From the Guidelines
Patients who have had a conducted electrical weapon (CEW) such as a Taser deployed on them generally do not require active monitoring in a hospital if they appear clinically well after the incident. According to the American Heart Association's update to practice standards for electrocardiographic monitoring in hospital settings 1, continuous electrocardiographic monitoring is not recommended for all hospitalized patients, and its use should be tailored to the individual patient's risk factors and clinical presentation.
When considering hospital evaluation for patients who have had a CEW deployed, the following factors should be taken into account:
- Persistent abnormal vital signs
- Altered mental status
- Evidence of significant trauma
- Pre-existing cardiac conditions
- Pregnancy
- Prolonged or multiple CEW discharges
If a patient is brought to the hospital, monitoring typically includes:
- Basic vital signs
- Cardiac monitoring if there are any concerning symptoms
- Observation for 4-6 hours in cases with risk factors
The medical rationale for this approach is that CEWs deliver brief electrical pulses that cause temporary neuromuscular incapacitation but rarely cause direct cardiac injury in healthy individuals, as noted in the context of electrocardiographic monitoring 1. Most CEW-related injuries are secondary to falls or from the barbs themselves rather than from the electrical current. Removal of CEW barbs can typically be performed in the field by trained personnel unless they are embedded in sensitive areas, which would require medical evaluation.
From the Research
Monitoring Requirements
- Patients who have been exposed to conducted electrical weapons (CEWs) such as Tasers do not require active monitoring in the hospital, according to the current medical literature 2, 3.
- Studies have shown that CEW exposure does not result in dangerous laboratory abnormalities, physiologic changes, or immediate or delayed cardiac ischemia or dysrhythmias in asymptomatic awake and alert patients 2, 3.
- The medical literature does not support routine performance of laboratory studies, electrocardiography, or prolonged ED observation or hospitalization for ongoing cardiac monitoring after CEW exposure in an otherwise asymptomatic awake and alert patient 2, 3.
Respiratory Effects
- Prolonged CEW application did not impair respiratory parameters in a population of human volunteers 4.
- Studies have shown that CEW exposure results in increased tidal volume, decreased end-tidal CO2 level, and increased end-tidal oxygen level, but these changes are not significant enough to require active monitoring 4.
Cardiovascular Effects
- CEW exposure has been shown to produce a statistically significant increase in heart rate, but no detectable dysrhythmias or changes in QRS and QTc cardiac intervals 5.
- Studies have also shown that CEW exposure results in a increase in blood pressure, but this increase is not significant enough to require active monitoring 5.
Exposure Duration and Acceptability
- The acceptability of longer-duration or repeated exposures to CEWs is still a topic of debate, and more research is recommended to determine the safety of such exposures 6.
- Current data suggest that short-duration exposures to CEWs result in limited effects, but longer-duration or repeated exposures may be utilized with caution 6.