Excited Delirium Syndrome (ExDS): Defining Based on a Review of the Literature
详细信息 查看全文
- 作者：Gary M. Vilke ; MD&lowast ; ; ; Mark L. DeBard ; MD&dagger ; ; Theodore C. Chan ; MD&lowast ; ; Jeffrey D. Ho ; MD&Dagger ; ; Donald M. Dawes ; MD§ ; ; | ; Christine Hall ; MD ; MSc¶ ; ; &lowast ; &lowast ; ; Michael D. Curtis ; MD&dagger ; &dagger ; ; &Dagger ; &Dagger ; ; Melissa Wysong Costello ; MD§ ; § ; ; Deborah C. Mash ; PhD|| ; Stewart R. Coffman ; MD¶ ; ¶ ; ; Mary Jo McMullen ; MD&lowast ; &lowast ; &lowast ; ; Jeffery C. Metzger ; MD&dagger ; &dagger ; &dagger ; ; James R. Roberts ; MD&Dagger ; &Dagger ; &Dagger ; ; Matthew D. Sztajnkrcer ; MD ; PhD§ ; § ; § ; ; Sean O. Henderson ; MD||| ; Jason Adler ; MD¶ ; ¶ ; ¶ ; ; Fabrice Czarnecki ; MD ; MA ; MPH&lowast ; &lowast ; &lowast ; &lowast ; ; Joseph Heck ; DO&dagger ; &dagger ; &dagger ; &dagger ; ; William P. Bozeman ; MD&Dagger ; &Dagger ; &Dagger ; &Dagger ;
- 关键词：excited delirium ; in-custody death ; sudden death ; TASER ; restraint ; agitated delirium
- 刊名：Journal of Emergency Medicine
- 出版年：2012
- 出版时间：November, 2012
- 年：2012
- 卷：43
- 期：5
- 页码：897-905
- 全文大小：125 K
文摘
Background
Patients present to police, Emergency Medical Services, and the emergency department with aggressive behavior, altered sensorium, and a host of other signs that may include hyperthermia, ¡°superhuman¡± strength, diaphoresis, and lack of willingness to yield to overwhelming force. A certain percentage of these individuals will go on to expire from a sudden cardiac arrest and death, despite optimal therapy. Traditionally, the forensic community would often classify these as ¡°Excited Delirium¡± deaths.Objectives
This article will review selected examples of the literature on this topic to determine if it is definable as a discrete medical entity, has a recognizable history, epidemiology, clinical presentation, pathophysiology, and treatment recommendations.
Discussion
Excited delirium syndrome is characterized by delirium, agitation, acidosis, and hyperadrenergic autonomic dysfunction, typically in the setting of acute-on-chronic drug abuse or serious mental illness or a combination of both.
Conclusions
Based upon available evidence, it is the consensus of an American College of Emergency Physicians Task Force that Excited Delirium Syndrome is a real syndrome with uncertain, likely multiple, etiologies.