16.135 - Excited Delirium

Effective Date:05/07/2019


This policy applies to the Department’s response to subjects who appear to be suffering from excited delirium. Excited delirium is defined as “A state of extreme mental and physiological excitement, characterized by extreme agitation, hyperthermia, hostility, exceptional strength and endurance without apparent fatigue” (Morrison and Sadler, 2001).  

1. A Sergeant and at Least Two Officers Shall Respond to Each Call That Appears to Involve a Subject With Excited Delirium

2. When Feasible, Responding Units Request Seattle Fire Department Response to Standby at a Safe Distance Until the Subject is Under Control

Research has shown that stress reduction, body positioning and immediate medical treatment increases the survivability of excited delirium and therefore decrease the potential for in-custody death.

3. Officers Shall Address the Medical Crisis Immediately After the Subject is Under Control and the Scene is Secure

4. When Feasible, Officers Will Place or Hold the Subject in the Recovery Position While Waiting for Medical Response

If the recovery position is not feasible, every attempt will be made to monitor the consciousness and breathing of the subject until medical personnel arrive.

5. Officers Shall Complete a Report Documenting the Incident

The report will include signs and symptoms observed, particularly the subject's:

-      Altered Level of Consciousness

Paranoia, hallucinations, delusions

Extreme agitation, disorientation

Shouting or keening (animal noises), unintelligible speech


“Bug eyes” – eyes wide open

Insensitivity to pain

Bizarre and/or aggressive behavior

-      Hyperthermia (overheating)

Sweating, hot to the touch

Seeking water

Inappropriate attire or no clothing

-      Danger to Self or Others

Violence towards others

Unexpected physical strength and stamina

Self harm

-      Violence or attraction to glass, reflection or lights

Including Emergency Vehicle Lights

-      Actual body temperature reading (to document hyperthermia, which is a significant indicator of excited delirium), if available

-      Any other vital information (pulse rate, blood oxygen level, blood temperature, etc.), if available

-      Elements of the criminal offense, if applicable

-      Witness information, if applicable