A number of "less lethal" weapons have been developed and are commonly used by modern law-enforcement agencies and some military organizations. The intent of these weapons is to subdue or incapacitate violent or dangerous suspects without causing serious harm or death. Commonly used less lethal weapons include chemical irritant agents, explosive distraction devices, kinetic impact munitions, and electrical incapacitation devices. While less lethal weapons are significantly safer than traditional firearms, no weapon can be entirely non-lethal and no weapon can be made entirely safe. Medical providers may treat subjects exposed to less lethal weapons and should presume injury until proven otherwise. The following is a review article on the medical aspects of less lethal weapons. Introduction A number of “less lethal” weapons have been developed and are commonly used by modern law-enforcement agencies and some military organizations. The intent of these weapons is to subdue or incapacitate violent or dangerous suspects without causing serious harm or death. Commonly used less lethal weapons include chemical irritant agents, explosive distraction devices, kinetic impact munitions, and electrical incapacitation devices. While these weapons are not intended to kill, they can and do cause injuries and occasional deaths. Medical personnel will encounter patients who have been exposed to and sustained injuries from these weapons. In this brief review we will discuss each of the above groups of less lethal weapons and their common injury patterns. The nomenclature used to describe these weapons varies. The United States military has adopted the term “nonlethal.” While accurate in conveying the intent of the weapons, this term has been criticized as implying that they do not cause death or serious injury, which is not the case. The term “less-than-lethal” has also been used and is subject to the same criticism. Many authors and users of the weapons prefer the term “less lethal,” which may better convey the weapons' reduced likelihood of causing death or serious injury while not excluding the possibility. The latter term will be used here, but any of the above terms may be treated as interchangeable. Chemical Irritant Agents While irritants agents have been used in war for centuries, modern agents were first developed by military organizations in the early 20th century. Also designated “riot control agents,” they can be used against individuals or groups to incapacitate or to deny access to an area. The agents are commonly referred to as “tear gas” due to the prominent lacrimation and blepharospasm they cause. [1]One of the most commonly used modern riot control agents is CS, so named after the initials of its inventors. Chemically 0-chlorobenzalmalononitrile, CS is an aerosolized powder (Table 1.) This agent has largely replaced the older and more toxic agent CN (Chloracetophenone) which saw extensive use in the Vietnam conflict of the 1960s, though CN is still available and used by some agencies. Another common riot control agent is Oleoresin Capsicum, abbreviated OC and commonly known as “pepper spray.” Originally derived from hot peppers, modern OC is synthetically manufactured and sprayed from pressurized containers. It is widely available in personal defense sprays. While chemically unrelated to CS or CN, OC produces similar clinical effects and is combined with CS in some products. Irritant agents can be deployed in a number of ways, including hand held sprays, thrown containers similar in appearance to hand grenades, and fired from rifle-like launchers. Containers of riot control agents are conventionally labeled in color coded type to aid in identification. (Table 1.) Some propellants used for riot control agent delivery devices are flammable and may represent an ignition hazard.[2] Numerous preparations of these agents are available to the public in the form of self defense sprays, though law enforcement and military preparation
展开▼
