Eighth , LEO ’ s should be alert to a subject who suddenly becomes tranquil and unresponsive after a period of extreme combativeness . When tactically feasible , the subject should be placed in a position so a LEO can monitor the subject ’ s face , remove items around the subject ’ s neck , check for vital signs , check for apparent injuries , and check for signs of functional consciousness . As warranted , a LEO should initiate lifesaving measures until relieved by paramedics . LEOs should also check themselves for apparent injuries .
Ninth , the subject should be transported to the hospital by paramedics .
Tenth , involved LEOs should submit a detailed written report describing : the nature of the call and the confrontation environmental variables ; when back-up and a supervisor was requested and arrived ; each LEOs level of involvement ; their observations , assessment , and perception of the subject ’ s behaviors ; the subject ’ s statements ; all of the symptoms of ExDS observed ; attempts to gain compliance of the subject ; the threat posed and the types of subject resistance prior to and after control and restraint ; the rationale for using all force measures , equipment , and restraints ; monitoring and rendering first aid to the subject ; apparent subject injuries ; when paramedics were requested and responded ; and the duration of the confrontation . 2
Photos of the LEOs and the subject should be taken .
LEOs are not expected to make clinical judgments . Rather , recognizing the symptoms and behaviors associated with ExDS , LEOs can enhance their personal safety leading to reasonable responses and simultaneously enhance subject safety .
References 1 . Brave , M ( 2020 , June ). Law enforcement use of force standards , degrees of certainty , and scientific probabilities . Governmental Liability , 24-30 . 2 . Ross DL , and Brave , M ( 2020 , March ). Assessing use-of-force liability and law enforcement response to the naked subject . Law Enforcement Executive Forum , 20 ( 1 ): 1-21 .
3 . International Association of Chiefs of Police ( 2015 ). Resolution on Excited Delirium . www . theiacp . org / resources / resolution / excited-delirium-syndrome 4 . Baldwin S , Hall C , Bennell C , Blaskovits B , and Lawrence C ( 2016 ). Distinguishing features of Excited Delirium in non-fatal use of force encounters . Journal of Forensic and Legal Medicine , 41:21-27 . 5 . Hall CA , Kader CS , McHale AM , et al . ( 2012 ). Frequency of signs of excited delirium syndrome in subjects undergoing police use of force : Descriptive evaluation of prospective consecutive cohort . Journal of Forensic Legal Medicine , 20 ( 1 ): 1-6 . 6 . Ross DL and Hazlett MH ( 2018 ). Assessing the symptoms associated with excited delirium syndrome and the use of conducted energy weapons . Forensic Research and Criminology International Journal , 6 ( 3 ): 187-196 . 7 . Baldwin S , Hall C , Bennell C , Blaskovits B , and Lawrence C , and Semple , T ( 2018 ). Excited delirium syndrome ( ExDS ): Situational factors and risks to officer safety in non-fatal use of force encounters . International Journal of Law and Psychiatry , 60 : 26-34 . 8 . Mash DC ( 2016 ). Excited delirium and sudden death : A syndrome disorder at the extreme end of neuropsychiatric continuum . Frontiers in Physiology , 7 : 435-449 . 9 . DiMaio TG and DiMaio VJM ( 2006 ). Excited delirium syndrome : Cause of death and prevention . CRC Press , NY . 10 . International Association of Chiefs of Police ( 1996 , November 1 ). Excited delirium resolution . 103rd Annual Conference , Phoenix , AZ . 11 . Stephens BG , Jentzen JM , Karch S , Wetli CV , Mash DC ( 2004 ). National Association of Medical Examiners position paper on the certification of cocaine-related deaths . American Journal of Forensic Medicine and Pathology . 25 ( 1 ): 11-3 . 12 . ACEP Excited Delirium Task Force ( 2009 , September 10 ). White paper on Excited Delirium Syndrome . American College of Emergency Physicians , Baltimore , MD . 13 . Coyne CJ , Ly BT , and Vilke , GM ( 2018 ). Excited delirium syndrome ( ExDS ) ( Chapter 9 , pp . 187-200 ). In DL Ross and GM Vilke ( Eds .) Guidelines for investigation officer-involved shootings , arrest-related deaths , and deaths in custody . Routledge Publisher , NY / London . 14 . Ruttenber AJ , Lawler-Heavner J , Yin M , et al . ( 1997 ). Fatal excited delirium following cocaine use : Epidemiologic findings provide new evidence for mechanism of cocaine toxicity . Journal of Forensic Science , 42 ( 1 ) 25-31 . 15 . Vilke GM and Payne-James JJ ( 2016 ). Excited delirium syndrome : aetiology , identification and treatment ( Chapter 6 , pp . 97-117 ). In John Gall and JJ Payne-James ( Eds .) Current Practices in Forensic Medicine Vol . 2 . Wiley and Sons , Ltd . 16 . Nakajima Y and Vilke GM ( 2017 ). Use of force in pre-hospital environment ( Chapter 12 , pp 173-188 ). In SL Zeller , KD Nordstrom , and MP Wilson ( Eds .), The Diagnosis and Management of Agitation , Cambridge University Press . 17 . Ross DL ( 1998 ). Factors associated with excited delirium . Modern Pathology , 11 ( 11 ): 1127-1137 . 18 . Castillo EM , Prabhakar N , and Luu B ( 2012 ). Factors associated with law-enforcement-related use of force injury . American Journal of Emergency Medicine , 30 : 526-531 . 19 . International Association of Chiefs of Police ( 2012 , Jan . 1 ). Reducing officer injuries , final report : A summary of data findings and recommendations from a multi-agency injury tracking study . Center for Officer Safety and Wellness , 1-40 .
www . theiacp . org / resources / document / reducing-officer-injuries-final-report 20 . Varvarigou V , Fariloli A , Korre M , et al . ( 2014 , Nov . 18 ). Law enforcement duties and sudden cardiac death among police officers in the United States : Case distribution study . The BMJ , 1-9 . 21 . Krexi L , Georgiou R , Krexi D and Sheppard MN ( 2015 ). Sudden cardiac death with stress and restraint : The association with sudden death syndrome , cardiomyopathy , and coronary artery disease . Medicine , Science and the Law : 1-6 .