LETTERS
LETTERS
TO THE
EDITOR
Submit all Letters to the Editor online at http://ees.elsevier.com/jen/ Health Effects of TASER™ Electronic Control Devices
Dear Editor: I read with interest the article in the Journal of Emergency Nursing by Dr Lefton 1 on the introduction of TASER™ electronic control devices (TASER International, Scottsdale, AZ) into emergency departments. Emergency departments are at times flashpoints where tensions are high, often fueled by alcohol and other recreational drugs. TASER™ electronic control devices have been promoted as a safe alternative to the use of firearms and generally as a “less lethal” response option for police, 2 and it is understandable that managers would consider interventions that offer to reduce violence and injuries to patients and staff. However, the introduction of TASER™ electronic control devices into hospital settings raises issues that are not so apparent in community policing. Emergency nurses may be familiar with the health concerns related to the use of TASER™ electronic control devices, 3 for example, reports of deaths after the use of TASER™ electronic control devices, injuries from TASER™ electronic control device use, and the possibility that TASER™ electronic control devices may precipitate ventricular fibrillation. 4 Although these issues are a subject of debate, they are of sufficient importance to be the subject of a considerable body of research evidence. The website of the manufacturer contains warnings about the potential effects of TASER™ electronic control devices on some groups, 5 including persons who are elderly or infirm, persons with a small body mass index, and pregnant women. Other risks include use of alcohol or other psychoactive substances, as well as persons with mental illness. 6 ED attendees may meet several of these criteria for increased risk. The research evidence suggests that TASER™ electronic control devices are safe when used in healthy individuals, 7 but study samples typically do not represent the real-world conditions of TASER™ electronic control device use. A related concern that nurses and other professionals need to be aware of is the substantial conflict of interest in TASER™ electronic control device–related research and publication. 4 It is likely that publication of research funded by TASER International and conducted by researchers with financial ties to the
J Emerg Nurs 2014;40:415-7. 0099-1767 Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
September 2014
VOLUME 40 • ISSUE 5
company has introduced systematic bias into this area of publication. 8 TASER™ electronic control devices may well have a legitimate role in ensuring patient and staff safety in emergency departments, but these benefits need to be tempered with an awareness of identified health concerns and the possibility that much of the available research is subject to conflicts of interest.—Anthony J O’Brien, RN, BA, MPhil, Senior Lecturer and Nurse Specialist (Liaison Psychiatry), Centre for Mental Health Research, University of Auckland, Grafton, New Zealand; E-mail: [email protected] http://dx.doi.org/10.1016/j.jen.2014.04.011
REFERENCES 1. Lefton C. The TASERs are coming, the TASERs are coming-conducted electrical weapons: tools to manage and prevent ED violence? J Emerg Nurs. 2014;40(2):174-6. 2. White MD, Ready J. The TASER as a less lethal force alternative. Findings on use and effectiveness in a large metropolitan police agency. Police Q. 2007;10(2):170-91. 3. Terrill W, Paoline EA. Conducted energy devices (CEDs) and citizen injuries: the shocking empirical reality. Justice Q. 2012;29(2):153-82. 4. Pasquier M, Carron P-N, Valotton L, Yersin B. Electronic control device exposure: a review of morbidity and mortality. Ann Emerg Med. 2011;58(2):178-88. 5. TASER International. TASER® handheld CEW warnings, instructions, and information: law enforcement. http://www.taser.com/images/resourcesand-legal/product-warnings/downloads/law-enforcement-warnings.pdf. Published 2013. Accessed March 31, 2014. 6. Robb M, Close B, Furyk J, Aitken P. Review article: emergency department implications of the TASER. Emerg Med Australas. 2009;21(4):250-8. 7. Bleetman A, Steyn R, Lee C. Introduction of the Taser into British policing. Implications for UK emergency departments: an overview of electronic weaponry. Emerg Med J. 2004;21(2):136-40. 8. Azadani PN, Tseng ZH, Ermakov S, Marcus GM, Lee BK. Funding source and author affiliation in TASER research are strongly associated with a conclusion of device safety. Am Heart J. 2011;162(3):533-7.
Response
Thank you, Mr. O’Brien, for your insightful comments. Echoing your sentiments, I believe the implementation of conducted electrical weapons (CEWs) in the emergency department most certainly should encompass training, guidelines regarding usage, and protocols that identify how to evaluate and treat “tased” patients. Currently there are no
WWW.JENONLINE.ORG
415
LETTERS
TO THE
EDITOR
Submit all Letters to the Editor online at http://ees.elsevier.com/jen/ Health Effects of TASER™ Electronic Control Devices
Dear Editor: I read with interest the article in the Journal of Emergency Nursing by Dr Lefton 1 on the introduction of TASER™ electronic control devices (TASER International, Scottsdale, AZ) into emergency departments. Emergency departments are at times flashpoints where tensions are high, often fueled by alcohol and other recreational drugs. TASER™ electronic control devices have been promoted as a safe alternative to the use of firearms and generally as a “less lethal” response option for police, 2 and it is understandable that managers would consider interventions that offer to reduce violence and injuries to patients and staff. However, the introduction of TASER™ electronic control devices into hospital settings raises issues that are not so apparent in community policing. Emergency nurses may be familiar with the health concerns related to the use of TASER™ electronic control devices, 3 for example, reports of deaths after the use of TASER™ electronic control devices, injuries from TASER™ electronic control device use, and the possibility that TASER™ electronic control devices may precipitate ventricular fibrillation. 4 Although these issues are a subject of debate, they are of sufficient importance to be the subject of a considerable body of research evidence. The website of the manufacturer contains warnings about the potential effects of TASER™ electronic control devices on some groups, 5 including persons who are elderly or infirm, persons with a small body mass index, and pregnant women. Other risks include use of alcohol or other psychoactive substances, as well as persons with mental illness. 6 ED attendees may meet several of these criteria for increased risk. The research evidence suggests that TASER™ electronic control devices are safe when used in healthy individuals, 7 but study samples typically do not represent the real-world conditions of TASER™ electronic control device use. A related concern that nurses and other professionals need to be aware of is the substantial conflict of interest in TASER™ electronic control device–related research and publication. 4 It is likely that publication of research funded by TASER International and conducted by researchers with financial ties to the
J Emerg Nurs 2014;40:415-7. 0099-1767 Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
September 2014
VOLUME 40 • ISSUE 5
company has introduced systematic bias into this area of publication. 8 TASER™ electronic control devices may well have a legitimate role in ensuring patient and staff safety in emergency departments, but these benefits need to be tempered with an awareness of identified health concerns and the possibility that much of the available research is subject to conflicts of interest.—Anthony J O’Brien, RN, BA, MPhil, Senior Lecturer and Nurse Specialist (Liaison Psychiatry), Centre for Mental Health Research, University of Auckland, Grafton, New Zealand; E-mail: [email protected] http://dx.doi.org/10.1016/j.jen.2014.04.011
REFERENCES 1. Lefton C. The TASERs are coming, the TASERs are coming-conducted electrical weapons: tools to manage and prevent ED violence? J Emerg Nurs. 2014;40(2):174-6. 2. White MD, Ready J. The TASER as a less lethal force alternative. Findings on use and effectiveness in a large metropolitan police agency. Police Q. 2007;10(2):170-91. 3. Terrill W, Paoline EA. Conducted energy devices (CEDs) and citizen injuries: the shocking empirical reality. Justice Q. 2012;29(2):153-82. 4. Pasquier M, Carron P-N, Valotton L, Yersin B. Electronic control device exposure: a review of morbidity and mortality. Ann Emerg Med. 2011;58(2):178-88. 5. TASER International. TASER® handheld CEW warnings, instructions, and information: law enforcement. http://www.taser.com/images/resourcesand-legal/product-warnings/downloads/law-enforcement-warnings.pdf. Published 2013. Accessed March 31, 2014. 6. Robb M, Close B, Furyk J, Aitken P. Review article: emergency department implications of the TASER. Emerg Med Australas. 2009;21(4):250-8. 7. Bleetman A, Steyn R, Lee C. Introduction of the Taser into British policing. Implications for UK emergency departments: an overview of electronic weaponry. Emerg Med J. 2004;21(2):136-40. 8. Azadani PN, Tseng ZH, Ermakov S, Marcus GM, Lee BK. Funding source and author affiliation in TASER research are strongly associated with a conclusion of device safety. Am Heart J. 2011;162(3):533-7.
Response
Thank you, Mr. O’Brien, for your insightful comments. Echoing your sentiments, I believe the implementation of conducted electrical weapons (CEWs) in the emergency department most certainly should encompass training, guidelines regarding usage, and protocols that identify how to evaluate and treat “tased” patients. Currently there are no
WWW.JENONLINE.ORG
415
