title: Excited Delirium Syndrome (ExDS): defining based on a review of the literature.
abstract: BACKGROUND
  Patients present to police, Emergency Medical Services, and the emergency department with aggressive behavior, altered sensorium, and a host of other signs that may include hyperthermia, "superhuman" strength, diaphoresis, and lack of willingness to yield to overwhelming force. A certain percentage of these individuals will go on to expire from a sudden cardiac arrest and death, despite optimal therapy. Traditionally, the forensic community would often classify these as "Excited Delirium" deaths.
  
  
  OBJECTIVE
  This article will review selected examples of the literature on this topic to determine if it is definable as a discrete medical entity, has a recognizable history, epidemiology, clinical presentation, pathophysiology, and treatment recommendations.
  
  
  CONCLUSIONS
  Excited delirium syndrome is characterized by delirium, agitation, acidosis, and hyperadrenergic autonomic dysfunction, typically in the setting of acute-on-chronic drug abuse or serious mental illness or a combination of both.
  
  
  CONCLUSIONS
  Based upon available evidence, it is the consensus of an American College of Emergency Physicians Task Force that Excited Delirium Syndrome is a real syndrome with uncertain, likely multiple, etiologies.
authors: Department of Emergency Medicine, University of California at San Diego Medical Center, San Diego, California 92103, USA.
authors: Gary M
authors: GM
authors: Vilke
authors: Mark L
authors: ML
authors: DeBard
authors: Theodore C
authors: TC
authors: Chan
authors: Jeffrey D
authors: JD
authors: Ho
authors: Donald M
authors: DM
authors: Dawes
authors: Christine
authors: C
authors: Hall
authors: Michael D
authors: MD
authors: Curtis
authors: Melissa Wysong
authors: MW
authors: Costello
authors: Deborah C
authors: DC
authors: Mash
authors: Stewart R
authors: SR
authors: Coffman
authors: Mary Jo
authors: MJ
authors: McMullen
authors: Jeffery C
authors: JC
authors: Metzger
authors: James R
authors: JR
authors: Roberts
authors: Matthew D
authors: MD
authors: Sztajnkrcer
authors: Sean O
authors: SO
authors: Henderson
authors: Jason
authors: J
authors: Adler
authors: Fabrice
authors: F
authors: Czarnecki
authors: Joseph
authors: J
authors: Heck
authors: William P
authors: WP
authors: Bozeman
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use; D003693:Delirium / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D011595:Psychomotor Agitation / Q000175:diagnosis* / Q000188:drug therapy; D013577:Syndrome
chemical_list: D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives