The correct answers are B. Positional asphyxia and E. Sudden cardiac arrest.

This question refers to patients with severe agitation or delirium, often described in EMS as excited delirium syndrome or severe behavioral emergencies.

Why B is correct (Positional asphyxia):

Agitated patients who are restrained improperly (especially in prone positions) are at high risk of:

Restricted chest wall movement

Impaired ventilation

Hypoxia

NREMT-aligned guidance emphasizes:

“Improper restraint positioning can lead to positional asphyxia.”

This is a major cause of morbidity and death in agitated or restrained patients.

Why E is correct (Sudden cardiac arrest):

Severely agitated or delirious patients are at risk of:

Extreme catecholamine surge

Metabolic acidosis

Cardiac dysrhythmias

These can rapidly lead to sudden cardiac arrest.

NREMT materials highlight:

“Patients with severe agitation are at risk for sudden cardiac arrest.”

“Excited delirium may result in sudden death if not properly managed.”

Why the other options are incorrect:

A. Seizure activity: Not a primary or common morbidity risk directly associated with agitation.

C. Hypovolemic shock: Not typically related to agitation unless trauma or bleeding is present.

D. Hemorrhagic stroke: Not a typical complication of agitation/delirium in EMS context.

Exact Extracts:

“Improper restraint can result in positional asphyxia.”

“Excited delirium is associated with sudden cardiac arrest.”

“Agitated patients require careful monitoring due to risk of sudden death.”