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TASER-Einsatz – ein notfallmedizinisches Problemfeld?

TASER—a problem in emergency medicine?

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Zusammenfassung

Beim TASER handelt es sich um eine Elektroschockwaffe (engl. Conducted Electrical Weapon, CEW), aus der zwei kleine Pfeile auf eine eigen- oder fremdgefährdende Person mit dem Ziel der Immobilisation verschossen werden. Bis zu einer Distanz von 10,6 m sind diese Pfeile über feine Drähte mit der Waffe verbunden und führen durch die Abgabe elektrischer Impulse mit durchschnittlich 1,9 mA und einer Spitzenspannung von 1900 V zur Unterbindung von Muskeleigenbewegungen der Zielperson. Während der Bewegungsunfähigkeit kann die Person dann von Polizei- oder Sicherheitspersonal überwältigt werden. Als Nebenwirkungen können im Moment des Einwirkens u. a. Herzrhythmusstörungen auftreten. Allerdings sind Verletzungen durch einen unkontrollierten Sturz der Zielperson infolge der Bewegungsunfähigkeit, Immobilisationstechniken, vorbestehende psychiatrische Erkrankungen oder eine akute (Drogen‑)Intoxikation deutlich häufiger der Vorstellungsgrund in der Notfallaufnahme als die Arrhythmien. Im notfallmedizinischen Management nach einem TASER-Einsatz sind daher die Erhebung einer Anamnese, die klinische Untersuchung zur Detektion von Verletzungen und der Ausschluss einer Eigen- oder Fremdgefährdung ebenso wichtig wie die Ableitung eines 12-Kanal-EKG. Bei einem unauffälligen 12-Kanal-EKG ist auch im weiteren Verlauf nicht mit TASER-assoziierten Herzrhythmusstörungen zu rechnen. Der vorliegende Beitrag gibt anhand eines Fallbeispiels und der Diskussion der Literatur Empfehlungen für das notfallmedizinische Management nach einem TASER-Einsatz.

Abstract

A TASER is a conducted electrical weapon shooting two small darts which stay connected to the weapon along small wires allowing an electrical impulse of 1.9 mA and up to 1900 V to be used against an aggressive person preventing controlled muscle movement at a distance of up to 10.6 m. The electric current may cause cardiac arrhythmias, but injuries due to uncontrolled falls and pre-existing (drug) intoxications lead to hospital admissions more often than arrhythmias do. Handling of tasered person includes medical history as well as clinical examination to detect any injuries or hints of endangerment to self or others and finally a 12-lead electrocardiogram (ECG). If the 12-lead ECG of a tasered person does not show any pathologic findings, there is no need for further monitoring or hospital admission, beside injuries or intoxication. This article describes the management of tasered persons from an emergency physician’s point of view starting from a case report and discussion of the scientific literature.

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Danksagung

Die Autoren danken Sylvi Thierbach für die Erstellung der Fotos und dem SEK Baden-Württemberg für die gute Zusammenarbeit und die sachdienlichen Informationen aus dem praktischen Einsatz.

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Authors and Affiliations

  1. Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin u. Schmerztherapie, Notfallmedizinisches Zentrum, Bundeswehrkrankenhaus, Oberer Eselsberg 40, 89081, Ulm, Deutschland

    T. Wunderlich, F. Josse, M. Helm &  B. Hossfeld OFA

  2. Arbeitsgruppe „Taktische Medizin“ des Arbeitskreises Notfallmedizin der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin (DGAI), Nürnberg, Deutschland

    F. Josse, M. Helm &  B. Hossfeld OFA

  3. Tactical Rescue and Emergency Medicine Association (TREMA) e. V., Ulm, Deutschland

    F. Josse &  B. Hossfeld OFA

  4. Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland

    M. Bernhard & S. Wolters

  5. Institut für Rechtsmedizin, Universität Leipzig, Leipzig, Deutschland

    B. Ondruschka

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  1. T. Wunderlich
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Correspondence to B. Hossfeld OFA.

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T. Wunderlich, F. Josse, M. Helm, M. Bernhard, S. Wolters, B. Ondruschka und B. Hossfeld geben an, dass kein Interessenkonflikt besteht.

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M. Bernhard, Düsseldorf

M. Helm, Ulm

T. Wurmb, Würzburg

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Wunderlich, T., Josse, F., Helm, M. et al. TASER-Einsatz – ein notfallmedizinisches Problemfeld?. Notfall Rettungsmed 21, 673–681 (2018). https://doi.org/10.1007/s10049-018-0544-2

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