Pubdate: Sat, 17 May 2008
Source: National Post (Canada)
Copyright: 2008 Southam Inc.
Contact:  http://www.nationalpost.com/
Details: http://www.mapinc.org/media/286
Author: Adrian Humphreys
Bookmark: http://www.mapinc.org/topic/excited+delirium (excited delirium)

'EXCITED DELIRIUM' BLAMED FOR DEATHS

'Not About Tasers'

The message inside the meeting room was one thing -- "we're not 
talking about Tasers" one speaker said three or four times during a 
presentation to 250 police officers and paramedics -- but the chatter 
outside was quite another.

"I've been Tasered twice -- once sober and once drunk," said an 
officer during the break. "How many times have you used yours?" 
another asked a colleague. A third complained her force now makes her 
fill out a form every time she uses her Taser, while another 
described it as "kind of freaky" zapping someone for the first time.

As emergency personnel reached past the baskets of apples, cookies 
and chips during conference breaks, talk quickly turned to the Taser, 
the police-issue stun guns thrust into the public spotlight when an 
agitated Polish immigrant in Vancouver's airport collapsed and died 
after being hit by police Tasers and held to the ground.

Controversy over the increasing use of Tasers and the attention 
accorded in-custody deaths is, after all, why most are here, in 
Guelph at a conference hosted by the local police force on 
recognizing the signs of excited delirium.

While the Taser draws most of the heat, debate over precisely why 
people die after a brisk battle with police to restrain them -- 
whether using a Taser or not -- is growing as more attention is being 
paid to a condition that is only now being popularized.

On one hand, the officers and medics who are called to deal with the 
agitated and disturbed

people say they know the phenomenon well. They have seen the 
irrational responses, bizarre behaviour and hyperactivity of the 
people; they have felt their superhuman strength as they struggle.

Police readily grab hold of the medical terminology of "excited 
delirium" to describe it.

That excited delirium is a condition almost exclusively associated 
with a struggle with police, however, creates concern with some. One 
does not hear of a person dying of excited delirium during a barroom 
brawl or a fight with a spouse or when out camping or shopping.

"Anytime you see a specific condition being referenced in only one 
context it raises serious question," said Graeme Norton, the director 
of the public safety project with the Canadian Civil Liberties Association.

Opponents in the United States go further, saying the term is used to 
mask over-aggressive police force.

Excited delirium is a term that has been accepted in the United 
States by the National Association of Medical Examiners, but not by 
the American Medical Association. It has been dismissed as a "pop 
culture phenomenon" in the pages of the Canadian Medical Association 
Journal and listed as a contributing cause of death in several 
coroner's reports in Canada.

At Thursday's conference, such debate was pushed into the background. 
As the presentations progressed, few in the room seemed to be nonbelievers.

A jerky video projection showed a large young man -- naked and 
agitated -- walking down the street with only passing compliance with 
orders to stop that are repeatedly called out by a growing cluster of 
police officers anxiously fingering canisters of pepper spray in 
their latex-gloved hands.

When the man starts punching out large sections of a wooden fence, 
the officers move in, bathing him in spray and piling on him as he 
pushes back with apparent superhuman strength.

As the video of the confrontation finishes, Chris Lawrence, a trainer 
with the Ontario Police College, turns to conference attendees and 
parodies what critics of police are saying: "We'd like you to 
negotiate with this individual; we can't understand why you just 
can't talk to these people."

The room erupts in knee-slapping laughter.

"We don't do this because we want to; we do this because we have to," 
he said of police restraint techniques, including Tasers, pepper 
spray, batons, handcuffs and physical holds.

Mr. Lawrence studied 407 police-related deaths in Ontario that went 
to inquest and are archived at the police college. He found 35 cases 
where excited delirium was deemed a factor, either by name or by 
mention of common features. The first death was in 1988.

Only one involved a Taser, although more recent examples may still be 
in the inquest system and are not included in his study. All but one 
of the 35 victims was male. Their average age was 34.

He found excited delirium deaths occurred over the years on every day 
of the week, but most often on weekends. All of the victims were 
either substance abusers (overwhelmingly cocaine) or suffering mental 
illness (most often schizophrenia) but rarely both at the same time. 
He found cases where the temperature was 31C and cases where it was 
- -7.2C; cases in the biggest city and in rural northern Ontario.

"We cannot seem to eliminate the problem," he said.

Dr. Christine Hall, an emergency room doctor with the Vancouver 
Island Health Authority, addressed critics who dismiss excited 
delirium because it is not listed in the Diagnostic and Statistical 
Manual of Mental Disorders, the standard guidebook to psychiatric diagnosis.

"It is not a diagnosis -- get over it," she said. "It is a state, a condition."

She compared it to other conditions, such as abdominal pain. 
Appendicitis might be the diagnosis for someone with abdominal pain. 
Excited delirium, she said, is a symptom or condition of an 
underlying disorder.

She echoed the contention that police restraint is typically 
necessary. "Psychiatrists do not undertake talk therapy with 
delirious people ... the medic's job is not to capture people," she 
said. "Physicians and nurses do not undertake treatment on people who 
are trying to kill them."

Dean Popov, paramedic practice manager at Sunny-brook-Osler Centre 
for Prehospital Care, told the conference that no matter what police 
and medics do in these cases, it could end badly: "The outcome may 
still be negative, even if everything is done properly. We truly 
don't 100% know what is causing this yet."
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MAP posted-by: Jay Bergstrom