Police learn about excited delirium

May 16, 2008
Lisa Varano, Guelph Mercury

The police encounter an agitated, paranoid, violent person who is naked and sweating profusely. Several officers are needed to restrain him because he is stronger than he looks and he won't stop struggling. He tries to kick out the windows of the police cruiser. Then, within minutes of quieting down, he is dead. What happened?

The person may have been in a state of "excited delirium," a medical condition that has garnered media attention recently.

Police officers and emergency personnel from across the province learned about the signs of excited delirium at a conference in Guelph yesterday.

The conference, organized by the Guelph Police Service, was the first in Canada to simultaneously educate the policing and medical communities about recognizing excited delirium. The condition has garnered attention recently because of some deaths in police custody.

Suspects in a state of excited delirium have died after being stunned with a Taser gun.

But an expert on excited delirium said deaths have also occurred in people who were not stunned. "We have no medical evidence" that police officers should not use a Taser on a suspect in excited delirium, said Dr. Christine Hall, an emergency room doctor and researcher in Victoria, B.C. She said research on excited delirium deaths should consider the effect of Tasers, but not fixate on the stun guns.

People in states of excited delirium have died of cardiopulmonary arrest in police cars, jail cells, ambulances and hospitals, Hall told 250 police officers and emergency medical technicians at Lakeside Church.

Excited delirium is not a diagnosis but rather a symptom of an underlying disorder, she said. Causes of excited delirium may include certain psychiatric illnesses, drug intoxication, alcohol withdrawal and heat stroke.

Police officers must restrain the person and describe the condition to medical personnel, Hall said. "What we're needing to start doing in Canada is to teach our nurses and our physicians what it is you're dealing with," she said.

Over the past decade Guelph Police have faced people a few times who may have been in excited delirium, said Constable Gary Mulder, a conference organizer and use-of-force trainer. None of them died in police custody, he said.

"First contact is the police. Then you get into medical involvement. Everybody has to treat it as a medical emergency," Mulder said. "We can't diagnose this person on the street. We're not doctors. We just have to recognize (excited delirium) and try to take the best possible course of action."