Policy California bans controversial ‘excited delirium’ diagnosis; is first state to do so

Landrew

Landrew

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A human rights activist hailed the decision as a “watershed moment” that could make it harder for police to justify excessive force.​

By KFF HEALTH NEWS

PUBLISHED: October 15, 2023 at 4:41 p.m. | UPDATED: October 17, 2023 at 2:22 p.m.

SACRAMENTO — California is the first state to ban doctors and medical examiners from attributing deaths to the controversial diagnosis known as “excited delirium,” which a human rights activist hailed as a “watershed moment” that could make it harder for police to justify excessive force.

Democratic Gov. Gavin Newsom signed a bill Oct. 8 to prohibit coroners, medical examiners, physicians, or physician assistants from listing excited delirium on a person’s death certificate or in an autopsy report. Law enforcement won’t be allowed to use the term to describe a person’s behavior in any incident report, and testimony that refers to excited delirium won’t be allowed in civil court. The law takes effect in January.

The term excited delirium has been around for decades but has been used increasingly over the past 15 years to explain how a person experiencing severe agitation can die suddenly through no fault of the police. It was cited as a legal defense in the 2020 deaths of George Floyd in Minneapolis; Daniel Prude in Rochester, New York; and Angelo Quinto in Antioch, California, among others.

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www.ocregister.com

California bans controversial ‘excited delirium’ diagnosis; is first state to do so

A human rights activist hailed the decision as a “watershed moment” that could make it harder for police to justify excessive force.
www.ocregister.com www.ocregister.com
 
MedicinalUser247 said:
Well I think that's just wrong because exited delirium is a diagnosis.
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Right, but in the context of cause of death it doesn't make much sense. You cannot die from psychotic/delusional agitation as far as I'm aware. Of course it could lead to secondary deaths from heart attacks/strokes or something, but if that's how someone died it's more accurate to write such on a death certificate.

Such a vague term eludes description of how police actions may have contributed to a death, regardless if deemed legal or warranted.

Qualified immunity needs to be changed. It allows bad cops to escape all accountability.
 
^ ^ Yes, but a person can die from the DT's if not properly treated. Putting a person with the DT's in jail instead of the hospital is just wrong.
 
Snafu in the Void said:
Qualified immunity needs to be changed. It allows bad cops to escape all accountability.
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I just learned the Vancouver Police carry Naloxone only to use on themselves. Strange world...

While paramedics have been supplied with injectable naloxone for use on someone who is overdosing, the VPD has been opposed to officers doing the same because they would be investigated by the Independent Investigations Office if the person died.

"It becomes an in-custody death," Montague said, adding the policy "defies logic" because paramedics or firefighters working alongside officers trying to save someone's life would not be subjected to an investigation but instead serve as witnesses.
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www.ctvnews.ca

Health news in Canada – Medicine, Disease and Healthcare – CTV News

Get the latest news on health care and medicine in Canada, emergency room delays, medical assistance in dying and more.
www.ctvnews.ca www.ctvnews.ca
 
MedicinalUser247 said:
^ ^ Yes, but a person can die from the DT's if not properly treated. Putting a person with the DT's in jail instead of the hospital is just wrong.
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DTs is different, but yes you are right. This is precisely to get people in psychosis help, for them to be treated properly, instead of 10 cops laying on top of them until they stop breathing or have a heart attack. More precisely, it's to stop cops being held unaccountable for killing them by simply blaming their death on psychosis.

These people sometimes die from excessive force, but the cops just say they died because they were crazy. It's wrong and opens vague infinite loopholes.

Of course people have heart attacks sometimes during arrest and that is unfortunate, but there are very notable examples where excessive force was used, such as Floyd, and then their defense is he died because he was crazed. That's the wrong part.
 
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Landrew said:
Long but very interesting, hotshot paramedic defends Ketamine for Excited Delirium, blames cops for deaths.

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this I never really understood... my understanding for emergency treatment of agitated psychosis was a "b52", which is basically an IM injection of 2mg lorazepam, 50mg diphenhydramine, and a modest does of an antipsychotic (I forgot which one). That will surely calm someone down... and is designed to treat psychosis.

Why give ketamine to a psychotic person? It seems like a brutish attempt to physically disable them so they literally cannot resist, but will only worsen a psychosis!!
 
Snafu in the Void said:
this I never really understood... my understanding for emergency treatment of agitated psychosis was a "b52", which is basically an IM injection of 2mg lorazepam, 50mg diphenhydramine, and a modest does of an antipsychotic (I forgot which one). That will surely calm someone down... and is designed to treat psychosis.

Why give ketamine to a psychotic person? It seems like a brutish attempt to physically disable them so they literally cannot resist, but will only worsen a psychosis!!
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I think you are expecting these treatments aka ketamine in this case to "help" a person which I dont think is really the case to be honest. Ketamine in this case would propably make a person docile aka easier to control.
 
K has considerably faster onset than benzos is the reason given in the vid, and I will ask him why hospitals have different policy.
 
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Landrew said:
K has considerably faster onset than benzos is the reason given in the vid, and I will ask him why hospitals have different policy.
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Yeah I guess that's somewhat logical thinking...

But at the same time, why make a resistant person immune to pain and further delusional? A common sense response to cops forcing you into painful positions is to stop. If you can't feel pain that response doesn't occur.

30 years ago cops were terrified of PCP freak outs who were insanely difficult to control... but now they want to create a new situation?
 
Snafu in the Void said:
this I never really understood... my understanding for emergency treatment of agitated psychosis was a "b52", which is basically an IM injection of 2mg lorazepam, 50mg diphenhydramine,
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Almost. 5mg haloperidol + 2mg lorazepam.

A friend worked in an RSU and so had first-hand experience of it's use.

As for using K - no idea.
 
Landrew said:
K has considerably faster onset than benzos is the reason given in the vid, and I will ask him why hospitals have different policy.
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Prepmedic Wrote:

A B52 is an incredibly outdated pharmaceutical treatment for behavioral emergencies. For starters lorazepam is very viscous and performs poorly when injected IM with >15 minute onset time and a bigger potential for hemodynamic collapse then ketamine.

Haldol (the anti psychotic you were thinking of) can cause dystonic reactions along with other issues and has pretty minimal acute effects on patients who are acutely violent. The entire reason Benadryl is included in a B52 injection is an attempt to mitigate the effects of dystonic reactions caused by the Haldol.

Now, consider the fact that every minute of onset time is more time the patient needs to be physically restrained. So 15 minutes of physical violence (for lack of a better word) which endangers the patient and caretakers or 5 minutes from Ketamine. Now consider how long it takes to draw up three different medications in one syringe where the dosing of each can’t be verified by simply showing the milliliters to a fellow health care worker.

On top of all of that the chance the patient is allergic or has an unfavorable reaction to one of the three medications in a B52 is much higher then just getting one injection of Ketamine. I don’t know where the myth that ketamine is more “brutish” then any other kind of sedation came from. It’s just a medication and a tool in the toolbox to treat a violent patient in a reasonable amount of time.
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Landrew said:
I just learned the Vancouver Police carry Naloxone only to use on themselves. Strange world...


www.ctvnews.ca

Health news in Canada – Medicine, Disease and Healthcare – CTV News

Get the latest news on health care and medicine in Canada, emergency room delays, medical assistance in dying and more.
www.ctvnews.ca www.ctvnews.ca
Click to expand...

There was a case awhile back were a cop apparently OD from handling fent. it has since been established that you can’t really OD from touching fent.

www.nbcnews.com

Viral video of San Diego deputy's fentanyl exposure raises questions

Some experts expressed doubts about the scenario. "You can't just touch fentanyl and overdose," physician Ryan Marino said.
www.nbcnews.com www.nbcnews.com
 
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