Distinguishing features of Excited Delirium Syndrome in non-fatal use of force encounters

Abstract

We demonstrate that there is the ability for law enforcement officers to consistently recognize and report features of ExDS that have been associated with ARD. The varying presence of features across the examined categories indicates that some features are more distinguishing than others, which may enable narrowing the scope of features that represent ExDS and understanding its pathophysiology. The current debate surrounding whether or not ExDS exists limits first responders and emergency physicians in their ability to increase awareness, improve training and interventions, and design appropriate policy and response protocols to reduce ARDs.

Assessing the symptoms associated with excited delirium syndrome and the use of conducted energy weapons

“…Since violence can be manifested regardless of the arrestee's condition, it was not considered a unique discriminator for ExDS and the assessment focuses on the twelve symptoms, excluding violence. This finding is consistent with the Hall et al, 45 and Baldwin et al, 46 studies. Table 1 also displays the prevalence of three categories of combinations of reported symptoms.…”

“…As shown in Table 1, the overall prevalence of the observed symptoms associated with ExDS of 635 arrestees identified as exhibiting behaviors consistent with a chemical substance (excluding alcohol), psychologically distressed, and/or both. Similar to the Hall et al, 45 and Baldwin et al, 46 studies, the symptoms were aggregated into three categories (combinations of symptoms) including: three to four, five to six, and seven or more symptoms. Overall thirteen symptoms associated with ExDS were reported by the officers and because multiple symptoms can be reported with one arrestee in one incident, they will total over 100 percent.…”

“…Currently there have been only two prospective studies published which identified and described ten features of ExDS and their frequency during the restraint and intervention process by police which included: violent behavior, including: tolerance to pain, did not fatigue, rapid breathing, superhuman strength, constant or near constant activity, non-responsive to police, sweating profusely, naked or inappropriately clothed, attraction to glass, and tactile hyperthermia. 45,46 The objective of this research was to replicate the two former prospective studies to examine the prevalence of symptoms associated with ExDS during a police use of force confrontation. We previously performed a prospective analysis of the outcomes violent prone restraint incidents in policing.…”

Ongoing issues with the diagnosis of excited delirium

“…The association of these episodes with aggressive and aberrant behavior and possible illicit drug taking will often result in the involvement of law enforcement officers [20]. Thus, dissecting out the story line and potential lethal mechanisms remains a vital component and an important challenge in each case.…”

Canadian Police Tactical Units: The Normalization of Police Militarization or a Pragmatic Response to High-Risk Calls?

“…Some definitions include low-levels of force, such as threats of arrest, handcuffing, searches, and pat downs (Terrill & Mastrofski, 2002), whereas others focus on physical UoF options (e.g., takedowns or punches; Lundstrom & Mullan, 1987). Consistent with previous Canadian research, this paper adopts the definition that force is the application of physical control hard techniques (e.g., strikes and stuns) and above (e.g., intermediate weapons and lethal force; Baldwin, Hall, Bennell, Blaskovits, & Lawrence, 2016;Butler & Hall, 2008). 4 The use of lethal force comprises a small proportion of all encounters and is therefore exceedingly rare (Bozeman et al, 2018;Wittmann, 2018).…”