UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH Gas, Beans and Other Unpleasantries: Less Lethal Weapon Injury Patterns Michael Lohmeier, MD, FACEP Assistant Professor of Medicine, University of Wisconsin School of Medicine and Public Health Medical Director, Dane County Sheriff TEMS Medical Director, Madison Fire Department Medical Director, Dane County EMS
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UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH
Gas, Beans and Other Unpleasantries: Less Lethal Weapon Injury Patterns
Michael Lohmeier, MD, FACEP Assistant Professor of Medicine, University of Wisconsin School of Medicine and Public Health
Medical Director, Dane County Sheriff TEMS Medical Director, Madison Fire Department
Medical Director, Dane County EMS
• Disclosures
– I have no financial disclosures
• Outline
– Background
– Less Lethal Basics
– Chemicals
– Mechanical / Kinetic Energy
– Conducted Electrical Devices
Less Lethal Weapon Injury Patterns
• Background
– EMS Fellowship, Washington University in Saint Louis
• Area of Concentration in Tactical Medicine
– Faculty, University of Wisconsin-Madison
• Emergency Medicine Physician
• City of Madison
• Dane County
• State of Wisconsin
Less Lethal Weapon Injury Patterns
• August 9, 2014
• March 4, 2014
Less Lethal Weapon Injury Patterns
• March 6, 2015
– Less Lethal Training
• May 12, 2015
Less Lethal Injury Patterns
• Less Lethal Basics
– Defined
• Categories of Less Lethals
– Electro-Magnetic Weapons
– Electrical Weapons
– Chemicals
– Audio
– Mechanical / Kinetic Energy
Less Lethal Weapon Injury Patterns
http://www.nato.int/docu/pr/1999/p991013e.htm
• Chemicals
– Phenacyl Chloride (aka CN or Mace)
• Developed during World War I
• Irritant smoke
• Injuries
– Corneal Epithelial Damage
– Chemosis
– Cutaneous Irritating Outbreaks
– Death
• Replaced by OC and CS gas
Less Lethal Weapon Injury Patterns
• Chemicals
– 2-chlorobenzalmalononitrile (aka CS gas)
• Powder or Solution
• Irritation and inflammation
• Insoluble
• Injuries
– Severe Erythema and Skin Vesication
– Contact Dermatitis
– Hypoxia
Less Lethal Weapon Injury Patterns
• Chemicals
– 2-chlorobenzalmalononitrile (aka CS gas)
• Treatment
– Move to Free Flowing Fresh Air
– Eye Flush
– Remove contaminated clothing
Less Lethal Weapon Injury Patterns
• Chemicals
– Oleoresin Capsicum (aka Pepper Spray)
• Burning Sensation to the skin, eyes and mucous membranes
• Coughing, gagging, shortness of breath and inability to speak
• Symptoms resolve in 10-15 minutes
• Injuries
– Corneal abrasions in 7-8.6% of all exposures
– Fatalities reported
Less Lethal Weapon Injury Patterns
Brown L, et al. Corneal abrasions associated with pepper spray exposure. Am J Emerg Med 2000;18:271. Watson WA, et al. Oleoresin capsicum (Cap-stun) toxicity from aerosol exposure. Ann Pharmacother
– Shooting of Tony Robinson. N.d. In Wikipedia. Retrieved October 20, 2015.
from https://en.wikipedia.org/wiki/Shooting_of_Tony_Robinson
– Shooting of Michael Brown. N.d. In Wikipedia. Retrieved October 20, 2015.
from https://en.wikipedia.org/wiki/Shooting_of_Michael_Brown
– Worthington E, Nee PA. “CS Exposure – Clinical Effects and Management”, J Accid Emerg Med. 1999 May; 16(3): 168-170.
– Strote, J., Campbell, R., Pease, J., Hamman, M.S. and Hutson, R. (2005), "The role of tasers in police restraint-related deaths", Annals of Emergency Medicine, Vol. 46 No. 3, p. s85.
– Brown L, et al. Corneal abrasions associated with pepper spray exposure. Am J Emerg Med 2000;18:271.
– Watson WA, et al. Oleoresin capsicum (Cap-stun) toxicity from aerosol exposure. Ann Pharmacother 1996; 30:733.
– Smith, J. and Greaves, I. "The use of chemical incapacitant sprays: a review", Journal of Trauma, 2002 Vol. 52 No. 3, pp. 595-600.
– Blain, P.G. (2003), "Tear gases and irritant incapacitants. 1-chloroacetophenone, 2- chlorobenzylidene malononitrile and dibenz[b,f]-1,4-oxazepine", Toxicol Rev. 2003;22(2):103-10.
– Charles A, Asensio J, Forno, W, Petrone, P, "Penetrating bean bag injury: intrathoracic complication of a nonlethal weapon", J Trauma. 2002;53(5): 997-1000.
– Fish RM, Geddes, LA, "Effects of stun guns and Tasers", Lancet. 2001 Sept 1;358(9283):687-8.
– Khonsari RH, Fleuridas G, "Severe Facial Rubber Bullet Injuries: Less Lethal But Extremely Harmful Weapons". Injury, Int J Care Injured 41(2010); 73-76.
– Rezende-Neto J, Silva F, “Penetrating Injury to the Chest by an Attenuated Energy Projectile: A Case Report and Literature Review of Thoracic Injuries Caused by “Less-Lethal” Munitions”, World J
Emerg Surg 2009, 4:26.
– Ho JD, Miner JR, Lakireddy DR, Bultman, "Cardiovascular and physiologic effects of conducted electrical weapon discharge in resting adults", Acad Emerg Med. 2006 Jun;13(6):589-95.