>> Risk Factors Associated with Excited Delirium Syndrome and Arrest-Related DeathS
psychosis , acute episode of severe stress , chronic heavy drug abuse , dehydration , and poor nutrition can significantly increase the risk of sudden cardiac arrhythmia
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Associated Risk Factors to LEO Safety LEOs are called to respond to these situations and less-lethal force is often required to capture , control , and restrain the subject . LEOs confronting a subject exhibiting six or more ExDS symptoms , face a significant threat of injury . Encountering a subject exhibiting six or more ExDS symptoms , an LEO is five times as likely to be assaulted , likely to encounter a subject with a weapon of opportunity , and three times as likely to struggle with the subject prior to capture and struggle after control and restraint on the ground . 6-7 Continued aggressive resistance by the subject is significantly associated with LEO injury . A subject who aggressively resists and prolongs a physical struggle with the LEO , lasting over one-minute represents a significant risk factor of injury for LEOs and the subject . 18-19 LEOs who engage in prolonged physical exertion to control the violent subject can increase their potential for injury and increases their risk of a sudden cardiac arrest . 20-21
Intervention Implications When a responding LEO encounters a subject exhibiting six or more of the ExDS symptoms the LEO is at a higher risk of assault and injury than other types of calls . Each intervention comprises numerous situational variables and LEOs must respond to the changing dynamics as they transpire . Officer safety is critical in responding to these incidents and the following response strategies should be considered .
First , as a LEO responds to an ExDS subject , the LEO should be aware of the situational environment , perform a threat assessment , identify as many of the ExDS symptoms previously described , and request back-up , and a supervisor . As feasible , the LEO should use time as a tactic and attempt to contain the subject .
Second , the LEO should radio for emergency medical personnel as soon as possible and stage medical personnel when the subject ’ s behaviors are known .
Third , throughout the incident , a LEO should radio dispatch frequently to develop a timeline of the LEO ’ s response . 2
Fourth , by definition , ExDS symptoms demonstrate the diminished capacity of the subject and the subject will be unlikely to follow verbal instructions . However , the LEO should use calm , reassuring statements and instructions to attempt to gain compliance of the subject .
Fifth , due to the subject ’ s tolerance to pain and extreme strength , LEOs should avoid using pain compliance techniques .
Sixth , as the subject ’ s violent behaviors continue , higher levels of force measures are commonly required . Use of force techniques and equipment used to control and restrain the subject should focus on rapid capture and control to minimize the subject ’ s exertional activity , minimize a prolonged struggle , while ensuring the safety of the LEO and the subject . LEOs should use reasonable force options that provide distance from the subject to enhance officer safety and conducted energy weapons ( CEW ) are preferred in these violent situations . 6 , 15-16 CEW ’ s effectively used can shorten the confrontation time span and can assist in multiple LEOs grounding the subject .
Seventh , LEOs should anticipate continued subject resistance on the ground during restraint . Using team takedown techniques , multiple LEOs should quickly control the subject by controlling large limbs to limit the subject ’ s ability to actively resist . 6-7 The use of efficient control techniques and restraints that minimize the physiological stress of the subject can minimize injury to subject and the involved LEOs . Restraint equipment / devices should be used to restrain the subject ’ s hands and the legs as warranted .
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