From the Guidelines
Managing a patient who has been tased requires immediate assessment and treatment of potential injuries while monitoring for complications, starting with checking for responsiveness as outlined in the 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1. To manage a patient who has been tased, the following steps should be taken:
- Ensure scene safety and perform a primary survey focusing on airway, breathing, and circulation.
- Remove the taser barbs by applying tension to the skin and pulling straight out, unless they are embedded in sensitive areas like the face, neck, genitals, or joints, which require physician removal.
- Clean the puncture sites with antiseptic solution and apply antibiotic ointment if needed.
- Monitor vital signs closely, including cardiac rhythm, as taser deployment can rarely cause cardiac arrhythmias, particularly in patients with pre-existing heart conditions or those under the influence of stimulants.
- Assess for secondary injuries such as falls, which may cause head trauma, fractures, or soft tissue injuries.
- Obtain a thorough history including medical conditions, medications, and substance use.
- Follow the guidelines for adult basic and advanced life support, which include checking for responsiveness, shouting for nearby help, activating the emergency response system, and getting an AED and emergency equipment 1.
- Laboratory tests are generally not required unless there are specific concerns about rhabdomyolysis, which may present with dark urine, muscle pain, or weakness.
- If rhabdomyolysis is suspected, check creatine kinase levels and ensure adequate hydration with intravenous fluids.
- Most patients who have been tased can be discharged after a brief observation period if they have normal vital signs and no complications.
- Document the incident thoroughly, including the patient's mental status before and after the event, physical findings, and treatment provided.
From the Research
Managing a Patient who has been Tased
To manage a patient who has been tased, it is essential to follow a systematic approach to assess and treat potential injuries. The Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach is a widely accepted method for immediate assessment and treatment in clinical emergencies 2.
Initial Assessment
- Assess the patient's airway, breathing, and circulation to identify any life-threatening conditions.
- Evaluate the patient's disability and exposure to determine the need for further treatment.
- Use the ABCDE approach to focus on the most critical clinical problems and improve outcomes.
Cardiovascular Effects
- Taser exposure can cause significant increases in heart rate, but cardiac dysrhythmias or morphologic changes are rare 3, 4.
- Alterations in the QT interval may occur, but their clinical significance is unknown 3.
- In some cases, taser exposure can lead to atrial fibrillation, even in previously healthy individuals 5.
Treatment
- If the patient is in asystole, consider using a hypothermia protocol after return of spontaneous circulation to improve neurologic outcomes 6.
- Monitor the patient's cardiac rhythm, rate, and blood pressure closely after taser exposure.
- Provide supportive care and treat any related injuries or conditions.