Cells to society: lactate and neuromuscular incapacitation devices.

Devices employed in electrical policing rely on fundamental responses of nerve and muscle to supraphysiologic current to quell disruptive behavior. Whilst widely deployed the use of neuromuscular incapacitation (NMI) remains controversial, in part, due to gaps in understanding of the underlying mechanisms related to injury. NMI device manufacturers are thus constrained by empirical evidence for safety and effectiveness for a specific device design. Here we examine published data for several NMI devices considering ex vivo signal characteristics and in vivo responses in relation to effectiveness and injury. The sensitivity of lactate production to NMI device signal frequency (Hz) and macro-dosimetry is explored as a primary device design factor in NMI modes of injury. The non-lethal approach to policing regardless of technology will result in fatalities due to compromised health and substance abuse status unknowable at the time of NMI application. Thus, research to establish a science-based understanding of NMI injury mechanisms, particularly for lactate production and limitations of deployment, are essential for social acceptance and improved NMI device design.