taser (use of) policy - south west yorkshire partnership …€¦ · web view · 2016-01-21use...

Document name: Deployment of Taser by police on Trust premises

Document type: Clinical Guidance

Staff group to whom it applies:

All staff

Distribution: The whole of the Trust

How to access: Intranet

Issue date: November 2015

Next review: November 2017

Approved by: Executive Management Team

Developed by: Managing aggression and violence Trust action Group sub group in consultation with Police

Director leads: Director of Nursing, Clinical Governance and Safety

Contact for advice: MAV Specialist Advisors LSMS Specialist Advisors

Table of Contents 1. Introduction .....................................................................................................1

2. Purpose and scope of the policy ....................................................................1

3. Duties .............................................................................................................1

4. Equality impact assessment ...........................................................................2

5. Dissemination and implementation arrangements ..........................................2

6. Guidance Principle .........................................................................................3

7. What is a Taser and how does it work ............................................................3

8. Normal effects of Taser use ...........................................................................3

9. Medical implications and risks of taser use and action following the use of a

taser..............................................................................................................4

10.Use of Tasers on Trust premises – working with the police to risk assess

the use of taser .............................................................................................6

11.The following clinic symptoms should be referred to the Accident &

Emergency Department ................................................................................7

12.Training ...........................................................................................................7

13.Process for checking compliance with the policy.............................................7

14.Process for monitoring compliance ................................................................8

15.Review and revision of arrangements ............................................................8

16.References/documentation .............................................................................8

17.Other relevant documents ..............................................................................8

AppendicesAppendix A

Monitoring protocols post deployment of a Taser ......................................................9

Appendix B

People involved in reviewing the policy .....................................................................10

Appendix C

Equality impact assessment tool ...............................................................................11

Appendix D

Checklist for the review and approval of procedural document .................................13

Appendix E

Version control sheet .................................................................................................15

Appendix F

South Yorkshire Police Document .............................................................................16

1. Introduction

The Taser has recently been introduced into British Policing for use by Firearms Officers and other specially trained units. It provides them with a safer, Human Rights compatible, “less lethal” weapon option in incidents when they are confronted with a potentially dangerous and violent individual. Although generally considered safer than many other interventions it is not completely risk free and staff should familiarise themselves with the principles in this guidance.

This policy should be read in conjunction with:

1.1 Managing aggression and Violence Policy1.2 First Aid Policy1.3 Rapid Tranquilisation Policy1.4 Seclusion Policy1.5 Health and Safety Policy1.6 Inpatient Observation Policy1.7 Mental Health Act

2. Purpose and scope of the guidance

This guidance is relevant for all staff caring for patients in inpatient areas of South West Yorkshire Partnership NHS Foundation Trust (The Trust).

This policy aims to:

2.1 Describe responsibilities of trust staff pre, during and post deployment of a Taser by the police to support the management of a service user on trust premises.

3. Duties

3.1 Executive Management Team

The Executive Management Team will be responsible for approving this guidance.

3.2 Director of Nursing, Clinical Governance and Safety

The Director of Nursing, Clinical Governance and Safety is the lead director for this guidance within the Trust. The lead director will be responsible for engaging relevant stakeholders in the development of the guidance and ensuring appropriate arrangements are in place for managing any resource implications, including dissemination and any training required and for ensuring the most current version is in use and obsolete versions have been withdrawn from circulation. The Director of Nursing, Clinical Governance and Safety will also link with the district directors to identify any problems with the operationalisation

Deployment of Taser by police on Trust premises 1

or monitoring of this guidance.


Clinical Governance and Clinical Safety Committee

Responsible for scrutinising the implementation and effectiveness of this guidance and providing assurance to the Trust Board.

3.3 Management of Aggression and Violence Trust Action Group (TAG)

The TAG will be responsible for reviewing and amending the guidance at the direction of the lead director.

3.4 District Director

The District Director is responsible for ensuring the implementation of this guidance within their clinical areas. They will draw the relevant managers’ attention to any performance issues on an exception reporting basis.

3.5 Clinical leads, General managers, Practice Governance Coaches, Service managers, unit/ward managers

Clinical leads, General managers, Practice Governance Coaches, Service managers and, unit/ward managers are responsible for ensuring that staff act within scope of the guidance.

3.6 All clinical staff

All staff have a duty to ensure that they understand guidance and to bring any training need to attention of their line manager.

4. Equality impact assessment

This guidance has no differential impact on equality, as identified by the equality impact assessment tool as included in the ‘Policy for the development, approval and dissemination of policy and procedural documents’ (Appendix C).

5. Dissemination and implementation arrangements

Once approved, the integrated governance manager will be responsible for ensuring the updated version is added to the document store on the intranet and is included in the staff brief.

Implementation of the guidance will be cascaded from the District Directors through their district structures and thence by General Managers as part of the supervision process.


6. Guidance Principles

6.1 This Procedure provides Trust staff with an understanding of the effects experienced by an individual upon whom a Taser has been deployed either on Trust premises or prior to admission.

6.2 It also details both the care required of that individual during their recovery and the possible complications that may occur needing more specialised medical intervention.

7. What is a Taser?

7.1 A Taser is a hand held device that fires two probes (or barbs) at an individual. The probes are intended to attach to the skin or clothing on the torso and/or lower limbs. The probes are attached to the Taser handset by thin wires.

7.2 A sequence of very short duration, high voltage electrical current pulses pass through wires delivering an electrical charge which incapacitates individual.

7.3 The current flows into the body and results in a loss of muscular control and pain. The effects are instantaneous but only last as long as the charge is applied.

7.4 The Taser also enables direct contact of the taser handset to the surface of an individual; two closely spaced fixed electrodes pass the current pulses into the subject. This manner of application is usually classed as use in “stun” or “probe” mode; pain is the principal local physiological effect.

7.5 The Taser has a red laser attached that is used to aim the barbs, but also is used as a warning to the subject that Taser may be fired.

7.6 However Taser can potentially cause injury in three ways:

the direct effect of electric current on the tissue conversion of electrical energy to thermal energy blunt injury from muscle contractions or falls

8 Normal effects of Taser use

8.1 During or shortly after the use of the Taser, individuals may experience the following:

Feeling dazed for several minutes Muscle twitches Loss of memory of the event Unsteadiness and a spinning sensation


Temporary tingling Weakness in the limbs Local aches and pains, and tissue swelling

These sensations are normal effects of the Taser, but if any of these persist for 24 hours later, medical advice must be sought.

9 Medical implications and risks of taser use and action following the use of a taser

9.0.1 The Duty On-Call Doctor or appropriate Medical personnel must attend as a matter of urgency whenever a Taser is, or is likely to be deployed on trust premises.

9.0.2 Any inpatient that has been subject to the use of a taser on Trust premises will be examined by a doctor as soon as is practical. Close monitoring of the individual throughout the period following application of the Taser should occur ideally, include Temperature, Pulse. Respirations, Blood Pressure. A chart is provided to facilitate this (appendix A) and this should be kept with clinical records. A review of

observation levels should also take place. An information sheet will be provided by the Police Officers to the person who has been subjected to the use of taser. (appendix F)

9.1 Post incident removal of the taser probes

9.1.1 Removal of the Taser probes must be undertaken by an individual who is trained in probe removal. This could be a medical professional with suitable training or the deploying police officer in line with operational necessity.

9.1.2 After removal of the probe, the area must be cleaned and a small dry dressing applied when any bleeding has stopped.

9.1.3 Any injuries noted should be recorded in the individual’s healthcare record.

9.1.4 Close monitoring of the individual throughout the period following application of the Taser as above.

9.1.5 Taser probes to the face, eye, throat, groin or an implant, especially in the female breast area, should be referred to the Accident & Emergency Department.

9.2 Taser Probe Penetrating the Skin

9.2.1 Skin is the primary resistor to flow of the electrical current delivered via the Taser. Skin resistance varies widely depending on the thickness, vasculacity, hydration, callosity and the area of the body to which electricity is delivered.


9.2.2 Taser probes are approximately 4mm in length and are designed to stick in the skin or in the clothing and not fall out. The 4mm depth is not deep enough to threaten internal organs or cause a pneumothorax.

9.2.3 There may be two small marks like bee stings in the skin. These are small puncture wounds from the short needles used to apply the electricity directly into the skin. There may be small burns similar to sunburn around the marks. These subside in a few days. If they do not and there is pain and swelling, these should be investigated further.

9.2.4 If the probes only made contact with clothing there still may be two small areas of skin underneath that look sunburned.

9.3 Post incident reporting and management

9.3.1 Appropriate support and post incident debrief should be offered to the all involved in the incident.

9.3.2 Depending on the circumstances of the incident, the individual may be removed in to Police custody.

9.3.3 Each incident where a service user presents particular management problems resulting in Police intervention must be reported using the Trust’s reporting procedure and an entry made in the clinical notes. Deployment of Taser should be recorded at least as an amber SI incident on Datixweb

(Type violence and aggression) .

9.3.4 The deployment of Taser by a police officer will ALWAYS be subject of post incident procedures and that a taser trained supervisor should oversee this process. There may be evidential matters that need to be addressed at the scene, dependant on any perceptual or actual considerations following the deployment.

9.4 Post Taser complications requiring referral to accident & emergency department. Police officer using Taser will be trained to deploy it in a way which minimised the risk of adverse medical outcomes, nevertheless staff should be aware of potential issues.

9.5 Burns

9.5.1 Several research papers have described minor burns in association with Taser probe strikes. These have been superficial and unlikely to result in permanent scarring. Burns


located between the Taser probes are not uncommon. Anything that looks worse than mild sunburn should be considered abnormal and medical review should take place.

9.6 Indirect Injury

9.6.1 In most cases, the application of a Taser will be sufficient to render an individual incapable of continuing an attack and is likely to result in the individual collapsing to the ground. The effect is not intended, nor is likely, to render the individual into a state of unconsciousness. The recovery from the effects of the Taser should be almost instantaneous once the current stops. The individual may be at risk of serious injury from an uncontrolled collapse although most individuals collapse in a semi controlled manner.

9.7 Pregnancy

9.7.1 Caution must be exercised in pregnant individuals.

9.8 Epilepsy

9.8.1 There is no evidence to suggest that appropriate taser use increases the risk of epilepsy.

9.9 Medication

9.9.1 There is no known adverse link between any medication and the use of Taser.

9.10 Individuals with known cardiac issues should have an ECG as soon as possible post taser deployment. Caution should be exercised where individuals have known to have consumed illegal drugs or alcohol and Trust staff should make police aware of this.

10 Use of Tasers on trust premises – working with the police to risk assess the use of taser

10.1 Trust staff will not use Tasers – any use of Tasers on Trust premises will be by the Police, when the police have been requested to attend and safely manage an incident

10.2 The Trust does not expect that service users will ordinarily be exposed to Tasers and expects Tasers to be used on Trust premises only in exceptional circumstances – where there is an immediate and significant risk of harm to any individual.


10.3 The Trust recognises that once the Police are requested to attend and manage an incident it is an operational decision for the Police as to how the incident is managed and whether Taser is deployed.

10.4 However, the physical effects of the use of Tasers (see section 9) carry some medical risks (see section 10) which will need to be risk assessed. Therefore in all situations where the police are considering the use of a Taser the Trust expects that, wherever possible, staff will work closely with the Police by sharing any relevant information about the individual(s) who is (are) potentially subject to the use of a Taser, to enable the police to undertake an informed risk assessment of the use of a Taser. This will include sharing information about any relevant/known medical conditions as well as the current medication regime and whether they are using drugs/alcohol.

11 The following clinical symptoms should be referred to the Accident & Emergency Department:

11.1.1 Persistent abnormal vital signs

11.1.2 Altered level of consciousness

11.1.3 Symptoms of hyperthermia

11.1.4 Abnormal, subjective complaints, including chest pain, shortness of breath, nausea or prolonged or severe headache

12 Training

12.1 Staff should monitor individuals wellbeing post Taser deployment in accordance with this guidance.

This is achieved through:

o MAV trainingo Rapid Tranquilisation training

in patient observation policy

13 Process for checking compliance with the policy

Service managers will be responsible for ensuring compliance with the guidance in their clinical areas via management supervision and caseload management. The MAV tag and the Health and Safety tag will review any incident from a practice and/or procedural perspective. All Taser deployment will be reported as an incident with a severity grading of at least Amber under the Trust’s Incident Management and risk severity grading procedures, and a management fact find review will be undertaken to establish if any further actions or investigation are warranted.


14 Process for monitoring compliance

Compliance with the guidance will be monitored via Business Delivery Unit performance management processes.

15 Review and revision arrangements

The guidance will be reviewed by the agreed review date, in line with the Trust’s ‘Policy for the development, approval and dissemination of policy and procedural documents’, or earlier if required. Responsibility for initiating a review and taking the new policy to the Executive Management Team for approval lies with the lead director. The review of the policy will be managed through the MAV TAG.

The integrated governance manager is responsible for placing the new version of the guidance in the electronic document store, for ensuring the document being replaced is removed from the document store and that an electronic and paper copy, clearly marked with version details, are retained as a corporate record.

16 References/documentation http://content.met.police.uk/Article/What-is-Taser/1400015952958/1400015952958

17 Other relevant documents

17.1 Managing aggression and Violence Policy

17.2 First Aid Policy

17.3 Rapid Tranquilisation Policy

17.4 Seclusion Policy

17.5 Health and Safety Policy

17.6 Inpatient Observation Policy

17.7 Mental Health Act

17.8 Mandatory Training Policy


http://content.met.police.uk/Article/What-is-Taser/1400015952958/1400015952958

http://content.met.police.uk/Article/What-is-Taser/1400015952958/1400015952958

Appendix AMonitoring protocols post deployment of a Taser

Name ………………………………. Rio Number ………………………………

Date of Taser deployment……………………………..Time of Taser deployment…………………………..See section 9

Date Time Temp Pulse Resp BP ECG Comment/action10 mins

30 mins

60 mins

Policy for the effective use of bedrails, version Control: V3 10

Observations should be completed after 10 minutes, 30 minutes and 60 minutes and repeated 4 hourly until review by medical staff indicates otherwise. ECG should be undertaken as soon as is practicable where individuals are known to have cardiac issues..

Appendix BPeople involved in reviewing the policy

.

The policy was developed by a sub group of the Management of Aggression and Violence/Health and Safety Trust Action Groups.

The policy was developed in consultation with:

MAV tag Ward managers West Yorkshire police South Yorkshire Police Business Delivery Unit Representatives Health & Safety TAG Safeguarding lead Mental Health Act Manager

Policy for the effective use of bedrails, version Control: V3 11

Appendix CEquality impact assessment tool

To be completed and attached to any policy document when submitted to the Executive Management Team for consideration and approval.

Equality Impact Assessment Questions:

Evidence based Answers & Actions:

1 Name of the policy that you are Equality Impact Assessing

Deployment of Taser by police on Trust premises

2 Describe the overall aim of your policy and context?

Who will benefit from this policy?

Describes responsibilities of trust staff pre, during and post deployment of a Taser by the police on trust premises

3 Who is the overall lead for this assessment?

Director of Nursing, Clinical Governance and Safety

4 Who else was involved in conducting this assessment?

MAV tag (including service user and carer reps)

5 Have you involved and consulted service users, carers, and staff in developing this policy?What did you find out and how have you used this information?

Service user and their representatives are members of MAV tag.

6 What equality data have you used to inform this equality impact assessment?

N/A

7 What does this data say? N/A

8 Have you considered the potential for unlawful direct or indirect discrimination in relation to this policy?

The author of the policy has considered this and ensured that the wording is not discriminatory to any one particular group.


Equality Impact Assessment Questions:

Evidence based Answers & Actions:

9 Taking into account the information gathered.Does this policy affect one group less or more favourably than another on the basis of:

The guidance covers all staff working in SWYPFT and all service users who are in contact with Trust bed based services. The policy will be implemented in the same way for everyone regardless of individual’s diverse characteristics.

YES NO

Race N

Disability N

Gender N

Age N

Sexual Orientation N

Religion or Belief N

Transgender N

10 What measures are you implementing or already have in place to ensure that this policy:

promotes equality of opportunity,

promotes good relations between different equality groups,

eliminates harassment and discrimination.

11 Have you developed an Action Plan arising from this assessment? If yes, then please attach any plans at the back of this template.

N/A

12 Who will approve this assessment and when will you publish this assessment.

Director of Nursing, Compliance and Innovation, and EMT. The assessment forms an attachment to this policy and will be available on the Trust’s intranet.


Appendix DChecklist for the review and approval of procedural document

To be completed and attached to any policy document when submitted to EMT for consideration and approval.

Title of document being reviewed: Yes/No/Unsure Comments

1. Title

Is the title clear and unambiguous? YES

Is it clear whether the document is a guideline, policy, protocol or standard?

YES

2. Rationale

Are reasons for development of the document stated?

YES

3. Development Process

Is the method described in brief? YES

Are people involved in the development identified?

YES

Do you feel a reasonable attempt has been made to ensure relevant expertise has been used?

YES

Is there evidence of consultation with stakeholders and users?

YES

4. Content

Is the objective of the document clear? YES

Is the target population clear and unambiguous?

YES

Are the intended outcomes described? YES

Are the statements clear and unambiguous? YES

5. Evidence Base

Is the type of evidence to support the document identified explicitly?

YES

Are key references cited? YES

Are the references cited in full? YES

Are supporting documents referenced? YES

6. Approval

Does the document identify which committee/group will approve it?

YES


Title of document being reviewed: Yes/No/Unsure Comments

If appropriate have the joint Human Resources/staff side committee (or equivalent) approved the document?

N/A

7. Dissemination and Implementation

Is there an outline/plan to identify how this will be done?

YES

Does the plan include the necessary training/support to ensure compliance?

YES

8. Document Control

Does the document identify where it will be held?

YES

Have archiving arrangements for superseded documents been addressed?

YES

9. Process to Monitor Compliance and Effectiveness

Are there measurable standards or KPIs to support the monitoring of compliance with and effectiveness of the document?

YES

Is there a plan to review or audit compliance with the document?

YES

10. Review Date

Is the review date identified? YES

Is the frequency of review identified? If so is it acceptable?

YES

11. Overall Responsibility for the Document

Is it clear who will be responsible implementation and review of the document?

YES


Appendix EVersion control sheet

This sheet should provide a history of previous versions of the policy and changes made.

Version Date Author Status Comment/changes1 Nov 2012 MAV sub

groupFinal Approved following consultation

with all stakeholders2 Nov 2015 MAV sub

groupdraft Reviewed and still relevant.

Updated to reflect changes in names of Trust groups. Circulated to MAVTAG forcomments.


Appendix F

SOUTH YORKSHIRE POLICEINFORMATION FOR PERSON SUBJECTED TO TASER

You have been subjected to the effects of the Taser. The Taser passed short pulses of electricity into your body. The electricity made your muscles contract. You may have lost balance and fallen to the ground.

The device was used by a specially trained police officer.

During, or shortly after the use of the Taser, you may have experienced the following:

Dazed for several minutes; Muscle twitches; Loss of memory of the event; Unsteadiness, and a spinning sensation; Temporary tingling; Weakness in the limbs; Local aches and pains, and tissue swelling.

These sensations are normal effects of the Taser.

If any of these effects are still present a day later, see a Doctor.

You may have two small marks like bee stings in your skin. These are small puncture wounds from the short needles used to inject the electricity directly into your skin. There may be small burns similar to sunburn around the marks. These should return to normal in a few days. If they do not and there is pain and swelling, you may have a local infection – see a Doctor.

If the probes only stuck in your clothing, you may still have two small areas of skin underneath that look sunburned.


taser (use of) policy - south west yorkshire partnership …€¦ · web view · 2016-01-21use...

Documents