Excited delirium syndrome (ExDS): Situational factors and risks to officer safety in non-fatal use of force encounters

Our study provides important information to guide the development of policy and procedure in law enforcement. Police encounter a subject with ExDS 1 in every 58 UoF incidents (1.7%). Those individuals are at higher odds of being intoxicated with drugs according to officers' assessments and at risk of being further exerted during a struggle on the ground, both of which appear to play a major role in deaths associated to ExDS. There is a demonstrable increase in risk to officers and public safety from the violent behaviour displayed by subjects presenting a greater number of features of ExDS. Our data suggests that up to 6.3% of subjects in a state of ExDS could succumb to ARDs; however, we cannot comment on the prevalence of death for persons with ExDS who do not encounter police. Further research is needed to determine which force options optimize outcome for police and subjects. Additionally, research surrounding pathophysiology leading to death should focus on subjects with six or more features of ExDS. Ultimately, a better understanding in this area will contribute to improving the outcomes of these encounters for those suffering from ExDS and those tasked with assisting them.