to hours ) transient disturbance in consciousness and cognition , marked by disorientation , disorganized and inconsistent thought processes , inability to distinguish reality from hallucinations , disturbances in speech , and disorientation to person , time and place . 9 In 1996 , the IACP recognized ExDS as a medical emergency . 10 Further , the National Association of Medical Examiners ( 2004 ) and the American College of Emergency Physicians ( 2009 ) have recognized ExDS as a diagnostic entity . 11-12
ExDS is described by its clinical symptoms . While not universally fatal , many subjects with ExDS have progressed to cardiac arrest and death . There are two populations at risk . About 70 percent involve those who use / abuse illicit drugs and may include : cocaine ; methamphetamine , phencyclidine ( PCP ); lysergic acid diethylamide ( LSD ); cathinone ( bath salts ); and marijuana have commonly been identified . Persons with a psychiatric illness account for about 30 % of the population who may also exhibit symptoms of ExDS . Commonly the mentally impaired have abruptly stopped taking their medication , have a history of consuming illicit drugs , and / or were combining their medications with illicit drugs at the time of the confrontation . Research has shown that males ranging from age 21 to 40 are more likely to exhibit symptoms of ExDS . 13-16
Research has identified the following symptoms are associated with ExDS and they present a medical emergency : extreme psychomotor agitation and bizarre behaviors ; violence against others / inanimate objects ; hyperthermia ( hot to touch ); pain tolerance ; yelling / screaming ; hyperactivity and extreme stamina ; non-compliant with police ; extreme strength ; incoherent speech ; grunting ; disorientation ; hallucinations ; naked / partially nude / disrobing ; extreme fear and paranoia ; profuse sweating / clammy skin ; and rapid breathing . 4-9 , 13-17 These symptoms represent a mind and body disconnect of the subject .
Significant distinguishing risk factors associated with ExDS and an ARD include : hyperactivity and strenuous physical exertion and struggle against capture , control , and restraint of the LEO ; hypothermia ( 104 to 109 °); hyperactivity , incoherent speech ; bizarre behaviors ; and superhuman strength which adds to the intense struggle . Field research has shown that a subject exhibiting 6 or more symptoms of ExDS are about five times as likely to be violent , assaultive toward the LEO , aggressively resists control and restraint , and are more likely to gain access to a weapon of opportunity ( i . e ., bat , piece of wood , hammer , broken glass , officer ’ s firearm , OC , CEW , impact weapon , etc .). 2 , 4-7 , 13-14 A prolonged struggle with an overheated subject can contribute to an increase of the core body temperature and exacerbates a hyperthermic state . An intense struggle also can delay needed medical attention . These symptoms in combination with a pre-existing medical condition ,
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