Crime Watch: Excited Delirium poses challenges to law enforcment

More and more often law enforcement is confronting an extremely challenging situation. People are using drugs and having a reaction that is sudden, violent and if not treated appropriately--deadly. It's called excited delirium.

In this week’s Crime Watch 7's Noelle Newton takes you inside a training aimed at preventing deaths.
In a video clip from inside the Williamson County jail an inmate pounds his fits, yells, sings and continuously slams his full body weight into the cell door without flinching. He is sweating profusely.

Jailers recognize these are all symptoms of excited delirium.

Deputy: "Alright relax. Sing for me. Sing for me."

Jail staff tries to distract the man as they come up with a plan to address what is considered a medical emergency. When everyone is in place, they move in.

Jailers tase the inmate to quickly gain control of his arms and legs. Medical department Lt. Douglas Wheless administers a sedative.

A couple minutes later, the inmate is asleep. He is turned over and loaded onto a stretcher.

"He was in the jail for a significant amount of time. He went to the hospital, was there for a couple days, came back and he couldn't remember anything. He was the nicest guy in the world,” said Wheless. "He said 'the last thing I remember is I bought a bag of marijuana.'"

Drug use is the number one cause of excited delirium.

The term was first coined in the 1800s, but law enforcement has only recently begun intervention training and recognized it is an immediate medical emergency. Wheless has conducted eight hour classes for Williamson County deputies and jail staff since 2009.

"One of the symptoms would be is they might be hyper-thermic, high body temperature, removing their clothes. Not making any sense, sometimes violent, delusional and hallucinating,” said Wheless.

What's troubling about a person in this situation is their lack of sensitivity to pain.

"You and I, when we go running and we start having any kind of pain we can say we need to slow down and stop they don't have that. They don't have the ability to shut it off, they continue on until there is exhaustion,” said Wheless. "If someone is exhibiting those symptoms of excited delirium then there's a high chance they could die if not treated."

Wheless' role is to show law enforcement how to spot symptoms and appropriately respond. These people have extremely high heart rates. Certain triggers can make matters worse.

"If there is a way to minimize the external stimuli that that person is exposed to then we should minimize that. Some of that is let's not use sirens. Let's not use lights. Let's get enough back up. Let's not put our hands on them unless we're prepared to go to the gurney of the medical providers if possible. The problem is, sometimes it's not possible,” said Wheless.

Wheless recommends calmly talking with the person, getting them to lie down and relax. Once a minimum of four officers are on scene and EMS is alerted, Wheless says a mechanical defeat maneuver can be used.

The mechanical defeat maneuver begins with the suspect being tased. As soon as the prongs hit the person's body, the deputies grab both arms and bring the person down. Two more deputies control the person's feet.

Pressure is used to lock the arms in place. The airway, chest and back, remains open while EMS administers a sedative.

"Absolutely it's minimized the problems,” Wheless said.

Even as the training sweeps the nation, there will be deaths.

In February, 17-year-old David Joseph, who is believed to have been exhibiting excited delirium symptoms, was fatally shot as he ran full speed at an Austin police officer.

A trainer told investigators he believed the officer's activation of his patrol lights attracted Joseph. The officer, Geoffrey Freeman, felt he could not risk waiting for back-up.

As these situations unfold, Wheless asks that we all take into account the extreme complexity of the syndrome.

"There's two sides to all these stories and that I think ultimately I think the police officers are doing the very best they can to confront a very difficult problem,” said Wheless.

The Austin Police Department teaches excited delirium courses to cadets and current officers. Unlike Williamson County, it is not a stand-alone class.  An excited delirium section is taught during annual taser re-certification. All officers who carry a taser must attend that training.