Excited Delirium
•Download as PPT, PDF•
4 likes•74,557 views
This presentation discusses excited delirium (ED), a condition where individuals display erratic and violent behavior that puts them at risk of death. The presentation outlines the causes, phases, indicators, and those at risk of ED. It recommends treating ED as a medical emergency, with police containing the individual and EMS sedating, treating, and transporting. Several protocols used by different emergency response teams are presented, including using Versed, Ketamine, or Haloperidol for sedation. The presentation emphasizes the need for multi-agency training and cooperation between police and EMS to properly manage ED cases.
![[object Object],[object Object],[object Object],[object Object],[object Object],What first responders need to know Excited Delirium](https://image.slidesharecdn.com/chcs-sharedepartmentsjaildiversion2009diversioninitiatives1citinternationalconference20101powerpointspowerpointsjerrystatoncitconfexciteddelirium-100610105348-phpapp01/85/Excited-Delirium-1-320.jpg)
![[object Object],[object Object],[object Object],[object Object],[object Object],Goals](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
More Related Content
What's hot
What's hot (20)
Similar to Excited Delirium
Similar to Excited Delirium (20)
More from citinfo
More from citinfo (20)
Recently uploaded
Recently uploaded (20)
Excited Delirium
- 9. Affordable Realistic Tactical Training
- 13. Sudden Unintended Unexplainable Negative autopsy Excited Delirium Syndrome
- 24. Agitation & Exertion Hyperthermia Acidosis & Rhabdomyolysis “ TREAT THE TRIAD” Stimulate/Intoxication Triad
- 25. A New Approach Access Capture Control Restrain Sedate Transport Chart Plan
Editor's Notes
- Version 13 5/06
- Version 13 5/06
- Version 13 5/06
- First Responders cast the broad net, Medical personnel are left to determine the root cause. Pharmacological and psychological are most frequent. Version 13 5/06
- First Responders cast the broad net, Medical personnel are left to determine the root cau Version 13 5/06
- Version 13 5/06 Explain Delirium, different types Hyperthermia > 102 degrees or in absence of a thermometer, hot to touch Cardiac Arrest most likely to occur following an sudden and immediate tranquility
- Dr Curtis is presenting to AMA to have it recognized as a disease Version 13 5/06
- Version 13 5/06
- Version 13 5/06
- Version 13 5/06
- Version 13 5/06 Locate and copy Texas’ mental health emergency commitment. Most common mental illness associated with ED/SDS is bi-polar in US. Schizophrenia in Canada.
- 2/3 of cases due to stimulant drug use 1/3 due to mental illness Version 13 5/06
- Version 13 5/06
- Wren Agitation Contributes to muscle exertion, tissue breakdown causing release of cellular content (lactic acid and potassium) May be an early warning sign of impending sudden death Could progress to violent /combative behavior Acidosis / Rhabdomyolysis Breakdown of muscle tissue during extreme prolonged exertion releasing toxic compounds into blood May cause massive fluid shifts away from circulating volume Reduces threshold for arrhythmias May already be present prior to ECD use Hyperthermia >102 Result of extreme, prolonged exertion “Run Away” metabolism Contribute to the agitation and acidosis Early predictor of mortality Seemingly invulnerable physically, the patient may be experiencing a cluster of life-threatening physiological stresses including hyperthermia, a change in blood acidity, electrolyte imbalances, a breakdown of muscle cells, and a leaching of cellular contents into the blood stream, all of which puts the heart significant risk of failure. Version 13 5/06
- There is something to say about sedation minimizing the patients ACTIVE RESISTANCE to physical restraints The key is you have to administer enough to achieve sedation Valium – We don’t carry enough Haldol – Long onset 30 min IM Versed – We don’t give enough 2-5 mg IM or a max of 20 mg IV Ketamine – 5mg/kg IM or 1.5 mg/kg IV Use sedation to help package patient for transport Version 13 5/06
- Transport NOT in a patrol car, EMS should transport immediately to hospital, preferably a trauma center Urgent and Rapid transport Take extra manpower, police if handcuffs are used as restraints Early Alert to hospital Version 13 5/06
- What’s wrong with this picture?? Prone or Scoop Sandwich positions are NOT acceptable Supine or on in Left Lateral Recumbent positions are preferred Version 13 5/06
- ED Patients suddenly die, usually immediately following cessation of combative resistance when not associated with sedation Normal Saline is fluid of choice Lactated Ringers may contribute to Acidosis (increase potassium which will cause heart to be hypersensitive to adrenal substances causing arrhythmias) Treat hypoglycemia with D50 and/or Glucagon If suspected alcohol intoxication, treat with Thiamine 100 mg IV Version 13 5/06
- Sedate, Lower Temp, and Neutralize Acid Miami-Dade Fire / EMS Give Versed via MAD, IV cooled fluids to lower body temperature then Bicarb to raise ph Nashville Fire / EMS First responders in Nashville have been using sedatives at street level for highly agitated patients for 2 years. Used 110 times, no negative effects, 8 - ED patients, all survived Champaign, Il Standard policy/protocol county wide all agencies Starts in dispatch with call takers Involves EMS early and brings medics in to help with restraint by sedation Ketamine sedation Appleton, WI You saw the video EMS uses Haldol for sedation, no cooling or bicarb therapy Version 13 5/06
- If it’s not documented, it didn’t happen! Don’t let your patient care report be used as a weapon to attack the police If allowed to remove probes, document location, is the probe intact, don’t cut/break wires, the name of the officer you released them to What types of treatments were performed and the response the patient had to those treatments Be as detailed as possible, most patients die and the more detailed you are the better position you will be in years later if sued Version 13 5/06
- JERRY Carefully review policies & procedures Liability is important but should not be your number one priority. Conduct training on sudden death syndrome with all first responders, call takers, and correctional staff. Version 13 5/06
- Version 13 5/06