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与泰瑟枪暴露相关的急性激越性谵妄状态。

Acute agitated delirious state associated with Taser exposure.

机构信息

Internal Medicine Department, Alameda County Medical Center, 1411 E 31st St, Oakland, CA 94602, USA.

出版信息

J Natl Med Assoc. 2010 Dec;102(12):1254-7. doi: 10.1016/s0027-9684(15)30755-0.

Abstract

BACKGROUND

The use of the Taser (Taser International, Scottsdale, Arizona) as a form of nonlethal force is increasingly common because of its safety profile. Tasers have been associated with in-custody mortality particularly in agitated individuals, though potential explanatory mechanisms are poorly understood. While Tasers are often used to subdue acutely agitated individuals, no study has reported Taser 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 Taser 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.

摘要

背景

由于其安全性,泰瑟枪(Taser International,亚利桑那州斯科茨代尔)作为一种非致命性武力形式的使用越来越普遍。泰瑟枪与羁押期间的死亡率有关,尤其是在激动的个体中,尽管潜在的解释机制还不太清楚。虽然泰瑟枪通常用于制服急性激动的个体,但没有研究报告泰瑟枪暴露会引发激动或谵妄,尽管高压电暴露已被独立记录会引发急性谵妄。

目的

我们报告了一例在休息时非激动状态下接受泰瑟枪电击后出现急性激动或谵妄状态的病例。

病例报告

患者为 37 岁非裔美国男性,无既往精神病史,在逮捕过程中多次被泰瑟枪电击。他在急诊科变得神志不清和激动,需要镇静和插管,随后持续 3 天出现难治性谵妄。毒理学筛查显示美沙酮的治疗剂量和痕量大麻,据认为与患者急性激动或谵妄状态的发作无关。影像学、神经科和精神科评估同样没有帮助。

结论

这名没有既往精神病史或大量物质使用史的患者出现急性激动和谵妄,提示与泰瑟枪暴露有关。本病例报告被认为是首例报告,表明泰瑟枪暴露与急性或谵妄状态之间存在时间关联。需要进一步研究来探讨泰瑟枪暴露与急性激动之间的关联。

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