Handling Excited Delirium and Dangerous Patients

Michael J. Magiera talks details a response idea for crisis intervention as a combined effort between police, fire and EMS agencies.


I’ve given the optimal way to handle a critical incident response through the eyes of law enforcement. We know that rarely do things work out the way they should, such as ambulance stages, but the engine company goes straight to the call. Maybe it is two officers rolling up alone on someone with Excited Delirium.

We all know Murphy’s Law, so if you and your partner and possibly even an engine company arrive on an Excited Delirium patient, don’t be a victim, be a good witness. If the patient runs off, let the officers know which way the patient went when they arrive. Most Excited Delirium patients don’t feel pain, so it doesn’t matter if you are an MMA fighter...that 105-pound, 5-foot nothing will wear you out. If you are backed into a corner, speak softly and look for an escape route. As a last resort, do what you have to do to defend yourself if you are cornered with no other options. You may run on these calls and follow my advice and it will seem like a big production over what turns out to be nothing. All I can say is how many structure fire calls turn out to be working fires?

Be safe, your family needs you to come home every day in as good or better condition than you left the house.

MICHAEL J. MAGIERA is a police lieutenant and a volunteer firefighter in Texas.