Magazine article Clinical Psychiatry News

Excited Delirium Syndrome Lacks Research, Coding

Magazine article Clinical Psychiatry News

Excited Delirium Syndrome Lacks Research, Coding

Article excerpt

EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE AMERICAN PSYCHIATRIC ASSOCIATION

PHILADELPHIA -- High doses of the anesthetic ketamine hydrochloride injected into the anterior thigh are the first line of defense when treating a patient with excited delirium syndrome, Dr. James R. Roberts reported at the meeting.

Excited delirium syndrome (ExDS) is characterized by delirium, agitation, acidosis, and hyper adrenergic autonomic dysfunction, according to the Journal of Emergency Medicine (J. Emerg. Med. 2011 March 24 [doi: 10.1016/j.jemermed.2011.02.017]). It is often comorbid with serious mental illness, drug abuse, or a combination of the two, said Dr. Roberts, who serves as director of emergency medicine at Mercy Philadelphia Hospital and Mercy Fitzgerald Hospital, and has more than 40 years of experience working in emergency departments.

Dr. Roberts said ExDS patients often have symptoms that include severe hypothermia, high levels of testosterone, elevated temperature, extreme paranoia, and tolerance to pain, and sweating. These patients also often display super-human strength and are non-compliant with police.

According to the American College of Emergency Physicians (ACEP), which formally recognized the illness as a unique syndrome in 2009, more than 95% of published fatal cases of ExDS involve males with a mean age of 36. …

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