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They were certainly negligent in not properly assessing McClain (who was already restrained) prior to ketamine admin. Once ketamine was given, they then also failed to monitor and recognize cardiac arrest.
This case will likely lead to change in paramedic emergency care protocols.
I sort of feel sorry for the paramedics in the sense that they were too complacent and should have told the cops "no" when they tried to dictate patient care (as in, 'you need to sedate this dangerous person'). I work in healthcare too, so I'm familiar with cops trying to dictate medical care and the importance of advocating for your pt when that happens. It can be intimidating to tell a cop to fuck off, but sometimes you have to do it. If nothing else, it's your ass on the line.
I understand you work in health but I work as a paramedic and have a few thoughts. First, it is very common for us to go into a scene with law enforcement and sedate someone if we believe it to be appropriate. Excessive fighting with law enforcement and being tased repeatedly tends to be followed by death. So, it is much easier and safer for everyone to sedate someone.
What protocols do you think will change? Should we just let people die fighting with law enforcement? I have mixed thoughts on the details here if we as paramedics can be prosecuted if someone has a negative reaction to a medication, however, I don’t think that is the case here. It says they gave an extra 150-200mg of ketamine, not sure why, not sure what their protocols are but if their dose is something like 5mg/kg IM like protocols I’ve worked under then maybe they thought it was an appropriate dose because we are bad at estimating weight. Regardless, it is industry standard to monitor capnography when sedating a patient. If they didn’t because of complacency, that might be on them if there isn’t any extenuating circumstance but I can’t think of any that would reasonably justify not monitoring capnography.
Maybe try sedating the cops? They'll be less aggressive and less likely to escalate.
E: spelling
I do think that may have helped in this situation. In a more broad sense my point is I would be disappointed if a paramedic didn’t do something to stop someone from dying. We don’t have to agree on the administration of sedatives but I’d rather me or my family be sedated and transported to the hospital instead of situations continuing to escalate while fighting with law enforcement that may lead to someone being killed.
To be clear, I don’t know the full details of this specific case, as I said in my original comment, there isn’t a reason I can think of for the medics not monitoring capnography, that’s industry standard as it will show in real time when someone stops breathing and allow us to take over. If the paramedics did not monitor capnography and the patient died then that is most likely negligence that resulted in someone’s death which is unacceptable. However if they did everything appropriately and recognized the change in condition and addressed it and the patient still died then then it’s hard to fault them, apart from giving the incorrect dose of ketamine, tho just giving an extra 200mg of ketamine will not cause someone to die but it can cause unwanted side effect that if unrecognized or untreated could lead to someone’s death.
This situation isn't really about the paramedics or if sedation is a good practice. The cops never should have touched the victim. There was literally nothing going on; he was walking down the street minding his own business and the cops attacked him and caused all of this. The Aurora PD are a bunch of drunken thugs (I live where this happened). Some of the Aurora PD members took a selfie mocking the murder at the site of the murder. They get busted for being drunk at work with shocking regularity, and there are rarely any consequences. Here's one of their more stellar members: https://kdvr.com/news/local/aurora-officer-found-drunk-passed-out-in-patrol-car-3-years-ago-gets-promoted/
I am agreeing with you. I don’t have much else to say on that topic because we agree. My job forces me work around law enforcement but I sure as hell don’t enjoy it and separating the subject from work I have zero trust for or desire to be around them.
However the title of this post is “Paramedics Found Guilty in Last Trial in Elijah McClain Death”. So my comments more go to the topic of the paramedics because I am a paramedic and I’ve been in these situations, law enforcement does shitty things and I have to make decisions based on what they tell me and what I see, they might be lying to me but I have to document what they told me, not if I believe them or not. In that context I’m going to elect to sedate and take the person into my care and out of custody of law enforcement as soon as possible because I don’t want anyone to be harmed by law enforcement (well I don’t want anyone harmed at all but this is in context of law enforcement). But law enforcement escalating a situation is something I have no control over, it would be a hell of a lot easier to give them some benzos to chill the fuck out than it is for me to sedate someone and have to potentially takeover their airway if they have any sort of reaction to the sedation.
The fact that the circumstances allow you to make an immoral choice doesn't privilege you to actually make it even if you think the outcome will be better. You have no right to medicate someone against their will. It should be an incredibly high bar to override the patients own wishes. You yourself are an incredibly immoral person by any conception of medical ethics or morality. The ends don't justify the means. I'm sorry you can't see that.
I’m not here do debate the details that go into complex situations as they need to be taken on a case by case basis. I apologize that you interpret this as immoral and I assure you the bar to go against a patient’s wishes is very high. Please take into consideration the fact that in emergency situations people are not always able to provide consent and that I am forced to work under what’s called “implied consent” meaning that if someone needing help is unable to provide consent I am to act as if they would consent to help if they could.
Which means I am not only authorized to medicate someone without consent but in situations where safety comes into question I am expected to. If you don’t like this then I encourage you to get involved with your local agencies and look into your area’s laws and advocate for the changes you want to see. But your comment sounds like someone screaming “I don’t consent” while being arrested, except that’s not what’s going on here. I am required to listen and follow someone’s wishes if they are able to provide informed consent and I am required to act as if they would consent if they cannot. It’s written in every textbook I’ve ever read, it’s written in my state’s laws, and it’s written in my department’s policies.
I can only assume you’ve never dealt with complex medical emergencies if you think everything that happens in an ambulance or helicopter is the same as going into a hospital for an elective or routine surgery they requires a dozen signatures to consent and multiple doctors explaining risks and complications of the procedure being performed. If you’d like to learn more I would encourage you to see if your local fire department or ambulance service would allow you to do a ride a long.
If you think someone being attacked and abused by the cops has given you implied consent you have never understood your own oath in the first place.
This will be my last reply to you as this is not a productive conversation and you are jumping to conclusions assuming we “take an oath” and refusing to acknowledge that we work on limited information while being forced to make decisions. Dislike it all you want, but by not acknowledging that this is how it works and not taking steps to change that you don’t like means you’re also allowing it to happen. If you’d like to be an adult and have an intelligent discussion instead of using fallacious attacks then by all means I am happy to discuss further.
They administered too much sedation and failed to bother to make sure he didn't die of it by monitoring him thereafter. They are not just negligent, they are outrageously negligent. It's easy to fault them which is why they were found guilty. I'm not sure why you find it hard.
If that is what happened, yes I agree that they are wrong and grossly negligent. What I find hard to believe is there is a department that would allow Ketamine to be given without monitoring capnography. Capnography would have alerted them that he stopped breathing within 15-30 seconds. The only details that are provided are too much medication was given and he died. Not monitoring capno would have made this an open and shut case.
The other reason I don’t jump on it’s their fault is because we follow something called “just culture” which says when an error is made we have to look at the totality of the circumstances and we console human error, coach reckless behavior and punish negligence. I wasn’t involved in any case reviews and I wasn’t on the jury. I don’t know the full circumstances so I’m going to remain impartial and let the jury’s verdict speak for itself.
I don't think we're being asked to believe that, as if that was the case the people in charge of policy would have been negligent, not the paramedics.