Incidents where the police and corrections officers confront a person exhibiting the symptoms of the excited delirium syndrome (ExDS) has become an important concern, although rare in occurrence. To date there has been two prospective, epidemiologic studies which have examined the frequency of the symptoms of ExDS during a police use of force confrontation. Using a prospective research design, we analyzed a cohort of 635 arrestees who exhibited symptoms of ExDS as reported by 17 police agencies from six states in the U.S. over twelve months in 2013 during a use of force incident. We sought to determine if police officers could recognize the associated symptoms of ExDS, determine their prevalence during a use of force confrontation, and to assess if the symptoms were observable across multiple agencies. We also assessed the types of resistance displayed by the arrestees and the outcomes of the use of a conducted energy weapon (CEW) in response to the resistance. Officers reported observing thirteen symptoms associated with ExDS. Using descriptive statistics and regression analysis (p=0.05) showed that 58 percent of the arrestees presented 3 to 4 symptoms, 30 percent presented 5 to 6 symptoms, and 12 percent presented 7 or more symptoms. A CEW was applied in 38 percent (n=240) of the incidents and all arrestees were controlled and restrained in the prone position. None of the arrestees died and in 79 percent of the incidents, an arrestee did not sustain an injury. Officers from multiple agencies were able to recognize the varying symptoms associated with ExDS and their prevalence. The outcome of the incidents showed that applying a CEW with an arrestee exhibiting signs of ExDS is a safe and viable use of force device reducing the likelihood of an arrestee death and minimizing arrestee injuries. Based on the results policy, training, and the focus of future research is discussed.