Adrenergic and metabolic effects of electrical weapons: review and meta-analysis of human data
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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.
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.
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.
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.
KeywordsForensic medicine Conducted electrical weapon Metabolic effects Catecholamines Biomarkers
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.
- 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
- 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.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
- 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.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