Excited Delirium Training Helped Save a Man’s Life – Now a Subject of a Wake Forest University Study

According to an article by Michael Hewlett in the Winston-Salem Journal from July 30, 2012, a police sergeant may have saved a man’s life from excited delirium.  Interestingly, this incident became the basis of a case report published online May 31, 2012 in the Journal of Emergency Medicine.

In 2008, Sgt John Morris of the Winston-Salem police received a call concerning a 30-year-old man confronting people.  Even though it was hot, the man was sweating profusely and babbling.  “When they got there, they knew something was not right with this gentleman,” he said. “The things he said didn’t make sense.”

A year before this incident, Sgt. Morris had received excited delirium training and therefore recognized the classic symptoms of excited delirium that the man was experiencing.  Fortunately, EMS staff were consulted and officers were able to calm the man down get him treatment at the emergency room at Wake Forest Baptist Medical Center.  To learn about excited delirium review this insightful White Paper Report on Excited Delirium Syndrome, American College of Emergency Physicians (ACEP) Excited Delirium Task Force from September 10, 2009

Upon examination, doctors determined that he man had an abnormal cardiac condition known as long QT syndrome;  he was treated and recovered fully.  However, this was a crucial factor in offering a possible explanation as to why so many people with excited delirium die suddenly in police custody and this incident may offer some important clues.

Dr. William Bozeman, associate professor of emergency medicine at Baptist, co-wrote a case report about this incident with Dr. James Winslow, also of Baptist, and Dr. Karim Ali of the Emory University School of Medicine which published on May 31, 2012 in the Journal of Emergency Medicine.

Bozeman said the 2008 case is significant because it provides a clue as to why many people afflicted with excited delirium die suddenly. At least 200 people a year die in police custody without any explanation and many of who had suffered from excited delirium, Dr. Bozeman said.  The issue has been controversial because some have attributed those deaths to police brutality, he said.  Further, autopsies and toxicology reports have offered few explanations for why many of these people died, Bozeman said.

In this specific case doctors were able to see an abnormality on the man’s electrocardiogram and determined he had long QT syndrome which is very dangerous as Dr. Bozeman said, “They could drop dead without any warning.”

While the 2008 incident doesn’t provide a clear link between long QT syndrome and excited delirium, but it does offer a possible explanation worth of research according to Dr. Bozeman.  Over the past decade, with excited delirium’s increased awareness, law enforcement officers have received increased training on how to recognize the syndrome and how to use nonviolent ways to deal with people exhibiting these symptoms.  EMS are also getting more training on how to treat people before taking them to the hospital.  Both of these group need to train officers and EMS that excited delirium needs to be treated as as a medical crisis.

Sgt. Morris said these incidents are challenging since police officers have to find ways to get these people under control so they can get medical attention.  Often, they don’t respond well to things such as pepper spray because they’re amped up on adrenaline, he said.

“The public needs to understand we’re not controlling this person to take them to jail,” said Sgt. Morris. “We’re controlling them to get them medical care.”

“This case demonstrates beautifully that that approach can be lifesaving,” Dr. Bozeman said.

Click this link for a VIDEO: Sgt. John Morris talks about a condition known as Excited Delirium

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