, Vincent AS, Nystrom PC, Moore JC, Steinberg LW, Tilton AM, Brave MA, Berris MS, Miner JR (2014) The neurocognitive effects of simulated use-of-force scenarios. Forensic Scio Med Pathol 10(1):9–17.  https://doi.org/10.1007/s12024-013-9510-y CrossRefGoogle Scholar
  18. 18.
    Vilke GM, Sloane CM, Bouton KD, Kolkhorst FW, Levine SD, Neuman TS, Castillo EM, Chan TC (2007) Physiological effects of a conducted electrical weapon on human subjects. Ann Emerg Med 50(5):569–575.  https://doi.org/10.1016/j.annemergmed.2007.05.004 CrossRefPubMedGoogle Scholar
  19. 19.
    Vilke GM, Sloane CM, Suffecool A, Kolkhorst FW, Neuman TS, Castillo EM, Chan TC (2009) Physiologic effects of the TASER after exercise. Acad Emerg Med 16(8):704–710.  https://doi.org/10.1111/j.1553-2712.2009.00458.x CrossRefPubMedGoogle Scholar
  20. 20.
    Dawes DM, Ho JD, Reardon RF, Miner JR (2010) The cardiovascular, respiratory, and metabolic effects of a long duration electronic control device exposure in human volunteers. Forensic Sci Med Pathol 6(4):268–274.  https://doi.org/10.1007/s12024-010-9166-9 CrossRefPubMedGoogle Scholar
  21. 21.
    Ho J, Dawes D, Miner J, Moore J, Nystrom P (2014) Neurocognitive effect of simulated resistance and use of force encounters on standardized field sobriety testing. J Emerg Med 46:283CrossRefGoogle Scholar
  22. 22.
    Dawes D, Ho J, Miner J (2009) The neuroendocrine effects of the TASER X26: a brief report. Forensic Sci Int 183(1-3):14–19.  https://doi.org/10.1016/j.forsciint.2008.09.015 CrossRefPubMedGoogle Scholar
  23. 23.
    Dawes DM, Ho JD, Reardon RF, Strote SR, Nelson RS, Lundin EJ, Orozco BS, Kunz SN, Miner JR (2010) The respiratory, metabolic, and neuroendocrine effects of a new generation electronic control device. Forensic Sci Int 207:55–60CrossRefPubMedGoogle Scholar
  24. 24.
    Ho JD, Dawes DM, Nystrom PC, Collins DP, Nelson RS, Moore JC, Miner JR (2013) Markers of acidosis and stress in a sprint versus a conducted electrical weapon. Forensic Sci Int 233(1-3):84–89.  https://doi.org/10.1016/j.forsciint.2013.08.022 CrossRefPubMedGoogle Scholar
  25. 25.
    Jauchem JR, Sherry CJ, Fines DA, Cook MC (2006) Acidosis, lactate, electrolytes, muscle enzymes, and other factors in the blood of Sus scrofa following repeated TASER exposures. Forensic Sci Int 161(1):20–30.  https://doi.org/10.1016/j.forsciint.2005.10.014 CrossRefPubMedGoogle Scholar
  26. 26.
    Dennis AJ, Valentino DJ, Walter RJ, Nagy KK, Winners J, Bokhari F, Wiley DE, Joseph KT, Roberts RR (2007) Acute effects of TASER X26 discharges in a swine model. J Trauma 63(3):581–590.  https://doi.org/10.1097/TA.0b013e3180683c16 CrossRefPubMedGoogle Scholar
  27. 27.
    Ho J, Lapine A, Joing S, Reardon R, Dawes D (2008) Confirmation of respiration during trapezial conducted electrical weapon application. Acad Emerg Med 15:398CrossRefPubMedGoogle Scholar
  28. 28.
    Dawes DM, Ho JD, Reardon RF, Sweeney JD, Miner JR (2010) The physiologic effects of multiple simultaneous electronic control device discharges. West J Emerg Med 11(1):49–56PubMedPubMedCentralGoogle Scholar
  29. 29.
    Ho JD, Dawes DM, Bultman LL, Moscati RM, Janchar TA, Miner JR (2009) Prolonged TASER use on exhausted humans does not worsen markers of acidosis. Am J Emerg Med 27(4):413–418.  https://doi.org/10.1016/j.ajem.2008.03.017 CrossRefPubMedGoogle Scholar
  30. 30.
    Ho JD, Dawes DM, Cole JB, Hottinger JC, Overton KG, Miner JR (2009) Lactate and pH evaluation in exhausted humans with prolonged TASER X26 exposure or continued exertion. Forensic Sci Int 190(1-3):80–86.  https://doi.org/10.1016/j.forsciint.2009.05.016 CrossRefPubMedGoogle Scholar
  31. 31.
    Moscati R, Ho JD, Dawes DM, Miner JR (2010) Physiologic effects of prolonged conducted electrical weapon discharge in ethanol-intoxicated adults. Am J Emerg Med 28(5):582–587.  https://doi.org/10.1016/j.ajem.2009.02.010 CrossRefPubMedGoogle Scholar
  32. 32.
    Ho JD, Miner JR, Lakireddy DR, Bultman LL, Heegaard WG (2006) Cardiovascular and physiologic effects of conducted electrical weapon discharge in resting adults. Acad Emerg Med 13(6):589–595.  https://doi.org/10.1111/j.1553-2712.2006.tb01016.x CrossRefPubMedGoogle Scholar
  33. 33.
    VanMeenen KM, Cherniack NS, Bergen MT, Gleason LA, Teichman R, Servatius RJ (2010) Cardiovascular evaluation of electronic control device exposure in law enforcement trainees: a multisite study. J Occup Environ Med 52(2):197–201.  https://doi.org/10.1097/JOM.0b013e3181cc58ba CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • S. N. Kunz
    • 1
  • H. G. Calkins
    • 2
  • J. Adamec
    • 3
  • M. W. Kroll
    • 4
    • 5
  1. 1.Department of Forensic PathologyLandspítali University HospitalReykjavikIceland
  2. 2.Johns Hopkins Medical InstitutionsBaltimoreUSA
  3. 3.Institute of Forensic MedicineLudwig-Maximilian UniversityMunichGermany
  4. 4.Department of Biomedical EngineeringUniversity of MinnesotaMinneapolisUSA
  5. 5.California Polytechnical InstituteSan Luis ObispoUSA

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