Excited Delirium Extreme mental & physiological excitement, characterized by extreme agitation, hyperthermia, hostility, exceptional strength & endurance without fatigue.
Excited Delirium Causes Substance Abuse Mental Illness Combination of Substance Abuse and Mental Illness
Substance Abuse Unpredictable Reaction to: Cocaine Methamphetamine PCP Discontinuation of anti-depressant medications
Mental Illness History of Depression, Schizophrenia or Bipolar Disease History of Other Psychotic Background
Signs and Symptoms Hyperthermia – overheating Foaming at the mouth Drooling Dilated pupils Unbelievable Strength Impervious to Pain Aggression (cont.)
Signs and Symptoms Hyperactivity Elevated Pulse Rate Extreme Paranoia Incoherent Shouting / Noises Bizarre and Violent Behavior Removal of Clothing Able to Offer Effective Resistance to Multiple Officers for Extended Time
Complications Hyperthermia (dangerously high temp) Blood Acidosis Electrolyte Imbalances Breakdown of Muscle Cells Leading to Heart Arrhythmia Susceptible to Ventricular Fibrillation Death
Agrivating Factors Ineffective Respirations Caused by Extended Prone Restraint (positional asphyxia) Extended Violent Resistance Multiple Taser Applications Delayed Emergency Life Support
Recommendations EMS response if possible when ED (excited delirium) is recognized ED training for dispatchers Delay struggle/restraint process until sufficient personal are on hand to perform rapidly and safely Immediate EMS upon restraint (cont)
Recommendations Use of Force Options (pain compliance may not be effective) Control Holds Pepper Spray (may not be effective) Impact Weapons (may not be effective) Tasers – Single Application (not effective in pain compliance mode) (cont)
Recommendations Restraint Positions Avoid Extended Time in Prone Position On Subjects Side Supine Monitor Vital Signs (cont)
Recommendations Transportation To Hospital by Ambulance Restrained for Transport Officer to Accompany Ambulance
Excited Delirium This is a life threatening medical emergency which often presents itself as a law enforcement problem Effecting physical control may be dangerous and difficult Despite all possible precautions death may still occur as the result of the excited delirium.