Emergency Department Evaluation After Conducted Energy Weapon Use

Review of the Literature for the Clinician

Gary M. Vilke, MD; William P. Bozeman, MD; Theodore C. Chan, MD


J Emerg Med. 2011;40(5):598-604. 

In This Article


The current human literature has not found evidence of dangerous laboratory abnormalities, physiologic changes, or immediate or delayed cardiac ischemia or dysrhythmias after exposure to CEW electrical discharges of up to 15 s. Therefore, the current medical literature does not support routine performance of laboratory studies, ECGs, or prolonged ED observation or hospitalization for ongoing cardiac monitoring after CEW exposure in an otherwise asymptomatic awake and alert patient.

Testing for cardiac conduction abnormalities or injury, or other physiologic effects of CEWs may be appropriate in individual cases based on medical history such as history of cardiac disease or symptoms like chest discomfort, shortness of breath, or palpitations suggestive of cardiac issues, pain suggesting muscle contraction injuries, or prolonged CEW exposure > 15 s. Coexisting conditions like intoxication, prolonged struggling, altered mental status, or symptoms of excited delirium syndrome may also be present in patients exposed to CEWs, although the CEW does not seem to be the precipitating factor. Presence of these findings should prompt additional evaluation or treatment of the underlying condition as clinically warranted.

For CEW activations in the probe mode, patients should be screened for injuries related to the dart penetration or surface burns due to CEW use, as well as injuries associated with falls and muscle contractions. Among patients who had a CEW activation in drive stun or touch stun mode, evaluation should focus on skin manifestations, which are typically limited to surface burns, also called signature marks.