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Erschienen in: Forensic Science, Medicine and Pathology 1/2021

18.09.2020 | Original Article

Electrical weapons and rhabdomyolysis

verfasst von: Mark W. Kroll, Klaus K. Witte, Mollie B. Ritter, Sebastian N. Kunz, Richard M. Luceri, John C. Criscione

Erschienen in: Forensic Science, Medicine and Pathology | Ausgabe 1/2021

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Abstract

It has been suggested that an application of a conducted electrical weapon (CEW) might cause muscle injury such as rhabdomyolysis and an acute inflammatory response. We explored this hypothesis by testing the effects of electrical weapons on circulating markers of inflammation and muscle damage. In a prospective study, 29 volunteers received a full-trunk 5-s TASER® X26(E) CEW exposure. Venous blood samples were taken before, 5 min after, and at 24 h following the discharge. We tested for changes in serum levels of C-reactive protein (CRP), alkaline phosphatase (ALP), myoglobin, albumin, globulin, albumin/globulin ratio, aspartate and alanine aminotransferase, creatine kinase, total protein, bilirubin, and lactic acid dehydrogenase. Uncorrected CRP and myoglobin levels were lower in the immediate post exposure period (CRP levels 1.44 ± 1.39 v 1.43 ± 1.32 mg/L; p = 0.046 and myoglobin 36.8 ± 11.9 v 36.1 ± 13.9 μg/L; p = 0.0019) but these changes were not significant after correction for multiple comparisons. There were no changes in other biomarkers. At 24 h, CRP levels had decreased by 30% to 1.01 ± 0.80 mg/L (p = 0.001 from baseline). ALP was unchanged immediately after the CEW application but was reduced by 5% from baseline (66.2 ± 16.1 to 62.7 ± 16.1 IU/L; p = 0.0003) at 24 h. No other biomarkers were different from baseline at 24 h. A full-trunk electrical weapon exposure did not lead to clinically significant changes in the acute phase protein levels or changes in measures of muscle cellular injury. We found no biomarker evidence of rhabdomyolysis.
Literatur
1.
Zurück zum Zitat Vilke GM, Chan TC. Less lethal technology: medical issues. Policing. 2007;30:341–57.CrossRef Vilke GM, Chan TC. Less lethal technology: medical issues. Policing. 2007;30:341–57.CrossRef
2.
Zurück zum Zitat 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;10:170–91.CrossRef 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;10:170–91.CrossRef
3.
Zurück zum Zitat MacDonald JM, Kaminski RJ, Smith MR. The effect of less-lethal weapons on injuries in police use-of-force events. Am J Public Health. 2009;99:2268–74.CrossRef MacDonald JM, Kaminski RJ, Smith MR. The effect of less-lethal weapons on injuries in police use-of-force events. Am J Public Health. 2009;99:2268–74.CrossRef
4.
Zurück zum Zitat Taylor B, Woods DJ. Injuries to officers and suspects in police use-of-force cases: a quasi-experimental evaluation. Police Q. 2010;13:260–89.CrossRef Taylor B, Woods DJ. Injuries to officers and suspects in police use-of-force cases: a quasi-experimental evaluation. Police Q. 2010;13:260–89.CrossRef
5.
Zurück zum Zitat Kroll M, Brave M, Pratt H, Witte K, Kunz S, Luceri R. Benefits, risks, and myths of TASER® handheld electrical weapons. Human Factors Mech Eng Defense Safety. 2019;3:7.CrossRef Kroll M, Brave M, Pratt H, Witte K, Kunz S, Luceri R. Benefits, risks, and myths of TASER® handheld electrical weapons. Human Factors Mech Eng Defense Safety. 2019;3:7.CrossRef
6.
Zurück zum Zitat Ferdik FV, Kaminski RJ, Cooney MD, Sevigny EL. The influence of agency policies on conducted energy device use and police use of lethal force. Police Q. 2014;17:328–58.CrossRef Ferdik FV, Kaminski RJ, Cooney MD, Sevigny EL. The influence of agency policies on conducted energy device use and police use of lethal force. Police Q. 2014;17:328–58.CrossRef
7.
Zurück zum Zitat Kroll MW, Adamec J, Wetli CV, Williams HE. Fatal traumatic brain injury with electrical weapon falls. J Forensic Legal Med. 2016;43:12–9.CrossRef Kroll MW, Adamec J, Wetli CV, Williams HE. Fatal traumatic brain injury with electrical weapon falls. J Forensic Legal Med. 2016;43:12–9.CrossRef
8.
Zurück zum Zitat Kroll M, Ritter M, Williams H. Fatal and non-fatal burn injuries with electrical weapons and explosive fumes. J Forensic Legal Med. 2017;50:6–11.CrossRef Kroll M, Ritter M, Williams H. Fatal and non-fatal burn injuries with electrical weapons and explosive fumes. J Forensic Legal Med. 2017;50:6–11.CrossRef
9.
Zurück zum Zitat Kroll MW, Ritter MB, Kennedy EA, Silverman NK, Shinder R, Brave MA, et al. Eye injuries from electrical weapon probes: incidents, prevalence, and legal implications. J Forensic Legal Med. 2018;55:52–7.CrossRef Kroll MW, Ritter MB, Kennedy EA, Silverman NK, Shinder R, Brave MA, et al. Eye injuries from electrical weapon probes: incidents, prevalence, and legal implications. J Forensic Legal Med. 2018;55:52–7.CrossRef
10.
Zurück zum Zitat Gapsis BC, Hoang A, Nazari K, Morcos M. Ocular manifestations of TASER-induced trauma. Trauma Case Rep. 2017;12:4–7.CrossRef Gapsis BC, Hoang A, Nazari K, Morcos M. Ocular manifestations of TASER-induced trauma. Trauma Case Rep. 2017;12:4–7.CrossRef
11.
Zurück zum Zitat Gleason JB, Ahmad I. TASER((R)) electronic control device-induced rhabdomyolysis and renal failure: a case report. J Clin Diagn Res. 2015;9:HD01–2.PubMedPubMedCentral Gleason JB, Ahmad I. TASER((R)) electronic control device-induced rhabdomyolysis and renal failure: a case report. J Clin Diagn Res. 2015;9:HD01–2.PubMedPubMedCentral
12.
Zurück zum Zitat Sanford JM, Jacobs GJ, Roe EJ, Terndrup TE. Two patients subdued with a TASER(R) device: cases and review of complications. J Emerg Med. 2011;40:28–32.CrossRef Sanford JM, Jacobs GJ, Roe EJ, Terndrup TE. Two patients subdued with a TASER(R) device: cases and review of complications. J Emerg Med. 2011;40:28–32.CrossRef
13.
Zurück zum Zitat Ho JD, Dawes DM. TASER device-induced rhabdomyolysis is unlikely. J Emerg Med. 2011;40:68–9 author reply 69.CrossRef Ho JD, Dawes DM. TASER device-induced rhabdomyolysis is unlikely. J Emerg Med. 2011;40:68–9 author reply 69.CrossRef
14.
Zurück zum Zitat Dawes DM, Ho JD, Sweeney JD, Lundin EJ, Kunz SN, Miner JR. The effect of an electronic control device on muscle injury as determined by creatine kinase enzyme. Forensic Sci Med Pathol. 2011;7:3–8.CrossRef Dawes DM, Ho JD, Sweeney JD, Lundin EJ, Kunz SN, Miner JR. The effect of an electronic control device on muscle injury as determined by creatine kinase enzyme. Forensic Sci Med Pathol. 2011;7:3–8.CrossRef
15.
Zurück zum Zitat Kunz SN, Calkins H, Adamec J, Kroll MW. Cardiac and skeletal muscle effects of electrical weapons: a review of human and animal studies. Forensic Sci Med Pathol. 2018;14:358–66.CrossRef Kunz SN, Calkins H, Adamec J, Kroll MW. Cardiac and skeletal muscle effects of electrical weapons: a review of human and animal studies. Forensic Sci Med Pathol. 2018;14:358–66.CrossRef
16.
Zurück zum Zitat Ho JD, Miner JR, Lakireddy DR, Bultman LL, Heegaard WG. Cardiovascular and physiologic effects of conducted electrical weapon discharge in resting adults. Acad Emerg Med. 2006;13:589–95.CrossRef Ho JD, Miner JR, Lakireddy DR, Bultman LL, Heegaard WG. Cardiovascular and physiologic effects of conducted electrical weapon discharge in resting adults. Acad Emerg Med. 2006;13:589–95.CrossRef
17.
Zurück zum Zitat Ho J, Dawes D, Miner J, Kunz S, Nelson R, Sweeney J. Conducted electrical weapon incapacitation during a goal-directed task as a function of probe spread. Forensic Sci Med Pathol. 2012;8:358–66.CrossRef Ho J, Dawes D, Miner J, Kunz S, Nelson R, Sweeney J. Conducted electrical weapon incapacitation during a goal-directed task as a function of probe spread. Forensic Sci Med Pathol. 2012;8:358–66.CrossRef
18.
Zurück zum Zitat Jauchem JR, Seaman RL, Fines DA. Survival of anesthetized Sus scrofa after cycling (7-second on/3-second off) exposures to an electronic control device for 3 minutes. Am J Forensic Med Pathol. 2011;32:124–30.CrossRef Jauchem JR, Seaman RL, Fines DA. Survival of anesthetized Sus scrofa after cycling (7-second on/3-second off) exposures to an electronic control device for 3 minutes. Am J Forensic Med Pathol. 2011;32:124–30.CrossRef
19.
Zurück zum Zitat Jauchem JR, Bernhard JA, Cerna CZ, Lim TY, Seaman RL, Tarango M. Effects of a TASER conducted energy weapon on the circulating red-blood-cell population and other factors in Sus scrofa. Forensic Sci Med Pathol. 2013;9:308–20.CrossRef Jauchem JR, Bernhard JA, Cerna CZ, Lim TY, Seaman RL, Tarango M. Effects of a TASER conducted energy weapon on the circulating red-blood-cell population and other factors in Sus scrofa. Forensic Sci Med Pathol. 2013;9:308–20.CrossRef
20.
Zurück zum Zitat Weibrecht K, Dayno M, Darling C, Bird SB. Liver aminotransferases are elevated with rhabdomyolysis in the absence of significant liver injury. J Med Toxicol. 2010;6:294–300.CrossRef Weibrecht K, Dayno M, Darling C, Bird SB. Liver aminotransferases are elevated with rhabdomyolysis in the absence of significant liver injury. J Med Toxicol. 2010;6:294–300.CrossRef
21.
Zurück zum Zitat Vladutiu AO, Venuto RC. Creatine kinase MB and lactate dehydrogenase 5 isoenzymes in rhabdomyolysis. Clin Chem. 1977;23:1366.CrossRef Vladutiu AO, Venuto RC. Creatine kinase MB and lactate dehydrogenase 5 isoenzymes in rhabdomyolysis. Clin Chem. 1977;23:1366.CrossRef
22.
Zurück zum Zitat Rudberg A, Magnusson P, Larsson L, Joborn H. Serum isoforms of bone alkaline phosphatase increase during physical exercise in women. Calcif Tissue Int. 2000;66:342–7.CrossRef Rudberg A, Magnusson P, Larsson L, Joborn H. Serum isoforms of bone alkaline phosphatase increase during physical exercise in women. Calcif Tissue Int. 2000;66:342–7.CrossRef
23.
Zurück zum Zitat Gulmez O, Ertan C, Yildirir A, Konas D, Bal U, Aydinalp A, et al. C-reactive protein levels increase after exercise testing in patients with increased platelet reactivity. Coron Artery Dis. 2007;18:437–42.CrossRef Gulmez O, Ertan C, Yildirir A, Konas D, Bal U, Aydinalp A, et al. C-reactive protein levels increase after exercise testing in patients with increased platelet reactivity. Coron Artery Dis. 2007;18:437–42.CrossRef
24.
Zurück zum Zitat Segal O, Behrbalk E, Shapira I, Otremsky I, Berliner S, Halpern P, et al. Timing of C-reactive protein increment in acute traumatic stress: relevance for CRP determinations in acute cardiovascular events. Stress Health: J Int Soc Investigat Stress. 2008;24:281–5.CrossRef Segal O, Behrbalk E, Shapira I, Otremsky I, Berliner S, Halpern P, et al. Timing of C-reactive protein increment in acute traumatic stress: relevance for CRP determinations in acute cardiovascular events. Stress Health: J Int Soc Investigat Stress. 2008;24:281–5.CrossRef
25.
Zurück zum Zitat Kunz SN, Calkins HG, Adamec J, Kroll MW. Adrenergic and metabolic effects of electrical weapons: review and meta-analysis of human data. Int J Legal Med. 2018;132:1469–75.CrossRef Kunz SN, Calkins HG, Adamec J, Kroll MW. Adrenergic and metabolic effects of electrical weapons: review and meta-analysis of human data. Int J Legal Med. 2018;132:1469–75.CrossRef
27.
Zurück zum Zitat Kroll MW, Perkins PE, Panescu D. Electric fence standards comport with human data and AC limits. Conf Proc IEEE EMBC. 2015;37:1343–8. Kroll MW, Perkins PE, Panescu D. Electric fence standards comport with human data and AC limits. Conf Proc IEEE EMBC. 2015;37:1343–8.
29.
Zurück zum Zitat Nimunkar AJ, Webster JG. Safety of pulsed electric devices. Physiol Meas. 2009;30:101–14.CrossRef Nimunkar AJ, Webster JG. Safety of pulsed electric devices. Physiol Meas. 2009;30:101–14.CrossRef
30.
31.
Zurück zum Zitat Chiles BD, Nerheim MH, Brave MA, Panescu D, Kroll MW. Electrical weapon charge delivery with arcing. Conf Proc IEEE Eng Med Biol Soc. 2018;2018:2234–9. Chiles BD, Nerheim MH, Brave MA, Panescu D, Kroll MW. Electrical weapon charge delivery with arcing. Conf Proc IEEE Eng Med Biol Soc. 2018;2018:2234–9.
32.
Zurück zum Zitat Brewer J, Kroll M. Field statistics overview. In: Kroll M, Ho J, editors. TASER conducted electrical weapons: physiology, pathology, and law. New York City: Springer-Kluwer; 2009. Brewer J, Kroll M. Field statistics overview. In: Kroll M, Ho J, editors. TASER conducted electrical weapons: physiology, pathology, and law. New York City: Springer-Kluwer; 2009.
33.
Zurück zum Zitat Bozeman WP, Hauda WE 2nd, Heck JJ, Graham DD Jr, Martin BP, Winslow JE. Safety and injury profile of conducted electrical weapons used by law enforcement officers against criminal suspects. Ann Emerg Med. 2009;53:480–9.CrossRef Bozeman WP, Hauda WE 2nd, Heck JJ, Graham DD Jr, Martin BP, Winslow JE. Safety and injury profile of conducted electrical weapons used by law enforcement officers against criminal suspects. Ann Emerg Med. 2009;53:480–9.CrossRef
Metadaten
Titel
Electrical weapons and rhabdomyolysis
verfasst von
Mark W. Kroll
Klaus K. Witte
Mollie B. Ritter
Sebastian N. Kunz
Richard M. Luceri
John C. Criscione
Publikationsdatum
18.09.2020
Verlag
Springer US
Erschienen in
Forensic Science, Medicine and Pathology / Ausgabe 1/2021
Print ISSN: 1547-769X
Elektronische ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-020-00311-7

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