Emergency Department Evaluation After Conducted Energy Weapon Use: Review of the Literature for the Clinician.

Abstract

Conductive energy weapons (CEWs) are used daily by law enforcement, and patients are often brought to emergency departments (EDs) for medical clearance. Our aim was to review the medical literature on the topic of CEWs and to offer evidence-based recommendations to emergency physicians for evaluation and treatment of patients who have received a CEW exposure. A MEDLINE literature search from 1988 to 2018 was performed and limited to human studies published from January 1, 1988 to November 1, 2018 written in English with the following keywords: TASER, conductive energy device(s), electronic weapon(s), conductive energy weapon(s), non-lethal weapon(s), conducted energy device(s), conducted energy weapon(s), conductive electronic device(s), and electronic control device(s). Studies identified then underwent a structured review from which results could be evaluated. Two hundred and sixty-three articles on CEWs were screened and 37 appropriate articles were rigorously reviewed. Evaluation and treatment recommendations are presented. These studies did not report any evidence of dangerous laboratory abnormalities, physiologic changes, or immediate or delayed cardiac ischemia or dysrhythmias after exposure to CEW electrical discharges of up to 15s. The current 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.