Less-lethal weapons and tactics are being increasingly used by law enforcement to minimize the reliance on more-lethal force. While these methods are designated as “less-lethal,” they can cause morbidity and mortality when deployed. Knowledge of these weapons and tactics can help direct the workup and management of patients with injuries from these methods and can protect clinicians from secondary exposure and injuries. This issue reviews the most common less-lethal weapons and tactics used by law enforcement, describes their mechanism of action, and discusses associated common injury patterns. Recommendations are provided for the evaluation and management of these patients in the emergency department.
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Following are the most informative references cited in this paper, as determined by the authors.
17. * Vilke G, Chan T, Bozeman WP, et al. Emergency department evaluation after conducted energy weapon use: review of the literature for the clinician. J Emerg Med. 2019;57(5):740-746. (Literature review) DOI: 10.1016/j.jemermed.2019.06.037
19. * Gardner AR, Hauda WE, Bozeman WP. Conducted electrical weapon (TASER) use against minors: a shocking analysis. Pediatr Emerg Care. 2012;28(9):873-877. (Retrospective review; 2026 patients) DOI: 10.1097/PEC.0b013e31826763d1
21. * Gapsis BC, Hoang A, Nazari K, et al. Ocular manifestations of TASER-induced trauma. Trauma Case Rep. 2017;12:4-7. (Case report) DOI: 10.1016/j.tcr.2017.10.001
35. * Olajos EJ, Salem H. Riot control agents: pharmacology, toxicology, biochemistry and chemistry. J Appl Toxicol. 2001;21(5):355-391. (Review article) DOI: 10.1002/jat.767
56. * Schep LJ, Slaughter RJ, McBride DI. Riot control agents: the tear gases CN, CS and OC—a medical review. J R Army Med Corps. 2015;161(2):94-99. (Review article) DOI: 10.1136/jramc-2013-000165
65. * Pineda GV, Hutson HR, Anglin D, et al. Managing law enforcement (K-9) dog bites in the emergency department. Acad Emerg Med. 1996;3(4):352-358. (Retrospective review; 4 patients) DOI: 10.1111/j.1553-2712.1996.tb03449.x
68. * Ifantides C, Deitz GA, Christopher KL, et al. Less-lethal weapons resulting in ophthalmic injuries: a review and recent example of eye trauma. Ophthalmol Ther. 2020;9(3):1-7. (Case report and review) DOI: 10.1007/s40123-020-00271-9
69. * Dhar SA, Dar TA, Wani SA, et al. Pattern of rubber bullet injuries in the lower limbs: a report from Kashmir. Chin J Traumatol. 2016;19(3):129-133. (Case series) DOI: 10.1016/j.cjtee.2015.05.005
75. * Feier CC, Mallon W. Injury pattern of the stingball. J Emerg Med. 2010;38(4):444-448. (Case report) DOI: 10.1016/j.jemermed.2007.09.063
77. * Haar RJ, Iacopino V, Ranadive N, et al. Death, injury and disability from kinetic impact projectiles in crowd-control settings: a systematic review. BMJ Open. 2017;7(12):e018154. (Systematic review; 26 articles) DOI: 10.1136/bmjopen-2017-018154
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Keywords: less-lethal weapon injuries, less-lethal law enforcement weapon injuries, conducted electrical weapon, conducted energy weapon, TASER, pepper spray, oleoresin capsaicin spray, tear gas, CS, CN, chemical irritants, police dog bite, canine bite, K-9 bite, law enforcement dog bite, kinetic impact projectiles, stingball, flashball, beanbag gun, rubber bullets, secondary exposure, secondary contamination, trauma-informed care
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In This Episode
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Dr. Ashoo is a practicing emergency physician, board-certified in emergency medicine and clinical informatics. Join him as he takes you through the August 2021 issue of Emergency Medicine Practice: Less-Lethal Law Enforcement Weapons: Clinical Management of Associated Injuries in the Emergency Department (Trauma CME)
Jessica Osterman, MD, MS; Cara Buchanan, MD
Edouard Coupet, Jr, MD, MS; James Dodington, MD, CPST, FAAP; Matthew Harris, MD, FAAP, FAEMS
August 2, 2021
September 1, 2024
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 1.5 Trauma CME credits.
Date of Original Release: August 1, 2021. Date of most recent review: July 15, 2021. Termination date: August 1, 2024.
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