I thought this post might be of interest because it isn’t something that is seen every day, but it is something that ED physicians will likely have to deal with sooner or later.
There is one police officer in our area who has the “Golden TASER Award.” If you look at him crosseyed, you’ll be down on the ground involuntarily twitching and he’ll be standing over you squeezing the trigger of that yellow gun.
Not really, but he always seems to have the misfortune of getting into altercations with perpetrators when I happen to be working in the emergency department. Aaaaand … he has a TASER and he’s not afraid to use it.
Before getting to the point of the post, I am clearly in favor of TASERs. No question. If it comes between jolting someone and going mano-a-mano, TASER wins every time. Police officers have enough to worry about without wondering whether they’re going to get sucker punched when they’re not looking. Think that the shock is harmful to your health? Do what the officer tells you and you won’t have to worry about being shocked. Wish we could have them in our emergency department.
This post isn’t about trying to convert you to a TASER user, though. It’s about what to do after the TASER has been deployed.
When a TASER is fired, two weighted barbs attached to long insulated wires shoot out of the unit and are supposed to implant in the subject needing restraint. See the pictures.
After hitting the target, it is not uncommon for TASER spikes to either stick in the clothing, partially implant, or be pulled out. Failure of the barbs to implant can present a problem for the police officer, since the TASER doesn’t work as well from a distance when both barbs don’t implant. Even after the TASER has been shot, it can still be used as a contact “stun gun.”
Assuming that the device works as intended and both barbs implant in the skin, most of the time, the barbs can be “plucked” out of the skin by bracing the surrounding skin with the palm of one’s hand and then quickly pulling up on the spike. One of the police officers compared removing the barbs to “plucking a chicken.” However, sometimes the barbs become implanted underneath the skin and can’t be removed manually. So what is an ED physician supposed to do?
I have had success doing the following:
1. Anesthetize the area at the site of attachment. I use an insulin syringe with 1% lidocaine.
2. Insert an 18 gauge needle along the side of the barb with the bevel of the needle facing the barb.
3. Advance the needle about half a centimeter.
4. Pull out the needle and the barb together at the same time.
If this doesn’t work, the 18 gauge needle is sharp enough to make a 1mm track directly alongside the barb. After making the track, advance the barb slightly and turn the barb 90-180 degrees to disengage the pointed end from the tissue below and do the “chicken plucking” thing pulling the barb through the middle of the track.
Obviously this isn’t a scientific study, but between these two techniques, there hasn’t been a barb that has beaten me.
If you have any other suggestions for removing embedded TASER barbs, I’d like to hear them. Leave a comment below.