Transcript Telecommunicator Orientation to Excited Delirium

Telecommunicator Orientation to
Street Drugs and Excited Delirium
Durham Police Department CIT
And
Durham County EMS
Synthetic Drugs
• Cannabinoids – K-2 or Spice – Versions of
synthetic marijuana
• Cathinones – “Bath Salts” – mimic the effects
of cocaine or meth
• These products are not intended for human
consumption but labeled and marketed to
allude to being used as a drug
Why are they dangerous
• No consistent way of manufacturing chemicals
• Many are more potent
• Individual behavioral reactions are unpredictable
• Long term treatment plans are wisely untested
Bath Salts
• Sold as crystalline powder with the names like:
Red Dove, Vanilla Sky, White lightening
• Can cause severe paranoia, violent behavior, and
hallucinations
• Symptoms may last 2 days
• Long term psychiatric care may be required
Herbal Incense
• Sold as incense with names like spice, K2,
Mojo, G-Four
• Inconsistency in product can lead to
differences in reactions
• Can cause anxiety, paranoia, confusion
Signs and Symptoms of Synthetic Drug
Use
• Altered mental status – speaking in
inappropriate language, making animal like
sounds
• Rapid heart rate
• Sweating profusely
• Very aggressive / Threatening Violence
• Removing clothes to point of nudity
• Elevated Body temperature
Video of Synthetic Drug Use
• http://www.youtube.com/watch?v=Wh_nZiuF
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• http://www.youtube.com/watch?v=HfEepVO
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Warning!!!
• May present with one or two signs and
symptoms at first
• Their condition will worsen over time
• Be aware of the key words that will indicate
the person is suffering from Excited Delirium
or Synthetic Drug Overdose
WARNING SIGNS / Key Words!!!!
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“He is taking off his clothes”
“He is Agitated”
“He is talking out of his head”
“He pacing back and forth”
“He is wanting to fight everybody”
“I think he took something”
“He is hearing voices / He is seeing things”
“He is sweating a lot”
Excited Delirium Videos
• http://www.youtube.com/watch?v=DWbQ3x
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• http://www.youtube.com/watch?v=4FljTDZR1
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Excited Delirium
• Excited Delirium is a controversial term used
to explain deaths of individuals in police
custody, in which the person being arrested,
detained, or restrained is highly agitated and
may be under the influence of stimulants. [1]
Excited Delirium- A Neurology Definition –
Dr. Deborah Mash - University of Miami
• “Someone who is disproportionately large,
extremely agitated, threatening violence,
talking in-coherently, tearing off clothes, and
it takes four to five officers to get the
attention of that individual and bring him out
of harms way – that’s excited delirium!”
What Causes Excited Delirium??
• The use of Stimulant Drugs Over a Period of
Time, specifically Cocaine,
Methamphetamine, and Synthetic Stimulant
Drug
• The use of Alcohol with these Stimulant Drugs
• Combined with Obesity, ethnicity, and often
unknown underlying heart disease
Recognizing Excited Delirium
• Unbelievable strength
• Imperviousness to pain
• Ability to offer effective resistance against
multiple officers over an extended period of time
• Hyperthermia (temperatures can spike to
between 105-113°F)
• Sweating
• Shedding clothes or nudity
• Bizarre and violent behavior
• Aggression
• Hyperactivity
Call Take/Dispatch Role
• When Warning Signs/Key Words present the
information should be clearly documented
and provided to responders
• Dispatch Crisis Intervention Team/Mental
Health trained responders when possible
• Consider dual response policy for PD/EMS
Special Note: Impervious Pain
• More Officers the better – due to the usual
techniques to control the person may be
ineffective – Taser, Baton, Pepper Spray
• Due to the lack of response to usual Law
Enforcement Techniques, One officer will be
overwhelmed in a short period of time.
• This can cause injuries or death to both the
Officer and the person consuming the drug
Treatment of Excited Delirium
• EMS and Law Enforcement response will focus
first on crew, officer, and patient safety
• We will treat immediate life threats – CPR,
Oxygen, Airway
• The person will receive medications to help
sedate and calm them both psychiatrically and
physically.
• They will also receive IV Fluids and Heart
monitoring to rule out their heart has not been
damaged by the drugs
Treatment at the Hospital
• Both immediate and long term treatments
focus on preserving body function, while
detoxifying and allowing metabolic functions
to return to a somewhat normal state.
• The major organs affected by the drugs are
Kidneys, Liver, Heart, and Brain.
QUESTIONS??