During a routine investigation, a suspect turns hostile. The officers on the scene spring into action and get the suspect under control by handcuffing him. Though the suspect has been successfully subdued he dies shortly thereafter.

A psychiatric patient suddenly becomes violent. The hospital staff struggles to control the patient

Theresa G. DiMaio, Vincent J. M. DiMaio, M.D.

Contents: INTRODUCTION TO DEATH DUE TO EXCITED DELIRIUM SYNDROME References HISTORY OF EXCITED DELIRIUM SYNDROME Bell's Mania Current Cases Psychopharmacology and the Disappearance of the Chronic Form of Excited Delirium Acute Excited Delirium References TRADITIONAL EXPLANATIONS FOR DEATH DUE TO EXCITED DELIRIUM SYNDROME Medical Examiner Positional/Restraint Asphyxia Neck Holds Vasovagal Reactions (Reflex Cardiac Death) Oleresin Capsicum Tasers Explaining Excited Delirium Syndrome References PHYSIOLOGICAL REACTIONS TO STRESS The Sympathetic Nervous System Physiological Effects of Strenuous/Violent Physical Activity References EFFECTS OF DRUGS ON THE HEART, BRAIN, AND SYMPATHETIC NERVOUS SYSTEM Cardiac Injury Due to Chronic Elevation of Blood Catecholamine Levels Psychotropic Drugs and Sudden Death Miscellaneous Drugs References Additional References SYNTHESIS OF PHYSIOLOGICAL REACTIONS TO STRESS, NATURAL DISEASE, DRUGS OF ABUSE, AND MEDICATIONS IN CASES OF EXCITED DELIRIUM References MEDICO-LEGAL INVESTIGATION OF DEATHS DUE TO EXCITED DELIRIUM SYNDROME The Investigation The Autopsy Toxicology Certification of Death References CASES OF EXCITED DELIRIUM SYNDROME Excited Delirium Syndrome Associated with Mental Illness and Natural Disease Excited Delirium Syndrome Associated with Mental Retardation and Obesity Excited Delirium Syndrome Associated with Mental Illness and Therapeutic Medications Excited Delirium Syndrome Associated with Use of Cocaine Excited Delirium Syndrome in Association with Methamphetamine Excited Delirium Syndrome in Association with Other Drugs PREVENTION OF EXCITED DELIRIUM SYNDROME: THE POLICE AND FIRST RESPONDERS Introduction The Problem Law Enforcement Prevention Emergency Responders Police and EMS at the Scene Emergency Rooms References SUDDEN DEATH OF THE PSYCHIATRIC PATIENT IN MENTAL HEALTH FACILITIES Introduction Identifying Patients Susceptible to Excited Delirium Syndrome Preventing Sudden Death from Excited Delirium Syndrome Overview of Preventive Measures