Police and Medics Working Together to Saves Lives

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Excited Delirium Training for Precinct 5 Officers

The medical community, police and EMS are finally realizing that some suspects are really patients and they may indeed die unless there is an integrated approach by Police Agencies and EMS. But, that message has not reached everyone. That’s why, since 2010, Cypress Creek EMS has been providing training to police officers, firefighters, and Medics. Cypress Creek Assistant Executive Director Wren Nealy and Special Ops Supervisor Bobby Sellers are established subject matter experts in the management of Excited Delirium. They lead day-long training sessions which is approved by the state of Texas as continuing education credit for officers and medics.

What is “Excited Delirium”

Excited Delirium Syndrome cases are those strange incidents we’ve all heard about on the news where, for instance, a naked man is running in traffic babbling about something nonsensical and proceeds to resist arrest with superhuman strength. There are several known causes but in many cases it has to do with illicit drugs like PCP, Cocaine, Bath Salts or Synthetic Marijuana. It can also be caused by damage due to prior heavy drug use. Sudden trauma such as in a car wreck resulting in a head injury can also cause it.

The underlying medical reason is that the person’s body is creating too much dopamine and adrenaline and can’t control it. That leads to dangerously high temperatures in excess of 105 degrees, which explains the lack of clothing. The problem is that the body is under so much stress that respiratory arrest followed by cardiac arrest and death are a near certainty.

They do not need to be transported in a squad car to jail. They need to immediately go to a hospital in an ambulance. But, how do you get “superman” on a stretcher with the least possible danger to innocent bystanders, police, medics and the patient?

That’s what Precinct Five officers, Cypress Creek Paramedics, and Medics from other agencies learned in this Cypress Creek EMS class. It’s training that we’ve taught to hundreds of officers and medics in area departments including Precinct 4. This training is required for CCEMS paramedics and dispatchers which gives them the opportunity to train alongside police officers.


Students learn what Excited Delirium is, what the warning signs are and how to work together to get the patient safely to the hospital. In most cases that is going to require a Taser, followed by multiple officers and medics holding down their arms and legs so that another medic can sedate the patient. Then multiple handcuffs are daisy-chained together secure the person’s arms and the patient is strapped to an EMS backboard which is then turned over and placed on a stretcher for the ride to the hospital.

Here’s a look at the backboard handcuff technique.

The following is an excerpt from an FBI Law Enforcement Bulletin from July 2014 written by three medical experts…. Brian Roach, M.D., Kelsey Echols, M.D., and Aaron Burnett, M.D. The title of the bulletin is, ” Excited Delirium and the Dual Response: Preventing In-Custody Deaths.”

“Excited delirium syndrome (ExDS) is a serious and potentially deadly medical condition involving psychotic behavior, elevated temperature, and an extreme fight-or-flight response by the nervous system. Failure to recognize the symptoms and involve emergency medical services (EMS) to provide appropriate medical treatment may lead to death.” (Note: See entire FBI Bulletin here.)