Advertisement

Electronic control device prongs: a growing cause of bloodborne pathogen exposure?

      To the Editor:
      Electronic control devices (ECDs) are now being used by many law enforcement agencies as nonlethal means to subdue individuals. The devices fire 2 small dart-like probes into a target individual that attach through the skin with a fishhook-like prong and remain attached to the weapon to deliver an electronic shock to disrupt voluntary muscle control. For the first time in our reported sharps exposure history, 2 separate BBP exposures involving ECD probes were reported at our medical center in the months of April and May of 2015. The first involved a staff member in our medical center's emergency department (ED) and the second concerned a law enforcement officer.

      Case 1

      An ED clinical staff member was taking the vital signs of a patient who was subdued using an ECD. The ECD probe was still embedded in the patient's soft tissue of their chest wall. The patient moved, causing the probe to dislodge and the prong tip punctured the staff member's palmer surface of their right hand. The staff member received treatment, including BBP exposure treatment, per our protocol.

      Case 2

      A law enforcement officer suffered an abrasion and puncture wound because of an ECD probe prong after it was removed from a man who was later brought to our ED. The Massachusetts Department of Public Health mandates the health care facility that receives individuals who are the source patient for an unprotected exposure provide testing for HIV (with consent) and hepatitis B and C. In addition, the exposed provider is offered medical care, follow-up, and counseling.
      Discussion with local law enforcement agencies determined that there has been increased use of ECDs and that at least 1 additional local law enforcement agency was anticipating to further increase their use of these devices.
      In follow-up to these 2 events, an alert memo was sent to all staff working in the medical center's 2 EDs and to affiliate EDs outlining the following reminders and guidelines:
      • ECD probe prongs represent a sharp exposure risk.
      • Ensure the cooperation of the patient so not to put yourself, staff, or the patient at risk of injury.
      • An instrument, such as a hemostat, should be used to remove ECD probes attached to a patient (and do not directly remove them by hand).
      • Dispose of ECD probes in an approved, hard-sided sharps container.
      • If there is an exposure, it should be treated the same as any bloodborne fluid exposure.
      Because the electric shock delivered by an ECD can potentially cause the subdued individual to fall or induce cardiac arrhythmias, it is likely that EDs will see an increasing number of patients presenting after they have been subdued by these devices.
      • Roberts J.
      ED treatment of tasered patients.
      • Ordog G.J.
      • Wasserberger J.
      • Schlater T.
      • Balasubramanium S.
      Electronic gun (Taser) injuries.

      ‘Study of Deaths Following Electro Muscular Disruption: Interim Report’ United States Department of Justice. June 2008, NCJ 222981.

      Institutions should consider educating staff as to the sharp injuries risk associated with them and implementing procedures to reduce the risk.

      References

        • Roberts J.
        ED treatment of tasered patients.
        Emergency Medicine News. 2012; 34: 18-19
        • Ordog G.J.
        • Wasserberger J.
        • Schlater T.
        • Balasubramanium S.
        Electronic gun (Taser) injuries.
        Ann Emerg Med. 1987; 16: 73-78
      1. ‘Study of Deaths Following Electro Muscular Disruption: Interim Report’ United States Department of Justice. June 2008, NCJ 222981.