Police actions involving naked people can lead to sudden deaths

Reports documenting citizens killed after police contact often include cases of individuals being restrained, but for anyone suffering from Acute Behavioural Disturbance (ABD), this approach can prove fatal.

Former Kent Police Sergeant Darren Moor describes in Policinginsight the key indicators of ABD and the steps that officers can take to ensure that medical support is available to the individual and what to do if police restraint is unavoidable.

Approximately 10% of cases of ABD, also known as ‘excited delirium’, result in sudden death, and the officer involved in this situation is likely to spend the next few years of their life reviewing their actions with the coroner in response to this tragedy.

ABD usually develops from chronic drug use or severe mental illness. The police officer may be sent to an incident of someone acting strangely. It could be described as an aggressive or violent individual, perhaps showing extreme agitation and physical exertion or, at the other end of the scale, simply being erratic.

Being naked, along with being warm to the touch and profuse sweating, are classic signs of ABD. Other indicators, according to the School of Emergency Medicine, would include:

  • Extremely aggressive or violent behaviour.
  • Excessive force and continuing to fight despite restraint.
  • Insensitivity to pain.
  • Acute psychosis, with fear of imminent death.
  • Constant physical activity, with no sign of fatigue.
  • Abnormally rapid breathing.
  • Heart rate greater than 100 beats per minute.
  • Hyperthermia – overheating (this is why they take off their clothes).

With ABD, the person’s heart rate is much faster than it should be, so much so that they are at risk of death if not treated as a medical emergency, and this is the main message the author of this study wants to convey.

As soon as an officer is suspected of being sent to an ABD incident, and this suspicion may arise simply from sensing that someone is naked and erratic, it should be declared via radio as such and explained to the operator that this is a medical emergency, where it is possible that the doctor may need to give tranquillisers before they could go into cardiac arrest, so an ambulance may also be needed to assist with informed care on what to expect.

The aim of the responding officers during this stage is to buy time until medical assistance arrives. The aim is to orchestrate it so that there is no practical police intervention until there is someone with the right skills and who is available to deal with the medical aspect, should it all go wrong. And there is a good chance it could all go wrong.

In the author’s experience, some ambulance professionals and operators are unfamiliar with ABD. They may feel that what the police are asking them to attend to is a much smaller incident than it really is.

The police control room operator may also be unfamiliar with the problem, and this is where one of those communication gap scenarios develops that can lead to tragedy.


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