TY - JOUR
T1 - Excited delirium syndrome (ExDS)
T2 - Defining based on a review of the Literature
AU - Vilke, Gary M.
AU - Debard, Mark L.
AU - Chan, Theodore C.
AU - Ho, Jeffrey D.
AU - Dawes, Donald M.
AU - Hall, Christine
AU - Curtis, Michael D.
AU - Costello, Melissa Wysong
AU - Mash, Deborah C.
AU - Coffman, Stewart R.
AU - McMullen, Mary Jo
AU - Metzger, Jeffery C.
AU - Roberts, James R.
AU - Sztajnkrcer, Matthew D.
AU - Henderson, Sean O.
AU - Adler, Jason
AU - Czarnecki, Fabrice
AU - Heck, Joseph
AU - Bozeman, William P.
PY - 2012/11
Y1 - 2012/11
N2 - Background: Patients present to police, Emergency Medical Services, and the emergency department with aggressive behavior, altered sensorium, and a host of other signs that may include hyperthermia, "superhuman" strength, diaphoresis, and lack of willingness to yield to overwhelming force. A certain percentage of these individuals will go on to expire from a sudden cardiac arrest and death, despite optimal therapy. Traditionally, the forensic community would often classify these as "Excited Delirium" deaths. Objectives: This article will review selected examples of the literature on this topic to determine if it is definable as a discrete medical entity, has a recognizable history, epidemiology, clinical presentation, pathophysiology, and treatment recommendations. Discussion: Excited delirium syndrome is characterized by delirium, agitation, acidosis, and hyperadrenergic autonomic dysfunction, typically in the setting of acute-on-chronic drug abuse or serious mental illness or a combination of both. Conclusions: Based upon available evidence, it is the consensus of an American College of Emergency Physicians Task Force that Excited Delirium Syndrome is a real syndrome with uncertain, likely multiple, etiologies.
AB - Background: Patients present to police, Emergency Medical Services, and the emergency department with aggressive behavior, altered sensorium, and a host of other signs that may include hyperthermia, "superhuman" strength, diaphoresis, and lack of willingness to yield to overwhelming force. A certain percentage of these individuals will go on to expire from a sudden cardiac arrest and death, despite optimal therapy. Traditionally, the forensic community would often classify these as "Excited Delirium" deaths. Objectives: This article will review selected examples of the literature on this topic to determine if it is definable as a discrete medical entity, has a recognizable history, epidemiology, clinical presentation, pathophysiology, and treatment recommendations. Discussion: Excited delirium syndrome is characterized by delirium, agitation, acidosis, and hyperadrenergic autonomic dysfunction, typically in the setting of acute-on-chronic drug abuse or serious mental illness or a combination of both. Conclusions: Based upon available evidence, it is the consensus of an American College of Emergency Physicians Task Force that Excited Delirium Syndrome is a real syndrome with uncertain, likely multiple, etiologies.
KW - TASER
KW - agitated delirium
KW - excited delirium
KW - in-custody death
KW - restraint
KW - sudden death
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UR - http://www.scopus.com/inward/citedby.url?scp=84869090430&partnerID=8YFLogxK
U2 - 10.1016/j.jemermed.2011.02.017
DO - 10.1016/j.jemermed.2011.02.017
M3 - Article
C2 - 21440403
AN - SCOPUS:84869090430
SN - 0736-4679
VL - 43
SP - 897
EP - 905
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 5
ER -