The scene has played out before and been witnessed by many, but usually only in a movie or on an episode of Cops. The patient is naked or partially clothed and is sweating profusely. He is violent, unstoppable, has what seems like superhuman strength and is impervious to pain. The patient’s bizarre behavior came on suddenly, and he is confused, won’t follow commands to desist and is shouting and screaming. The patient is also violent against objects, especially glass.
To the untrained observer, the assumption is often made that the individual is acting this way because he is on drugs or mentally ill, which is an important part of the story. However, there is another concern that often gets lost, and that is the threat of cardiac arrest. Furthermore, what is so catastrophic is that the cardiac arrest caused by excited delirium syndrome (ExDS) is most often irreversible, and despite rapid and advanced efforts at resuscitation, these patients do not respond and are ultimately pronounced dead upon arrival at the hospital.