Excited delirium, while in custody..

[Mall Director]

I am not sure how many are aware of this, but it seems to be of greater interest lately to our fields and associated fields, as well as Law Enforcement. I didnt pay much attention to this, until recently when another Law Enforcement agency in our state was having some issues with this rearing up.

A Short Summary: Individuals under the inlfuence of narcotics, such as cocaine and other related types, hit a downfall on their "high", in which their bodies blood pressure are increased (or during the high), and as we place these subjects under control, there are related deaths. Commonly its related as "In custody" deaths. Some cases where the subject, once placed in restraints, start to burn up, as their bodies continue to increase blood pressure, and essentially, their hearts explode internally, from the build up with no ability to "walk" it down.

One of our closest LE departments suggested that we accomodate these factors by placing benches with single restraints holds, as so that we can place the subject on the bench but with one restraint on the wrist locked to the bench, as so the subject can still move around "semi-freely" until medical response can arrive. This has been one of the few suggestions made, as this type of issue inreases in interest.

I am sure there may be many out there, very aware of this issue, but I thought it may not hurt to atleast throw it out there, and those that have no knowledge can peak around a little, and just have it as a FYI in the back of our minds!

[N. A. Corbier]

From what I understand, there are some indicators for excited delirium. The first, as Jerry McCauley wrote, "You cannot reason with a naked sweating person in the middle of the street." Obviously, if someone is peeling their clothes off in public, is agitated, and is sweating... Something is most likely medically wrong with this individual. Summon an ambulance, they will probably need it after they're in custody.

ED's been around for quite awhile, various forms, various names. The medical establishment is beginning to see it as something that is a "real condition," as well.

Mostly, you find these types of cases with tasers. Before that, OC spray caused it. A guy (or girl) hyped up on stimulants and the fact that people want to hunt him/her down and capture him/her. Their heart can't take it, especially after the equivalent of a 30 minute workout (a taser hit), and boom, they go into arrest.

I think the easiest protocol for recognizing and dealing with ED incidents is note how the person is acting during initial enforcement action. We should be already doing this, after all, we're gonna try to arrest this person. If they're agitated, excited, etc, and then suddenly go "calm and silent" after they're in custody... Make sure they didn't just arrest on your bench.

If you have someone who is stripping their clothes off, acting agitated, etc... Call an ambulance immediately. They're most likely fevered. They are probably sick.

Even with recongizing and taking steps to prevent arrest in ED patients, they still seem to happen.

(A lot of this information is paraphrased from DT4EMS and SPE Tactical.)

[Eric]

Our Ontario Security Guard and Private Investigator Act is undergoing a face lift stemming from a case of ED in 1999.

PETER SMALL
STAFF REPORTER

Crowds who gathered at Agincourt Mall as a shoplifter was held face down by two Loblaws employees and a security guard yelled that he wasn't breathing, an inquest jury into the man's death has heard.But Loblaws employee Donald Moore, who had his hands on Patrick Shand Jr.'s shoulder blades, said he could feel his back rise and fall, coroner's counsel Robert Ash said yesterday, in summarizing expected evidence at the inquest into the 31-year-old Scarborough man's death more than four years ago."This led him to believe that Shand was still breathing and that he had simply calmed down because he now `knew he was caught,'" Ash said.At that point, Shand's girlfriend, Jennifer Armstrong, intervened. "She was also yelling that Shand was not breathing and pointed out that there was blood coming from his mouth," Ash said.Armstrong and a bystander turned him over, and Moore and the bystander started administering cardiopulmonary resuscitation. But it would prove to be too late.On the morning of Sept. 14, 1999, Shand was caught sneaking two boxes of baby formula cans from the Loblaws at the mall, at Sheppard Ave. E. and Kennedy Rd.Moore and another Loblaws employee, Victor Gentile, along with mall security guard Steven Rafuse, held Shand face down and handcuffed him with the brief assistance of Brinks guard Larry Avramidis, Ash said.The coroner's inquest, which began yesterday, is throwing a spotlight on the use of force by private security guards and employees in making citizens' arrests. Besides the Shand family and Loblaws Supermarkets Ltd., parties with standing are Wackenhut of Canada Ltd. security services, Brink's Canada and the Ministry of Community Safety and Correctional Services, which regulates private security guards.Julian Falconer, the family's lawyer, told reporters that Ontario has no rules governing the use of force by private security guards or employees acting in a security role. "Two cartons of baby formula, under anyone's rationale, cannot equal death," he said."It's a good day for the justice system," said Shand's mother, Lethel Shand, 60, who attended the inquest with her husband, Patrick Sr., 61, and their other son, Colin, 32."All we ever wanted was the truth on how Patrick died," she told reporters. She said she hoped that laws governing security guard training would be improved. "Policing should be left to the police."According to expected evidence, Shand's girlfriend warned the two Loblaws employees as they struggled with Shand that he had asthma and heart problems, Ash said.But Detective Sergeant Rob DiDanieli testified he could find no indication of such problems in Shand's medical records and that his mother could not recall any such problems.The officer added that Shand had a history of abusing crack cocaine.As Shand struggled to get free, Ash told the jury, Rafuse held him down by the midsection. Gentile held his legs and had removed his shoes to keep from being kicked, while Moore had the man in a bear hug.At one point in the struggle, Shand complained that he couldn't breathe."Moore told him to calm down and he would loosen his hold," Ash said. "Shand did calm down and Moore released his hold. He maintained control of Shand by keeping his hands between his shoulder blades."Dr. Jim Cairns, Ontario's deputy chief coroner, testified that in cases of excited delirium — a life-threatening hyperactive condition that strikes cocaine or alcohol abusers, or schizophrenics off their medication — restraining them on their stomachs can lead to asphyxia."By putting them on their stomach and hog-tying them, you will increase the likelihood that that person will die," he said, adding often these people appear to have suddenly grown quiet just before they expire of exhaustion.

[davis002]

Mall Director LIVES!!!

[HotelSecurity]

Mall Director LIVES!!!

Welcome back Mall Director! You had us worried. Please don't disappear again

[Mall Director]

My appologies... LOL.. I am sure many of you have been scoping the news.. and may be aware that Malls in my state and close to home are under attack by the ACLU and other orginizations.. Less then 50 miles from our mall, a close by Mall has been hit with a Racism card. I have spent this last month in community meetings often explaining that our facility is different and we dont descriminate, other then the violator v non-violator! Its been pretty hot in that area, fortunately our PD has been supporting, and I am getting the point across, whew!

But I will be on more here as things die down!

[sgtnewby]

As a hospital S/O, we see patients that are experiencing exited delirium fairly frequently, either brought in by PD or medics. They are usually very out of control and displaying unusual strength. I know this doesn't work very well for other types of security due to not having the same resorces, but we get called to restrain them prior to them actually arriving. When the squad or rig pulls up, we're waiting for them. In a hospital setting, we will usually use as many as 6 of us to have as much control over the patient and using as little force as possible. In the feild, PD will usually call in their Crisis Intervention Team (CIT) (if your local PD has those) that are equiped with Tasers, and get them handcuffed as soon and safely as they can. My advice, when you have a subject experiencing exited delirium, either call PD and let them know about the person with exited delirium and wait for them to respond while you just keep an eye on the subject (if it's possible), or use as many officers as you can gather. Remember, strength in numbers, the more officers, in most situations at least, the less force you will need to use. You just want to gain control, not beat the $h!! out of them. Be safe all!

[james2go30]

hey

glad to you made it back mall director...hope all the issues you are facing pan out for ya. welcome back.

[Mall Director]

Thank you! LOL!.. One thing I wasnt told when I was hired, is that I would have to go to public meeting and give speeches to a room full of people who already hate me, then convince them otherwise! LOL!

[GCMC Security]

Thank you! LOL!.. One thing I wasnt told when I was hired, is that I would have to go to public meeting and give speeches to a room full of people who already hate me, then convince them otherwise! LOL!

heh, my ex wife's family reunion was like that for me!

[SecTrainer]

Very interesting thread, but remember that "excited delirium" itself remains under considerable dispute in the medical and psychiatric communities as to whether such a thing even exists.

Read this discussion on topic by the SFPD psychiatrist, for instance: Is There Such A Thing as "Excited Delirium"??

As the author states, there is grave concern that police departments themselves are themselves giving credence to this rather questionable and unproven diagnosis by simply acting as if it exists...as we seem to be doing here, in fact.

I seriously doubt there is such a thing, personally, (uncontrolled rage, for instance, is nothing more or less than that)...which I hope won't throw anyone who does believe in it into a state of excited delirium.

[Taktiq]

I worked in a rehab center and drugs and alcohol can wreak havok on the body that most, even professionals, don't even realize. Whether ED exists or not, here's my advice....

If you feel the subject is under the influence of narcotics or some other substance, DO NOT HESITATE call for back-up, PD if necessary. Once the subject is under control, make sure paramedics are in route as well. I feel it's always better to overdo it and have too many people involved than to have your subject die in custody.