Excited Delirium Syndrome : Cause of Death and Prevention book cover
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Excited Delirium Syndrome
Cause of Death and Prevention




ISBN 9780849316111
Published September 22, 2005 by CRC Press
164 Pages 1 B/W Illustrations

 
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Book Description

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 with four point restraint. While order has been restored and the patient has been restrained – she dies soon afterward…

Criminal and civil cases often cite “positional asphyxia” as the cause of death in such instances, blaming the rough treatment individuals may have received during restraint. The authors of Excited Delirium Syndrome: Cause of Death and Prevention, however, propose a different explanation. In this groundbreaking book, they cite the reason being a condition called Excited Delirium Syndrome, in which the normal physiological changes produced by violent activity culminate in sudden cardiac death, often in conjunction with the effects of a drug. 

After introducing the topic, the book recounts the condition’s history and examines traditional explanations as to why such deaths occur, and then counter as to why they are not justifiable. In addition, it illustrates the effects that stressors, legal medication, and drugs of abuse have on the cardiovascular system. The effects of underlying disease, including endogenous mental disease are also discussed. In addition, the book details prevention, assesses the role of first responders, investigators, and mental health professionals, and describes “high-risk” individuals.

These topics, along with the many actual case studies that provide further insight, make Excited Delirium Syndrome: Cause of Death and Prevention an essential resource for anyone treating or interacting with those that may have this disorder. 

Table of 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
Conclusion
References
INDEX

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Reviews

“This short, easy-to-read, 10-chapter book provides current information on the syndrome, dispels common myths, and provides prevention strategies on how to interact with individuals experiencing and excited delirium. It also provides a well-constructed discussion of the chronology of the mechanism resulting in sudden death during an episode of excited delirium with extensive references. … will be of greatest benefit for nurses who interact with psychiatric patients. It outlines the features used to identify patients susceptible to excited delirium and the actions to prevent sudden death. … is a useful reference tool for both legal and medical professionals who may come face-to-face with an individual exhibiting these symptoms. The chapters are well organized and laid out, easy to read, and provide useful information and references. Again, this book is an excellent resource to all members of the law enforcement, forensic, investigation, treatment, and prosecuting teams. …”
— Steven A. Koehler, Forensic Epidemiologist for the Allegheny County Coroner’s Office, Pittsburg, PA, in the Journal of Forensic Nursing, Vol. 2, No. 4, Winter 2006

"The authors’ poignant description of what those who work in the trenches experience on a daily basis is alone worth the read and rounds out the entire discussion."

– Kathryn A. LaFortune, Chief, Forensic Psychological Services, Oklahoma Indigent Defense System, in Jurimetrics, Winter 2008, Vol. 48, No. 2