History:
- Drug Abuse
- Cardiac History
- History of Asthma
- Psychiatric History
Signs and Symptoms:
- External signs or trauma
- Palpitations
- Shortness of breath
- Wheezing
- Altered Mental Status
- Intoxication/Substance Abuse
Differential:
- Agitated Delirium Secondary to Psychiatric Illness
- Agitated Delirium Secondary to Substance Abuse
- Traumatic Injury
- Closed Head Injury
- Asthma Exacerbation
- Cardiac Dysrhythmia
Treatment:
Evidence of Traumatic Injury or Medical Illness ?
-
- Appropriate Protocol and Transport
Use of Pepper Spray ?
-
- Irrigate face/eyes
- Remove contaminated clothing
Wheezing ?
History of Asthma ?
Wheezing ?
History of Asthma ?
Agitated Delirium ?
-
- Coordinate disposition with patient, law enforcement personnel, and if necessary Medical Control
Use of Taser ?
Significant Injury from Entry Point of Taser or from Fall after Taser Use ?
-
- Appropriate Protocol and Transport
Cardiac History with Pacemaker, Chest Pain, or Palpitations ?
-
- Appropriate Protocol and Transport
Agitated Delirium ?
-
- Coordinate disposition with patient, law enforcement personnel, and if necessary Medical Control.
Pearls:
- For this protocol to be used, the patient does not have to be under police custody.
- Agitated delirium is characterized by marked restlessness, irritability, and/or high fever. Patients exhibiting these signs are at high risk for sudden death and should be transported to hospital by ALS personnel.
- Patients restrained by law enforcement devices cannot be transported in the ambulance without a law enforcement officer in the patient compartment who is capable of removing the devices.
- If there is any doubt about the cause of a patient’s alteration in mental status, transport the patient to the hospital for evaluation.
- If an asthmatic patient is exposed to pepper spray and released to law enforcement, all parties should be advised to immediately recontact EMS if wheezing/difficulty breathing occurs.
- All patients in police custody retain the right to request transport. This should be coordinated with law enforcement.
- If extremity/chemical/law enforcement restraints are applied, complete Restraint procedure in call reporting system.