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Preventing Deaths in Police Custody Lessons Learned

Preventing Deaths in Police Custody Lessons Learned. http://vimeo.com/36009007. Excited delerium(5) Drug / alcohol overdose(2) Gastrointestinal disease(1) CNS disease(1) Circulatory(1) External injuries(1) Asphyxiation(1) Poisoning(1) Awaited / no PM(2).

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Preventing Deaths in Police Custody Lessons Learned

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  1. Preventing Deaths in Police CustodyLessons Learned

  2. http://vimeo.com/36009007

  3. Excited delerium(5) • Drug / alcohol overdose(2) • Gastrointestinal disease(1) • CNS disease(1) • Circulatory(1) • External injuries(1) • Asphyxiation(1) • Poisoning(1) • Awaited / no PM(2)

  4. Deaths 1998/99 – 2008/09

  5. Drugs 120 Drugs 120 Alcohol 184 74 61 106 53 46 48 11 10 14 Restraint 87 23 Mental Health 58 Drugs 120 106 44 30 20 Alcohol 184 26 14 Restraint 87 27

  6. Alcohol

  7. Alcohol metabolism

  8. Blood alcohol & behaviour <50 not obvious, driving skills deteriorate 50 – 100 ‘dizzy and delightful’ bravado, slurred speech 100 – 200 ‘drunk and disorderly’ staggering gait, uncooperative 200 – 300 ‘dead drunk’‘mortal’ vomiting, incontinence 300 – 400 coma, impaired respiration, loss of reflexes >400 ‘devil’s disciple’ death

  9. Alcohol ?

  10. DRUGS • Benzodiazepines – dilated pupils, respiratory depression. Withdrawal seizures. • Opiates e.g. Heroin - nausea, vomiting, pinpoint pupils, eyelids closing, respiratory depression, lethargy, drowsiness and difficulty to rouse, and loss of consciousness • Cannabis - anxiety, hallucinations, and loss of consciousness • Cocaine - agitation, dilated pupils, seizures, raised body temperature, fast pulse, and chest pains. Irregular heart beats may occur. • Amphetamines - nausea, vomiting, dilated pupils, fast pulse, sweating and seizures • ‘Legal highs’ BEWARE EXCITED DELERIUM

  11. Excited delerium • Pain tolerance • Raised respiratory rate • Sweating • Agitation • Hyperthermia • Non-compliance • Lack of tiring • Unusual strength • Inappropriate clothing • Attraction to reflection

  12. Restraint • Positional asphyxia • Excited delerium • Post arrest peril

  13. Mental Health

  14. Mental Health (Care and Treatment) (Scotland) Act 2003 Meaning of “place of safety” In this Part of this Act, “place of safety” means— (a) a hospital; (b) premises which are used for the purpose of providing a care home service (as defined in section 2(3) of the Regulation of Care (Scotland) Act 2001 (asp 8)); or (c) any other suitable place (other than a police station) the occupier of which is willing temporarily to receive mentally disordered persons.

  15. Suicide risks • Serious violent or sexual crime against family member • Public interest or public shame • First experience of custody • Anniversaries and key dates • Substance misuse or detox including alcohol • Additional charges

  16. THE FATAL ACCIDENTS AND SUDDEN DEATHS INQUIRY (SCOTLAND) ACT 1976

  17. Case studies • Alan Irvine • Alexander Ogg Wylie • Angela Smith • Angus Malone • Daryl Shearer • Catherine Wingate • Gerard McNally • Kristoffer Batt • Martin Jamieson • Phillip Duffy • Robert Shreenan

  18. Case studies • Alan Irvine • Died GRI 22/08/10 • 0435 H • Naprophyne lignocaine and cocaine intoxication • Non avoidable • No systemic defects

  19. Case study • Alexander Ogg Wylie • Died Ninewells 27/12/09 • Quadrangle Bell St • Atherosclerosis • Minor blunt force injuries • POs & medics did their jobs • Not preventable • No systemic defects

  20. Case study • Angela Smith • Died 22/12/09 • St Leonard’s Police Station • Drugs related arrest • Withdrawal • 1(a) Coronary arrythmia • 1(b) Myocardial fibrosis & emphysema • 1(c) Misuse of cocaine & opiates • Observations insufficient • Care planning • Reviews • Integration of nursing

  21. Case study • Angus Malone • Died 13/08/07 • Dunfermaline Police Station • Hidden package • Strip search • Cell search • Communications failures • Failure to examine

  22. Case study • Daryl Shearer • Died 27/10/08 • Dingwall Police Station • Head & neck trauma • DHC & BDZ intoxication • Refrain from fighting • Refrain from abusing controlled drugs • Rx administration • Communications • Head injury advice

  23. Case study • Gerard McNally • Died 25/05/12 • Raigmore Hospital Inverness • Phosphine toxicity • Not preventable • No systemic defects

  24. Case study • Kristoffer Batt • Died 28/11/07 • Cell 11 Police HQ West Bell St Dundee • Heroin & Diaepam • Full body search • Past substance history • Vulnerability checks • Light/buzzer

  25. Case study • Martin Jamieson • Died 21/05/2008 • Monklands Hospital • Methadone & Olanzapine intoxication • Risk assessment • Communication • Mentoring

  26. Case study • Phillip Duffy • Died 24/10/2010 • Crosshouse Hospital • Head Injury as a result of a fall • Not preventable

  27. Case study • Robert Shreenan • Died 24/10/2010 • Cell 17 Clydebank Police Office • Plastic bag asphyxia

  28. Case study • Catherine Wingate • 9/10/2009 • Mill Street Paisley • Cardiac failure • LVH • Drug intoxication • Hyperthyroidism • Police casualty surgeon not asked to assess

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