title: Prehospital resuscitation of a man with excited delirium and cardiopulmonary arrest.
abstract: Features consistent with the syndrome known as excited delirium (ExDS) have been associated with law enforcement restraint-related death. The pathophysiology and exact causative factors of restraint-related death associated with ExDS remain unclear. We present a case of successful field resuscitation of a man with ExDS who experienced cardiopulmonary arrest while being restrained by law enforcement officers. Despite the presence of a severe lactic acidosis on emergency department admission, the patient recovered following prehospital treatment with advanced cardiac life support measures and intravenous sodium bicarbonate, likely in part due to early recognition of the disease process.
authors.forename: Patrick Joseph
authors.initials: PJ
authors.lastname: Maher
authors.forename: Mimi
authors.initials: M
authors.lastname: Walsh
authors.forename: Thomas
authors.initials: T
authors.lastname: Burns
authors.forename: Jared
authors.initials: J
authors.lastname: Strote
mesh_terms: D000138:Acidosis / Q000628:therapy; D000328:Adult; D061906:Advanced Trauma Life Support Care; D003693:Delirium / Q000150:complications / Q000523:psychology / Q000628:therapy*; D004558:Electric Stimulation / Q000295:instrumentation; D004632:Emergency Medical Services; D005554:Forensic Medicine; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D016495:Police; D011595:Psychomotor Agitation / Q000628:therapy*; D012149:Restraint, Physical; D012151:Resuscitation; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D013577:Syndrome
chemical_list: D017693:Sodium Bicarbonate