Acetaminophen (Tylenol, Paracetamol, APAP) is a commonly used analgesic and antipyretic agent found in many over the counter and prescription medications. It is one of the most common toxic exposures responsible for an estimated 450 deaths annually in the United States, and it is the most common cause of acute liver failure in the United States.
Excited delirium syndrome is a pathophysiologic progression that Emergency Medicine physicians are exposed to daily. While the initial management often takes place in the pre-hospital setting, these patients are at high risk of respiratory and cardiac arrest if proper management is not continued after hitting our doors. Despite a growing awareness of excited delirium syndrome and it's associated increased risk of death, the majority of the 250 annual deaths from this entity occur while in police custody.