Acute Agitated Delirious State Associated With laser Exposure

作者：Feeney Colin^*; Vu Julie; Ani Chizobam

来源：Journal of the National Medical Association, 2010, 102(12): 1254-1257.

• injury
• psychiatry

Background: The use of the laser (laser International, Scottsdale, Arizona) as a form of nonlethal force is increasingly common because of its safety profile. lasers have been associated with in-custody mortality particularly in agitated individuals, though potential explanatory mechanisms are poorly understood. While lasers are often used to subdue acutely agitated individuals, no study has reported laser exposure precipitating agitation or delirium, even though high-voltage electrical exposure is well documented independently to precipitate acute delirium.
Objectives: We present a case of an acute agitated or delirious state occurring post-Taser exposure in a resting, otherwise nonagitated individual.
Case Report: The patient was a 37-year-old African American male with no prior psychiatric history, tasered multiple times during an arrest episode. He became delirious and agitated while in the emergency department, requiring sedation and intubation, followed by 3 days of continued refractory delirium. Toxicology screening demonstrated therapeutic doses of methadone and trace amounts of marijuana, not thought to be associated with the acute onset of the patient's agitated or delirious state. Imaging, neurological, and psychiatric assessments were similarly not contributory.
Conclusion: The occurrence of acute agitation and delirium in this patient without any prior psychiatric history or significant substance use suggests an association with laser exposure. This case report is thought to be the first report demonstrating a temporal association between Taser exposure and an acute or delirious state. Further studies to explore the association between Taser exposure and acute agitation are needed.

• 出版日期2010-12