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Excited Delirium

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Sudden Deaths in Custody

Part of the book series: Forensic Science and Medicine ((FSM))

Abstract

“Excited delirium accounts for 1% of our EDP (emotionally disturbed persons) cases and 99% of our headaches.” This comment, made some years ago at a New York City conference of police chiefs captures the managerial and legal concerns of this entity. Police managers are concerned because their officers are suddenly confronted with psychotic, violent persons, which sets into motion an escalation of the use of force continuum, and death may occur despite the appropriate application of sublethal control techniques. The violent nature of the conflict, often witnessed by citizens and sometimes the news media, often leads to accusations of excessive use of force by the police, which in turn may engender community outrage. Subsequent civil litigation against the municipality, the police department, and the individual police officers is to be expected.

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References

  1. Paquette M. Excited delirium: does it exist? Perspectives in Psychiatric Care 2003;39:93–94.

    Article  PubMed  Google Scholar 

  2. Wetli CV. The history of excited delirium: characteristics, causes, and proposed mechanics for sudden death. In: Encyclopedia of Forensic and Legal Medicine, Elsevier, UK, 2005.

    Google Scholar 

  3. Wendkos MH. Acute Exhaustive Mania in Sudden Death and Psychiatric Illness, Spectrum Publications, New York/London, 1979, pp. 165–175.

    Google Scholar 

  4. Fishbain DA, Wetli CV. Cocaine intoxication, delirium, and death in a body packer. Ann Emerg Med 1981;10:531–532.

    Article  PubMed  CAS  Google Scholar 

  5. Wetli CV, Fishbain DA. Cocaine-induced psychosis and sudden death in recreational cocaine users, J. Forensic Sci 1985;30:873–880.

    PubMed  CAS  Google Scholar 

  6. Raval M, Wetli CV. Sudden death from cocaine-induced excited delirium: aroanalysis of 45 cases., Am J Clin Path 1995;104(3):379

    Google Scholar 

  7. Stratton ST, Rogers C, Brickett K, Gruzinski G. Factors associated with sudden death of individuals requiring restraint for excited delirium. Am J Emerg Med 2001;19:187–191.

    Article  PubMed  CAS  Google Scholar 

  8. Hick JL, Smith SW, Lynch MT. Metabolic acidosis in restraint—associated cardiac arrest: a case series. Acad Emerg Med 1999;6:239–243.

    PubMed  CAS  Google Scholar 

  9. O’Halloran RL, Frank JG. Asphyxial death during prone restraint revised—a report of 21 cases. Am J Forensic Med & Pathol 2000;21:39–52.

    Article  CAS  Google Scholar 

  10. O’Halloran RL. Reenactment of circumstances in deaths related to restraint. Am J Forensic Med & Pathol 2004;25:190–193.

    Article  Google Scholar 

  11. Chan TC, Vilke GM, Neuman T, Clausen JL. Restraint position and positional asphyxia. Am J. Emerg Med 1997;30:578–586.

    Article  CAS  Google Scholar 

  12. Chan TC, Vilke GM, Neuman T. Reexamination of custody restraint position and positional asphyxia. Am J Forensic Med & Pathol 1998;19:201–205.

    Article  CAS  Google Scholar 

  13. Schmidt P, Snowden T. The effects of positional restraint on heart rate & oxygen saturation. Am J Emerg Med 1999;17:777–782.

    Article  CAS  Google Scholar 

  14. Parkes JM. Sudden death during restraint: a study to measure the effect of restraint positions on the rate of recovery from exercise. Med Sci Law 2000;40:39–43.

    PubMed  CAS  Google Scholar 

  15. Chan TC, Vilke GM, Clausen J, et al. Related articles, links abstract: the effect of oleoresin capsicum “pepper” spray inhalation on respiratory function J Forensic Sci 2002;47:299–304.

    PubMed  CAS  Google Scholar 

  16. Chan TC, Neuman T, Clausen J, Eisele J, Vilke GM. Weight force during prone restraint and respiratory function. Am J Forensic Med Pathol 2004;25:185–189.

    Article  PubMed  Google Scholar 

  17. Farnham FR, Kennedy HG. Acute excited states and sudden death. BMJ 1997;315:1107–1108.

    PubMed  CAS  Google Scholar 

  18. Wetli CV, Mash DC, Karch SB. Cocaine-associated agitated delirium & the neuroleptic malignant syndrome. Am J Emerg Med 1996;14:425–428.

    Article  PubMed  CAS  Google Scholar 

  19. Stephens BG, Jentzen JM, Karch S, Wetli CV, Mash DC. National association of medical examiners positionpaper on the certification of cocaine-related deaths. Am J Forensic Med Pathol 2004;25:11–13.

    Article  PubMed  Google Scholar 

  20. Ruttenber AJ, McAnally HB, Wetli C. Cocaine-associated rhabdomyolysis and excited delirum: different stages of the same syndrome. Am J Forensic Med Pathol 1999;20:120–127.

    Article  PubMed  CAS  Google Scholar 

  21. Ruttenber AJ, Lawler-Heavener J, Yin M, Wetli C, Hearn L, Mash DC. Fatal excited delirium following cocaine use: epidemiologic findings provide new evidence for mechanisms of cocaine toxicity. J Forensic Sci 1997;42:25–31.

    PubMed  CAS  Google Scholar 

  22. Roth MD, Alarcon FJ, Fernandez JA, et al. Acute rhabdomyolysis associated with cocaine iintoxication, N Engl J Med 1988;931:673–677.

    Article  Google Scholar 

  23. Mash DC. Neuropsychiatric consequence of chronic cocaine abuse. In: Karch SB, ed. Drug-Abuse Handbook CRC Press, Boca Raton, FL, 1998, pp. 412–419.

    Google Scholar 

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© 2006 Humana Press Inc., Totowa, NJ

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Wetli, C.V. (2006). Excited Delirium. In: Ross, D.L., Chan, T.C. (eds) Sudden Deaths in Custody. Forensic Science and Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-015-7_7

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  • DOI: https://doi.org/10.1007/978-1-59745-015-7_7

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-475-3

  • Online ISBN: 978-1-59745-015-7

  • eBook Packages: MedicineMedicine (R0)

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