Cities and towns across the United States have paid out hundreds of millions of dollars in connection with deaths of individuals associated with restraint and sedation. While most of these deaths have involved law enforcement, an increasing number involve EMS providers. Historically, EMS providers received limited training on the management of agitated patients and the risks of restraint and sedation. A restructured program, emphasizing de-escalation, limited use of prone restraint and a more rigorous approach to sedation, has the potential to dramatically reduce risk and financial exposure.
The essential reading list for developing a better understanding of the issues related to death in custody, management of the agitated patient, behavioral emergencies, de-escalation, restraint, sedation and excited delirium.
De-escalation, which seeks to help the person calm themselves, should be thought of as the primary strategy.
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