Use of stun guns for venomous bites and stings: a review





Wilderness and Environmental Medicine: Vol. 12, No. 2, pp. 111-117.

Use of stun guns for venomous bites and stings: a review
E. BEN WELCH, PharmD; BARRY J. GALES, PharmD

From the Department of Pharmacy Practice, School of Pharmacy,
Southwestern Oklahoma State University, Weatherford, OK.



During the past 2 decades, articles suggesting that stun guns be
utilized to treat venomous bites and stings have appeared in both the
lay and medical press. Although never widely considered to be standard
therapy for venomous bites and stings, stun guns are still considered
to be a treatment option by some medical practitioners and outdoor
enthusiasts. A Medline search was performed using these terms:
venomous bites, venomous stings, snake bites, spider bites,
electrical, stun gun, high voltage electricity, low amperage
electricity, direct current, and shock therapy. Articles selected
included laboratory-based isolated venom studies, animal studies, and
case reports involving humans in which a stun gun or some other source
of high voltage, low amperage direct current electric shocks were used
to treat actual or simulated venomous bites or stings. We concluded
that the use of stun guns or other sources of high voltage, low
amperage direct current electric shocks to treat venomous bites and
stings is not supported by the literature.

Key Words: venoms, arthropod venoms, snake venoms, viper venoms,
antivenoms, electric stimulation therapy







Introduction

Some articles published in the lay and medical literature during the
past 2 decades have recommended the use of electronic immobilization
devices, commonly referred to as stun guns, in the treatment of
venomous bites or stings. Stun guns are designed to deliver high
voltage (25000-100000 kV), low amperage (<4.5 A), short duration (20
microseconds), repetitive (5-20 pulses per second) shocks when in
contact with the victim's skin. The devices develop more difficult to
control, higher amperage (190 A) shocks when administered over an air
gap or through thick clothing. Stun gun shocks stimulate superficial
nervous system tissue, resulting in repetitive muscular contractions,
pain, numbness, ataxia, and confusion. Stun gun shock duration of 0.5
seconds usually startles the victim, thus limiting their advancement.
Stun gun shock duration of 1-2 seconds usually causes the victim to
lose balance, resulting in a fall. Stun gun shock duration of 3-5
seconds causes the involved musculature to become temporarily (15
minutes) unresponsive to voluntary central nervous system control and
leaves the victim incapacitated.1-3 Over 7000 stun guns were sold
prior to the Food and Drug Administration banning the advertising of
stun guns for the treatment of bites and stings in April 1990. Stun
guns, although previously advertised for the treatment of venomous
bites or stings, have never been licensed by the Food and Drug
Administration for the treatment of any medical condition.4 Stun guns
remain commercially available and are marketed as personal protection
devices.



Spider bites

In 1999, sixty-four poison control centers fielded 15139 calls
concerning spider bites. Common sources of spider bites included
unidentified spiders (66.4%), widow spiders (Latrodectus spp; 16.3%)
and brown recluse spiders (Loxosceles spp; 15.9%). Two deaths
attributed to Loxosceles spp were reported in 1999.5 The spiders most
commonly associated with significant bites are Latrodectus spp and
Loxosceles spp.6-8 In a letter to the editor, Russell and Gertsch
describe their experiences treating what were diagnosed as probable
brown recluse spider bites. The authors found that 80% of suspected
spider bites were not actually spider bites and that accurately
diagnosed spider bites were usually attributable to non-Loxosceles spp
spiders.8 To date, no information, either scientific or anecdotal, has
been published concerning the use of high voltage direct current
(HVDC) therapy for documented Latrodectus spp bites.

Carl D. Osborn, an Oklahoma gynecologist, wrote the majority of
information detailing the use of HVDC shock therapy for spider bites
in humans. In a series of 3 articles and 1 letter published in the
Journal of the Oklahoma Medical Association, Osborn describes his
experience with HVDC therapy.9-12 In the first article, Osborn
describes his HVDC delivery device as a hand held stun gun (45-50 kV,
4.5 mA) and an extension wire. The extension wire was utilized to
allow the transfer of HVDC through large and irregular shaped lesions.
Brief case summaries of 21 patients who received HVDC shock therapy
for spider bites over a 13-month period are detailed in the body of
the article. In only 5 cases was a spider (3 brown recluse, 1 wolf
[Lycosa], and 1 unidentified spider) seen at or near the time the bite
was thought to occur. The remaining 16 cases were diagnosed as spider
bites on the basis of the clinical appearance of the lesion. Patients
received between 2 and 12 total HVDC shocks, with 6 shocks the most
common. The lesions were typically shocked twice through the lesion
and twice across the lesion in a cross pattern for 1 to 2 seconds per
shock. As early as 4 hours and as late as 1 month (mean 3 days) after
the alleged bites, HVDC therapy was initiated. Patients frequently
received corticosteroids (13 patients) and antibiotics (6 patients) in
addition to HVDC therapy. The author reported that all patients
experienced quick and dramatic reductions in pain and that no
extension of tissue damage occurred after HVDC therapy. Curiously, 6
patients (29%) received a second course of HVDC therapy 1 to 5 days
after their initial course because of pain, swelling, or lesion
enlargement. The author concluded that HVDC therapy appears to be an
effective first aid measure or supplement to conventional therapy for
all kinds of venomous bites and stings.9

The second article provided summary statistics and a few case
summaries from 147 patients treated with HVDC therapy between
September 1988 and January 1991. Included in this number were the 21
patients previously described9 and 126 additional patients treated
between October 1989 and January 1991. During this 16-month period,
the author treated, on average, 7.9 patients each month with HVDC
therapy. The majority (87%) of spider bites treated were diagnosed on
the basis of lesion appearance alone. Spiders were visually identified
as the bite source in 13% of treated patients, with brown recluse
spiders found in the area at the time of the bite in 10.9% of
patients. Patients ranged in age from 15 months to 89 years, with 12
patients 10 years and 13 patients 66 years of age being treated.
Several patients were treated for multiple bites at the same time, and
5 patients were treated for bites more than once at different times.
The time to HVDC treatment ranged from 2 hours to 5 weeks after lesion
appearance. HVDC treatment was initiated within 2 days in 58.5%, 2-5
days in 29.9%, 6-14 days in 6.8% and >14 days in 4.8% of patients. The
author stated, "As long as there is any evidence of venom activity,
such as pain, fever or inflammation, HVDC therapy may be beneficial."
Patients reportedly experienced relief of local pain and swelling,
systemic pain, nausea, and shortness of breath within 15 minutes of
receiving HVDC therapy. The author again reported that no patient
experienced progression of venom-induced tissue damage after the
initial course of HVDC therapy. However, repeat HVDC therapy was
provided to a number of patients for residual itching and discomfort.
Transient local discomfort was the only adverse effect reported by the
author. The author concluded that HVDC therapy should be used in all
cases of confirmed or suspected venomous spider bites and that
specific identification of a vector is not necessary to achieve good
results.10

The third article consists primarily of case reports detailing the use
of HVDC therapy for 1 wasp sting and 5 snakebites. In the introduction
of this article, the author states that they have successfully treated
a total of 304 spider bites with HVDC therapy. Included in the 304
cases were the 147 cases previously described10 and 157 additional
patients between February 1991 and June 1992. During this 17-month
period, the author treated, on average, 9.2 spider bite patients each
month with HVDC therapy. J & K Industries, a stun gun manufacturer,
and Outdoor Life magazine were credited with providing the information
necessary to develop the HVDC therapy protocol. The author recommended
that HVDC therapy be initiated as soon as possible to avoid
anaphylaxis, limit tissue damage, and reduce pain. This has reportedly
reduced the need for some routine procedures. Again, the author states
that identification of the vector is unnecessary because all venoms
encountered to date have responded favorably to HVDC therapy. The
author concluded that patient age, underlying medical conditions, or
both are not contraindications and that HVDC therapy should become a
routine first aid treatment.11

The fourth publication was a letter to the editor refuting the
potential dangers of HVDC therapy. Osborn stated that he has used HVDC
therapy 498 times, on patients as young as 5 months of age and as old
as 93 years of age, without a single complication. He went on to state
that his HVDC-therapy protocol is safe because it utilizes multiple 1-
2-second discharges, whereas a continuous 3-5-second discharge is
required to disable a person with a 50-kV stun gun.12

Barrett et al13 examined the effects of HVDC and dapsone therapy on
simulated brown recluse spider bites in Hartley guinea pigs. The study
was performed prospectively and in placebo-controlled fashion. Spider
venom was obtained from a commercial source, and by use of a dose-
ranging study, the authors found that a 30-μg dose induced a lesion
characteristic of necrotic arachnidism. Primary study outcome measures
were the size (expressed as area [mm2]) of erythema, induration,
blistering, and necrosis within the lesions. Lesion measurements were
performed 16, 24, 48, and 72 hours after venom injection. The initial
(16 hour) measurements were used as a baseline to calculate percentage
of change in lesion size on the second and third study days. Guinea
pigs received a single intradermal venom injection in a shaved area on
their dorsum and were randomized into 1 of 4 treatment groups. The
first group (4 animals) received dapsone 0.7 mg/kg twice daily for 3
days. The second group (4 animals), while anesthetized, received four
1-second shocks in a clockwise pattern around the lesion from a Parali/
azer stun gun (Southwest Shooters' Supply, Oklahoma City, OK) equipped
with extension wires. The third group (5 animals), while anesthetized,
received four 1-second shocks in a clockwise pattern around the lesion
from a Guardian stun gun (Life Products, Las Vegas, NV) equipped with
an extension wire. The fourth group (6 animals) received no treatment.
Treatment was initiated 16 hours after venom injection in groups 1, 2,
and 3. The authors felt that a 100% increase in lesion area over the
72-hour study period would be clinically significant. Use of the
Parali/azer stun gun delayed wound healing and resulted in
significantly (P .05) larger (values not given) areas of induration
when compared to untreated animals. Use of the Guardian stun gun was
not associated with any significant lesion area alterations at any
time period. Dapsone treatment was associated with significant (P .
05) reductions in the area of lesion induration at 72 hours compared
to control and Guardian stun gun-treated animals (25 vs 60 and 65 mm2,
respectively). At 72 hours, the area of lesion necrosis was also
significantly (P .05) reduced in the dapsone versus control and
Guardian stun gun-treated animals (3 vs 9 and 13 mm2, respectively).
The area of lesion necrosis was significantly smaller (P .05) at 48
hours (4 mm2) and 72 hours (3 mm2) than at 24 hours (16 mm2) in the
dapsone group but not in any other treatment group. The authors
thought that the large variability between the Guardian and Parali/
azer stun guns may have been secondary to differences in arc duration.
The authors pointed out that with sufficient time all simulated spider
bites healed.13



Other arthropod bites or stings

Using the spark plug wire of an internal combustion engine to treat
scorpion stings is a folk remedy that dates back to at least the 1940s.
14,15 This practice has not been proven effective and may be dangerous.
14 An unreferenced article in the magazine Sierra off-handedly stated
that HVDC therapy effectively treats ant and sea scorpion bites.16
Guderian et al, in a letter to the editor, reported that HVDC therapy
has been successfully used to treat ant (Paraponera spp) bites and
black scorpion (Tityus spp) stings in the jungles of Ecuador.17
Osborn9 reported that HVDC therapy immediately relieved the local
symptoms associated with bee, bumble bee, and red wasp stings. In a
subsequent article,11 Osborn reported that he had successfully used
HVDC therapy to treat 42 stings. These patients attributed their
stings or bites to 25 unknown agents, 9 wasps, 3 bumblebees, 2
scorpions, 2 yellow jackets and 1 tick. HVDC therapy reportedly
relieved pain and itching in 10 to 15 seconds, with reductions in
local reactions and systemic symptoms (neither defined) apparent
within 15 minutes. No specific information was presented detailing why
these 42 stings or bites required treatment as aggressive as HVDC
therapy. Osborn also described the clinical course of a 12-year-old
boy treated with HVDC therapy for a red wasp sting on the bridge of
the nose. The patient presented to the emergency department 3 hours
after the sting with facial swelling and slight dyspnea. The patient
had taken 50 mg of diphenhydramine orally at home and received
epinephrine and methylprednisolone 80 mg intramuscularly on arriving
at the hospital. Approximately 15 minutes later, HVDC therapy (3
shocks) was initiated, with the patient reporting an immediate relief
of discomfort. The patient was discharged from the emergency
department approximately 25 minutes later with reduced facial swelling
and without dyspnea.11



Snakebites

In 1999, sixty-four poison control centers fielded 5767 calls
concerning snakebites. The most common sources of snakebites were
nonpoisonous snakes (37.7%), unidentified snakes (30.9%), rattlesnakes
(17.2%), copperheads (10%), and cottonmouths (1.9%). Two snake bite-
associated deaths were reported in 1999.5 Five genera of poisonous
snakes are indigenous to the United States.18 In 1999, the 3 genera
encompassing rattlesnakes, copperheads, and cottonmouths were
responsible for 93% of all reported venomous snake bites to humans in
the United States.5 The remaining 2 genera of poisonous snakes are
coral snakes (family Elapidae).18 In 1999, coral snakes accounted for
2.5% of all reported venomous snake bites to humans in the United
States.5

The use of HVDC shock therapy has been touted17,19,20 and also
repudiated 18,21-27 as a safe and effective treatment modality for
venomous snakebites. In 1986, Guderian et al reported that they had
treated 34 snakebitten Waoroni Indians in Ecuador with HVDC shock
therapy.17 The shock treatments were administered by using a stun gun
that delivered 20-25 kV of less than 1 mA of direct current to the
bite site. Initially, 1 fixed probe of the stun gun was used as the
ground while the other fixed probe was utilized to apply the shock.
Guderian later modified his HVDC shock technique by attaching an
extension wire to one of the stun gun's fixed probes. The addition of
an extension wire allowed the HVDC shocks to be administered through
or across the entire affected area. Typically, 4 or 5 HVDC shocks were
administered with a 5 to 10 second rest between shocks. Only 2 of 34
bites detailed in this report were positively identified as coming
from pitvipers (Bothrops atrox [fer-de-lance] and Lachesis muta
[bushmaster]). The author reported that both of the patients with
documented pitviper bites recovered after administration of 7 HVDC
treatments. Seven patients reportedly refused HVDC shock therapy. All
7 experienced complications as a result of their snakebites and 2
required life-saving amputations. The authors hypothesized that the
beneficial effects of HVDC therapy may be the result of direct effects
on the venom or that the therapy prevents the vascular spread of the
venom.17 Theakston et al later determined that 78% of Waoroni Indians
tested positive for snake antibodies that might afford at least some
degree of immunity to snakebites.28

Harding interviewed Guderian approximately 3 years after the initial
publication of his letter to the editor detailing the use of HVDC
therapy in Ecuador. At this time, Guderian had treated 300 snakebite
victims with HVDC. In approximately 100 of these cases, a venomous
snake was identified and medical follow-up was adequate for
evaluation. Almost all (96) patients treated within half an hour
exhibited no envenomation effects. Guderian reported that he had quit
using stun guns and now utilized the ignition system of small motors
to deliver HVDC therapy. Guderian stated that he still considers HVDC
experimental and would like to see further clinical trials.29

Mueller, in the first of 2 articles published in 1988 in Outdoor Life
magazine, related several anecdotal stories of both people and animals
being treated with HVDC shock therapy for snakebites. The first case
described was of a veterinarian's successful use of a pickup truck
ignition system and 2 pieces of insulated wire to treat a dog bitten
by a rattlesnake. The second case described a Missouri physician's use
of his car and a set of jumper cables as a means of delivering HVDC
shocks to a woman bitten by a copperhead snake. According to the
article, the physician thought that the high-voltage shock would upset
the electrical properties of the metal ions found in snake venom,
"possibly uncoupling what makes the venom work." Mueller goes on to
report that Dr Guderian has received numerous reports about the
successful use of HVDC shock therapy for treating venomous snakebites
from several countries, including Japan, Peru, Columbia, Argentina,
New Guinea, and Africa.19

In the second article, Mueller describes other conditions that
reportedly were successfully treated with HVDC shock therapy,
including stingray stings, scorpion stings, fire-ant stings, migraine
headaches, boils, chronic back pain, and infections unresponsive to
antibiotic therapy. On a conservative note, he suggests that treating
the bite of a coral or cobra snake is not practical because of the
speed at which these snakes' neurotoxic venom works.20

McPartland and Foster detailed their experiences of treating
snakebites with a stun gun in a letter to the editor. One of the
authors sustained 2 bites from a timber rattlesnake on the radial
aspect of the left forearm. Three fang puncture sites were quickly
identified and shocked 6 times (0.5-1 second per shock) each with a
Nova-Spirit stun gun (40 kV) (J B K Industries, Claremore, OK). The
fourth fang puncture site was found sometime later and was not treated
with HVDC therapy. The untreated puncture site was the only involved
area to develop a hemorrhagic ulcer. The untreated puncture site was
located 2 cm from a HVDC treated puncture site that led the authors to
postulate that the accuracy of shock placement is very important to
the success of HVDC therapy. The authors suggest that HVDC therapy
reduces complications and enhances healing of snakebites.30

Kroegel and Meyer zum Buschenfelde proposed 3 possible mechanisms for
the success of HVDC shock therapy. First, the applied current may
destroy secondary and tertiary structures of enzymes by changing
hydrogen bonds. Second, the electrical current may reduce some metal
ions that may serve as mandatory cofactors for enzymes in the venom.
Third, the applied electrical current may have some yet unknown direct
action on the venom itself.31

Numerous articles and letters have appeared repudiating the validity
of using HVDC shock therapy for venomous snakebites. Russell
considered that the use of electricity to treat snakebites was "folk
medicine" and that it may delay the use of proven lifesaving therapies.
21 Gold stated that the continued use of HVDC shock therapy for
treatment of snakebites is another instance in which favorable results
of anecdotal reports have not been reproduced in controlled studies.23
Bucknall, in a lengthy letter to the editor, summarized the data on
the use of HVDC shock therapy for venomous bites and stings and
systematically repudiated each claim and theory.22 In 1992, Hardy
published an insightful and thorough review of the literature
describing the use of HVDC therapy for venomous snakebites. Hardy, in
addition to summarizing the literature, was also able to include
numerous pertinent personal communications from involved individuals
and briefly describe the results of 2 unpublished animal studies that
found no benefit from HVDC therapy. Ultimately, Hardy determined that
the data currently available did not support the use of HVDC therapy
for venomous snakebites.29

In one of the few laboratory studies available, Johnson et al
evaluated the effects of HVDC shock therapy on mice injected with
snake venom. Mice were injected with reconstituted rattlesnake venom
(Crotalus viridis oreganus) at various LD50 multiples. Some mice
received HVDC shock therapy from a car electrical coil powered by a 12-
V battery producing a 20-25-kV current. All mice injected with either
3.0 mg/kg or 6.0 mg/kg of venom died in both HVDC and control groups.
Approximately 87% of mice died in both groups after venom doses of
1.75 mg/kg, whereas all mice survived venom doses of 1.5 mg/kg. The
authors concluded that HVDC therapy was ineffective in reducing the
lethal effects of snake venom in their study and speculated that mice
may not be the best animals to use for this type of study.25

In an interesting experiment, Dart et al attempted to simulate the
conditions present in the Ecuadorian jungle. During the preliminary
phase of the experiment, mice were injected with Western diamondback
rattlesnake (Crotalus atrox) venom and then shocked using a spark plug
wire from a 1956 Ford truck. Results from the preliminary phase of the
experiment were inconsistent. However, the fact that some groups of
shocked animals appeared to respond to the therapy prompted the
authors to conduct a second, better controlled study. During the
second experiment, 40 Sprague-Dawley rats were injected with 80 mg/kg
of C atrox venom. The HVDC treatment group immediately received ten
1.8-second shocks (25 Hz, 25 kV, and 1 mA) from a modified automotive
ignition system, whereas controls received no treatment. No benefit of
HVDC therapy was identified in this study and mortality was similar in
both treated and untreated rats at 12 and 24 hours.32

Howe and Meisenheimer found that the use of HVDC shock therapy failed
to reduce either morbidity or mortality in rats injected with diluted
commercially available venom of the Ecuadorian fer-de-lance snake (B
atrox).33 Stoud et al reported that four 2-second shocks (1800 V, 8.19
A) did not improve outcomes after rabbits were injected with 1 mg/kg
of Eastern diamondback rattlesnake venom (Crotalus adamanteus).34
Snyder et al studied the effects of HVDC therapy on simulated Western
diamondback rattlesnake (C atrox) and cottonmouth (Agkistrodon
piscovorus leukostoma) envenomation in dogs.35 Dogs in the HVDC group
received five 1-3-second shocks as previously described by Guderian.17
No differences were evident to the investigators during their 36-hour
comparison of HVDC-shocked and control dogs.35

Davis et al treated isolated rattlesnake venom with HVDC shocks to
determine if high voltage had any effect on the lethality of the
venom. The isolated venom was shocked for 18 times longer than
recommended by the stun gun manufactures advertising their devices as
snakebite treatments. Subsequent LD50 determinations carried out in
mice found no significant difference between the HVDC-shocked and
nonshocked venom.24

Dart and Gustafson described in detail the case of a 28-year-old man
who was bitten near his right upper lip by his pet Great Basin
rattlesnake (Crotalus viridis lutosus). The patient had been
previously bitten 14 times. During treatment for 1 of these 14 bites,
the patient had experienced an anaphylactic reaction to antivenom. On
the basis of information they had read in an outdoorsman's magazine,
the patient and his neighbor developed a plan to use HVDC shock
treatment in case the patient was bitten again. The patient and his
neighbor were provided with the opportunity to test their plan after
the patient's 15th rattlesnake bite. The snakebitten patient was
placed on the ground close to the car. The HVDC shock was delivered by
attaching a lead wire from one of the car's spark plug wires to the
patient's lip. The neighbor then started the car and revved the engine
to 3000 revolutions per minute repeatedly for approximately 5 minutes.
The patient reportedly lost consciousness during the first HVDC shock
treatment. The ambulance crew, who arrived about 15 minutes later,
found that the patient was unconscious and had fecal incontinence. On
the basis of the ambulance crew's initial evaluation of the patient's
unstable vital signs, he was transported to a hospital by helicopter.
The patient arrived at the hospital approximately 1 hour and 40
minutes after the bite. In the emergency department, the patient was
found to be obtunded, hypotensive (blood pressure 62/palpable mm Hg),
tachycardic (pulse rate 120 beats/min) and hypothermic (35.4°C). The
patient experienced severe face and neck swelling that necessitated
nasotracheal intubation. After fluid resuscitation therapy, the
patient regained consciousness and vital signs stabilized. Laboratory
testing revealed moderate coagulopathy (protime 20 seconds) and
thrombocytopenia (<40000 mm3) that resulted in the administration of
10 units of platelets. The patient exhibited a positive skin test
reaction to Crotalidae polyvalent antivenom and received
hydrocortisone 200 mg, diphenhydramine 100 mg, and cefazolin 1 gm
intravenously as antivenom pretreatment. During the following 8 hours,
the patient received 27 vials of antivenom. The patient was discharged
after a bout of serum sickness with residual facial edema and loss of
facial tissue, which ultimately required surgery.35

All of the studies available to date have their limitations. One major
recurring concern of HVDC therapy advocates is that no human subjects
were used, only laboratory animals. HVDC supporters question whether
using an animal (mice and rats) that venomous snakes normally prey on
is appropriate. In a letter to the editor, Blaylock27 stated that
"rats are not human, but it is unlikely that electrotherapy will be
found more beneficial than placebo in the management of snakebite."
Other recurring concerns involve the type (fresh vs commercially
available), source (species), and dose of venom administered in the
controlled trials.



Safety

Stun gun shocks may produce symmetrical circular areas of superficial
hypopigmentation or burns. Up to 4 (2 from the primary contacts and,
less commonly, 2 from the voltage-limiting spark-gap pins) of these
lesions may develop at each site where the stun gun delivered a shock.
Fresh HVDC lesions may also be raised and erythematous.1,2 Robinson et
al studied the performance of 6 stun guns at a resistance load of 500-
5000 Ω and found that peak voltage ranged from 1.9 to 27.4 kV, peak
current from 2.9 to 8.1 A, and pulse duration between 4.5 and 41.6
microseconds.3 Deaths have occurred 5 to 25 minutes after HVDC shocks
delivered by a Taser electronic gun (barbed projectiles deliver the
shock) in phencyclidine intoxicated patients.37

Roy and Podgorski2 studied the effects of 2 stun guns, 1 high output
and 1 low output, on the cardiac conduction of 2 anesthetized
Yorkshire pigs. Studies were conducted with the stun guns placed
externally on the chest wall, on the exposed pericardium, and on the
chest wall of a pig with an implanted cardiac pacemaker. When placed
on the intact chest wall, both guns produced superficial burns, but
only the high output device altered cardiac rhythm. The high output
gun was able to induce asystole for as long as it remained on when
firing through 3 layers of operating room towels placed on the chest
wall. Cardiac rhythm returned to normal if the device was shut off in
30 seconds. If the device remained activated for >30 seconds the
animal developed ventricular fibrillation with resultant pump failure.
Direct pericardial shocks resulted in arrhythmias after shocks from
the low output gun and ventricular fibrillation after shocks from the
high output gun. The internal leads of the implantable cardiac
pacemaker efficiently carried impulses from external chest wall shocks
resulting in ventricular fibrillation.

Gushee and Dedolph38 describe the successful use of stun guns to
resuscitate a patient. The 39-year-old patient had no pulse and was
not breathing when found by police officers. The patient had attempted
suicide by ingesting sleeping pills, followed by hanging. The officers
performed cardiopulmonary resuscitation, which led to return of both
pulse and respirations. After several minutes of spontaneous
respiration and palpable pulse, the patient became apneic and
pulseless. The officers administered HVDC shocks by discharging 2 NOVA
stun guns placed on the patient's chest. This resulted in return of
both a palpable pulse and spontaneous respiration. The officers
successfully repeated this procedure 5 more times for reoccurring
episodes of pulselessness and apnea prior to the arrival of
paramedics. Unfortunately, no cardiac monitoring devices were
available during these episodes. Thus, we cannot be sure that the HVDC
shocks altered a potentially fatal dysrhythmia or simply caused
significant pain that stimulated the patient's cardiac and respiratory
activity.

Global statements concerning the safety of stun gun devices cannot be
confidently made because the devices have been insufficiently tested,
exhibit considerable intragun and intergun variability, and tend to
malfunction frequently.3,39 The potential fibrillatory risk associated
with prolonged stun gun shocks has not been well studied.2,3 HVDC
shock therapy is likely most dangerous in the very young, the elderly,
phencyclidine intoxicated patients, and patients with preexisting
cardiac disorders or pacemakers.2,37-39

Using the ignition system of an internal combustion engine may have
contributed to the death of at least 1 patient and the disfigurement
of another.21,36 Significant tissue damage has been reported in
patients who were mistakenly shocked with a lead from a high amperage
ignition system.21,22



Summary

There is a large amount of data available detailing the potential
beneficial effects of HVDC therapy in the form of personal
testimonials, anecdotal reports, and uncontrolled case reports
involving both humans and animals. In contrast, the results of
controlled trials utilizing snake or spider venom injected into mice,
rats, rabbits, and dogs have found HVDC therapy does not positively
effect the natural course of envenomation and, in some cases, may
delay wound healing. Administration of HVDC shocks is reportedly well
tolerated by patients and appears to carry little intrinsic risk in
otherwise normal, healthy patients. One major concern about the use of
HVDC shock therapy is that patients may believe that they have been
treated adequately and thus may not promptly seek appropriate medical
care after a clinically significant bite or sting. HVDC shock therapy
is not supported by the scientific literature and should not be
considered a viable treatment option for venomous bites or stings.



References

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3. Robinson MN, Brooks CG, Renshaw GD. Electric shock devices and
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4. Barrett SM, Walker JS, Romine-Jenkins M. Electrotherapy for
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Corresponding author: E. Ben Welch, PharmD, SWOSU Pharmacy Education,
St Anthony Hospital, PO Box 205, Oklahoma City, OK 73101 (E-mail:
welchb@xxxxxxxxx).



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