#tazers

Johnny HALLIDAY "Gabrielle / Né pour vivre sans Amour" (7". 1976) [FR]

SUN RA "Monorails and Satellites" (LP. 2001 / rec. 1966) [US]

ทองคำ เพ็งดี & ฉวีวรรณ ดำเนิน [Performance of the Laotian Mor Lam of Princess Taeng-on (sections 13-24)] (LP. ?) [THA]

V/A "Siamese classic Songs" (LP. ?) [THA]

Michel DINTRICH [Philippe DROGOZ / Louis ROQUIN] "Guitare éclatée" (LP. 1975 / rec. 1974) [FR]

TAZERS "Don't classify me!" (LP. 2000 / rec. 1982/84) [US]

The TIMES "This is London" (LP. 1983) [UK]

Jean-Louis CADEE "Vibra-Jazz" (LP. 197?) [FR]

DISCO ZOMBIES "Drums over London" (LP. 2011 / rec. 1978-80) [UK]

Tomoko SAUVAGE "Ombrophilia" (LP. 2012 / rec. 2009) [JAP]

Masahiko SATO & Wolfgang DAUNER "Pianology" (LP. 2016 / rec. 1971) [JAP/GER]

CIRCLES "Circles" (LP. 2015 / rec. 1983) [GER]

Henri CHOPIN "Oh Audiopoems" (2xLP. 2016 / rec. 1959-79) [FR]

Barney WILEN "Moshi" (2xLP + DVD. 2017 / rec. 1972) [FR]

V/A "Fluxus Anthology" (LP. 2017 / rec. 1956-89) [various]

Walter MAIOLI, Fred GALES, Pit PICCINELLI "Amazonia 6891" (2xLP. 2016 / rec. 1985) [ITA]

TAZERS

"Don't classify me!"

(LP. Rave Up rcds. 2000 / rec. 1980/83) [US]

Whoa, so, I was away for the weekend at a wedding and didn’t get to see this episode till now, but it definitely deserves a medical review. Spoilers below.

This episode has it all- tasers, dubious intravenous access, poison, stumbling around escaping the bad guy, collapsing on a sidewalk, getting shot in body armor, even radiation. All so whumpy and delightful.

Let’s rip it apart medically.

The first part of the episode follows Jack and Mac getting into an argument in which Mac thinks he can take care of himself and Jack insists that he should at least let people know where he is, even when he engages in more personal missions. Mac affirms his ability to take care of himself, and is promptly kidnapped by Murdoc. He’s initially incapacitated when someone working for Murdoc shoves a conducted electrical weapon (CEW) into his chest, causing him to grunt and collapse.

CEWs, probably best known by the brand name Tazer, force an electrical arc through a person’s body that causes pain and temporary incapacitation. They work in two main ways:

When fired from a distance, two barbs enter the body at different points. The body completes a circuit which triggers a high-voltage-low-amperage arc between the two barbs. The arc itself does little damage (some minor burns and puncture wounds from the darts may result) but causes severe pain and temporary paralysis as the sudden electricity overloads parts of the central and peripheral nervous systems (link to video).

When used up close, like in the episode, the person still creates a circuit between two electrodes, but the electrodes are set in the weapon and are at most a couple inches from each other. The arc will still hurt a lot (pain compliance), but won’t cause paralysis.

CEWs do not cause unconsciousness unless something is really, really wrong- either the person fell and hit their head, they were repeatedly shocked and didn’t recover in between them and suffocated (no breathing while paralyzed), or the electricity caused a problem with their heart’s electrical system, sending them into a bad rhythm (most likely to happen if the victim already had a heart condition). None of these things appear to have happened to Mac, nor do we actually see him lose consciousness.

That being said, the scene immediately cuts to Mac waking up handcuffed to a chair in a cinderblock basement. Not only handcuffed, but also tethered to a bag of IV fluid. 

Let’s talk about the actual IV “lock,” or part that attaches to the person. In the scene, its actually not an IV catheter, but a device called a winged infusion set or “butterfly needle” (see the little blue “wings”?), that has been taped into Mac’s arm. Winged infusion sets consist of a metal needle flanked by two plastic tabs (you pinch them together when inserting, which makes it easier to control where the needle goes) and connected to a short length of tube. The other end of the tube also has a needle, this one for puncturing the top of a blood tube (a vacuum in the tube pulls the blood into it).

Winged infusion sets are used exclusively for pulling blood out, and while there is nothing explicitly preventing material from flowing in the opposite direction, you’d have to put effort into removing the tube needle and figuring out how to attach it to other tubing.

Another (and probably a better) reason you really couldn’t practically use a butterfly needle as an IV set is the fact that its a sharp metal needle. Veins are fragile things. Even secured perfectly, the sharp metal will puncture the other side of the vein the second Mac moves. Putting another hole in the vein would be both painful and cause whatever is going through the IV tubing to leak out into the surrounding tissue. This makes it swell up and can be very painful or do damage to tissue depending on the kind of fluid or medication.

Modern IV catheters are flexible plastic with rounded edges (even then, infiltration sometimes still happens). The only metal part to them is a needle that breaks the skin during insertion. That needle is immediately removed once the catheter is in the vein.

In the episode, not only does Murdoc use a butterfly needle and fail to secure it, but actually wiggles it around purposefully. The sheer fact that this caused Mac pain is a good sign that he totally ruined this impromptu IV.

Now, if you’re desperate and a bit of a medical, um, MacGyver, you can use a butterfly needle as a means of introducing a continuous infusion of fluid into a person- just not into their veins.

If you’re in a situation where all you have are butterfly or other metal needle infusion sets and a person needs fluid but can’t take them orally, you can insert the needle at an angle into subcutaneous (fat) tissue and secure it with tape. By removing the needle at the other end and figuring out how to attach the setup to IV tubing, you could create a controlled infiltration (you can only instill about 60ml/hr this way and have to put it in a different place every two hours or so) which the body will slowly absorb in order to rehydrate. I know they weren’t doing this in the episode due to the placement- there’s no useful fat in the inside of the elbow. If you were doing this, it would be best to insert into the back of the arm (in flabbier people), belly, or thigh.

One last note before moving on- there’s a slight inconsistency between the butterfly needle in his arm, and the needle in the close up where he’s bending it to make a lock pick. Basically that they’re just two completely different products. The one he bends is a straight needle (like the kind used for injecting into muscle). My guess is that they couldn’t get the actor to bend the needle without engaging the safety cover on the butterflyand just went ahead and used something without one:

Mac manages to bend the needle into a lock pick and escape into a sewer tunnel. He stumbles along it for a while, and ends up climbing out of a manhole cover into a busy street. He makes it to the sidewalk, only to collapse. Bystanders call 911.

The next scene sees him in the Phoenix Foundation infirmary, apparently recovered and getting blood drawn to figure out what Murdoc dosed him with.

We’ve got a couple of clues:

Physically, Mac was drowsy, uncoordinated, had some visual distortions, was sweating, but was still reasonably alert and oriented, and his ability to problem solve was intact.

Murdoc mentions that it was good Mac could “still feel pain,” alleging that there was a chance the drug could interfere with that.

Murdoc mentions the purpose of the drug was to slow Mac down, but not knock him out completely.

Mac does eventually lose consciousness (or at least collapses), even after being disconnected from the drip.

Mac suggests that the drug could have come from the nightshade family, naming atropine, hyoscymine, and scopolamine as possible culprits.

Based on just the physical symptoms (except for sweating) he experienced, hyoscymine and scopolamine both make some sense. Both are drugs that work by blocking a neurotransmitter called acetylcholine, and cause drowsiness, confusion, visual disturbances, and in high doses problems with balance and coordination. Its possible that either of those could have made him very sleepy, but unless there was some severe overdose situation, Mac probably wouldn’t have passed out (we don’t know objectively if he was unconscious, just that he fell over and people called 911). 

They don’t make as much sense when you add in sweating (though drugs.com does list it as a side effect of scopolamine), because one of the main effects of most drugs in that class is inhibition of sweating. Neither of these impact pain either, and one of the main effects of high doses of scopolamine (and probably hyoscyamine too) is amnesia. Since Mac’s memory of the events are so explicitly crucial to the plot, I’m not sure this was truly the drug used (though, as I can’t seem to find anything that fits the symptoms perfectly, we can really only assume Murdoc probably created something himself). 

A reason Mac may have assumed it to be in that class of drugs, though, is the fact that scopolamine has been used as a “truth serum” for its ability to make it difficult to come up with and remember lies. As a Phoenix agent, Mac may have been trained to recognize its use.

It also lines up with the timeline for his escape- it takes about 10 minutes to begin working when given IV, and about 50mins-1hr to reach its peak effect. Given that it lasts for up to 6 hours, a person on a continuous infusion could be up to an hour behind in feeling the drug’s effect, making it very difficult to titrate correctly (continuous infusions are much better for very short acting drugs, as there’s less chance of overdose). This difficulty, however, could lead to Mac  continuing to lose coordination and faculties until he collapsed on the sidewalk, even well after stopping the infusion.

The last thing I want to mention is body armor injuries. Later in the episode, Murdoc shoots Cage in the chest. Turns out she’s wearing body armor, but the force of the bullet still knocks her to the ground, where she lays gasping for several seconds. Mac comes to the rescue and opens her shirt, revealing the bullet lodged in the upper right of the vest.

I’m not particularly well versed in what vests stop what bullets, so I’m not going to comment on whether or not that part was accurate (someone who knows more about guns than I do please feel free to add!).

Assuming everything was good with that, though, I do find it refreshing that not only was Cage reasonably incapacitated by the bullet, but that Mac actually reacted by calling for a medic, who genuinely checked her out to make sure nothing was severely wrong.

Even if a vest manages to stop a bullet, many still have issues dissipating the force of the impact. See how in the picture below, there is a scabbed area? This is because the armor deforms around the impact site and can actually hit the body with enough concentrated force to break skin (and structures below it).

In real life, it would be very important to get someone to an emergency department for imaging (CT, x-rays), and care for the injuries sustained, as even though a person may not be dealing with a GSW, there’s still a chance for life-threatening internal injury (depending on where the bullet impacted, these could include any blunt force trauma injuries, like flail chest, internal bleeding, pneumo- or hemothorax, ruptured organs, spinal damage) from the impact. It was nice to see the medic actually taking vitals/doing an assessment in the background of the scene.

Due to her activities later, I would probably guess she didn’t suffer anything too severe. But, you know, it was refreshing that they cared.