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ABSTRACT: Despite human laboratory and field studies that have demonstrated a reasonable safety profile for TASER brand conducted electrical weapons (CEW), the results of some swine studies and arrest related deaths temporal to the use of the CEWs continue to raise questions regarding cardiac safety. TASER International, Inc., has released a new CEW, the TASER X2, touted to have a better safety profile than its long-standing predecessor, the TASER X26. We have developed a model to assess the relative cardiac safety of CEWs and used it to compare the TASER X2 and the TASER X26. This safety model was also used to assess the relative safety of an experimental probe design as compared to the standard steel probe. Our results suggest that the TASER X2 has an improved safety margin over the TASER X26. The new probe design also has promise for enhanced cardiac safety, although may have some disadvantages when compared to the existing design which would make field use impractical.
Forensic Science Medicine and Pathology 03/2013; · 1.44 Impact Factor
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ABSTRACT: Subcutaneous sumatriptan is an effective treatment for pain from acute migraine headache, and can be used in patients with known migraine syndrome and in patients with primary headaches when secondary causes have been excluded. In limited comparative trials, subcutaneous sumatriptan performed in a manner comparable with oral eletriptan and intravenous metoclopramide, was superior to intravenous aspirin and intramuscular trimethobenzamide-diphenhydramine, and was inferior to intravenous prochlorperazine for pain relief. The most common side effects seen with subcutaneous sumatriptan are injection site reactions and triptan sensations. As with all triptans, there is a risk of rare cardiovascular events with subcutaneous sumatriptan and its use should be limited to those without known cerebrovascular disease and limited in those with known cardiovascular risk factors and unknown disease status. In studies of patient preference and tolerability, the subcutaneous formulation has a faster time of onset and high rate of efficacy when compared with the oral formulation, but the oral formulation appears to be better tolerated. It is important to consider the needs of the patient, their past medical history, and what aspects of migraine treatment are most important to the patient when considering treatment of acute migraine or primary headache. Subcutaneous sumatriptan is a good first-line agent for the treatment of pain from acute migraine headaches and primary headaches.
Patient Preference and Adherence 01/2012; 6:27-37. · 1.14 Impact Factor
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ABSTRACT: The physiology of many sudden, unexpected arrest-related deaths (ARDs) proximate to restraint has not been elucidated. A sudden decrease in central venous return during restraint procedures could be physiologically detrimental. The impact of body position and applied weight force on central venous return has not been previously studied. In this study, we use ultrasound to measure the size of the inferior vena cava (IVC) as a surrogate of central venous return in the standing position, prone position, and with weight force applied to the thorax in the prone position.
This was a prospective, observational study of volunteer human subjects. The IVC was visualized from the abdomen in both the longitudinal and transverse section in the standing and prone positions without weight force applied, and with 100 lbs (45 kg) and 147 lbs (67 kg) of weight force on the upper back in the prone position. Maximum and minimum measurements were determined in each section to account for possible respiratory variation of the IVC.
The IVC significantly decreased in size with each successive change: from standing to prone, from prone to prone with 100 lbs (45 kg) weight compression, from prone with 100 lbs (45 kg) weight compression to prone with 147 lbs (67 kg) weight compression (p < 0.0001). The vital sign measurements had no statistical change.
The physiology involved in many sudden, unexpected ARDs has not been elucidated. However, in our study, we found a significant decrease in IVC diameter with weight force compression to the upper thorax when the subject was in the prone position. This may have implications for the tactics of restraint to aid in the prevention of sudden, unexpected ARD cases.
Forensic science international 07/2011; 212(1-3):256-9. · 2.10 Impact Factor
