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Ketamine that's injected during arrests draws new scrutiny

abcnews.go.com

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Re: Ketamine that's injected during arrests draws new scrutiny

#131

Post by guscost »

vmception wrote: post #65
nottorp wrote: post #60

This is happening in China right?

[flagged]

If you care about hearing a serious response, I think most Americans would agree that this protocol is on the wrong side of the line, but at the same time not thoroughly murderous in intent. It sounds like an extreme tactic that should be re-thought, and it is perfectly legal and normal for me to share this opinion or organize votes for change.

In China there are “execution vans” with no other purpose even suggested: https://en.m.wikipedia.org/wiki/Execution_van

Re: Ketamine that's injected during arrests draws new scrutiny

#132

Post by GhostVII »

Pretty much everywhere in the world, paramedics are allowed to inject sedatives when treating a patient. Ketamine is used in many places (the US, UK, Canada, Australia, Austria) by paramedics, because it is very safe relative to other sedatives. So the main concern should whether or not police are ordering EMS to administer it when it is not actually required (police do not administer it themselves), since I don't think administering it after an arrest should be an issue if it is actually required.

The article doesn't really give much evidence that this actually happens very frequently. The main piece of evidence is this:

In Minneapolis, a report conducted by the Office of Police Conduct Review found eight of those cases between 2016 and 2018, ranging from officers requesting paramedics use the drug to emergency medical workers asking officers for their opinions on sedating someone.

8 cases across three years in one city, where some of those cases were just paramedics asking for a second opinion, does not seem to indicate a very widespread issue across the US, especially when the city being investigated is know to have a bad police department.

Re: Ketamine that's injected during arrests draws new scrutiny

#133

Post by jbnorth »

refurb wrote: post #4

I'm confused. The police aren't administering the drug, EMS is. Can't you just solve this by telling EMS not to administer it unless they feel it's needed?

They don't administer it unless it meets all criteria in their protocols. Something like administering Ketamine would be under a standing order meaning that the paramedics would not need to consult with medical control prior to administration. There would need to be a post-call consultation with medical control to document it and explain why it was given in addition to everything being documented in the patient care report given to hospital staff at the time of transfer of patient care.

Re: Ketamine that's injected during arrests draws new scrutiny

#134

Post by mauvehaus »

JshWright wrote: post #122
chrisseaton wrote: post #87

Earlier quoted context omitted.

How do you estimate the weight of a person? I know how much I weigh, but I don't know how much anyone else weighs. I guess some other people don't even weigh themselves so don't even know how much they weigh. How do you estimate it?

> How do you estimate the weight of a person? Practice. In theory if you're doing this a lot, you should be able do a decent job of estimating +/- 10%, which is more than accurate enough. There are certainly other complications (some medications are dosed on "ideal body weight" (ignoring subcutaneous fat), etc...)

I'll second this. Climbers tend to get at least half-way decent estimating the weight of other climbers because it's pretty relevant if you're lead belaying somebody.

In fairness, we're usually estimating the weight of people of fairly fit builds, but with some practice estimating people of other builds, I agree that you'd get within 10%.

Re: Ketamine that's injected during arrests draws new scrutiny

#135

Post by vmception »

GhostVII wrote: post #117
rvnx wrote: post #112

Sounds like the worst idea ever. Hope these practices will stay in the US only.

Also happens in Canada ( https://communityedition.ca/paramedics-in-wr-will-soon-admin... ), they administer it for pretty much the same reason as in the US. And Australia.

Seems more like these are narcostates with excess inventory.

Imagine landing that government contract. Imagine approving that government contract. Think about who these people are. Use your noggin.

Re: Ketamine that's injected during arrests draws new scrutiny

#137

Post by rscho »

wittyreference wrote: post #130
rscho wrote: post #93

Earlier quoted context omitted.

> 315 milligrams is still.. a lot. Especially injected into the bloodstream (I presume?) Iv dose for induction of general anesthesia is ~3-5 mg/kg. Or ~5 mg/kg intramuscularly. The main thing with ketamine is that it causes tachycardia/arrhythmias and increases blood pressure. While that can be desirable for people in shock, it is a big problem if the person is already under proarrhythmic drugs (e.g. cocaine). In Eur…

I’m pretty sure the lit goes up to 8 mg/kg for IM. In the case of a 100lb pt, that’s what, 50kg? So they give the pt 6 mg per kg. It’s not out of the range of sanity, all else equal. Key point though: you wouldn’t give the pt 8 mg/kg in a fucking bolus. Time to onset for sedative effect is fast (10min or so); time to peripheral adverse effects can easily take an hour. You’d start way lower than 8, and work your way u…

> So they give the pt 6 mg per kg. It’s not out of the range of sanity, all else equal.

Well yeah, but as I understand it the goal is not to intubate in this case, right? So in my opinion, 6 is already way too much.

In fact, I don't think we can agree on a safe standard dose in this case. Which suggests that it's not the right choice of drug for that use case...

Re: Ketamine that's injected during arrests draws new scrutiny

#138

Post by [deleted] »

axaxs wrote: post #12
FireBeyond wrote: post #9

Earlier quoted context omitted.

Because when the feedback loops on his 140lb musculature are blocked and he will keep going to the point of permanent damage... and when his ability to feel pain is decreased... and there's a very real concern for hyperthermia, rhabdomyolysis with an extended struggle, dysrhythmia, then maybe ketamine becomes the better option. That being said, ketamine should be an EMS decision to minimize risk to patient and others…

So cops are doctors now? Or EMS even? Neither have any real medical training, at all. No offense meant, EMS grind for little money, but they're not medical doctors. Narcan I was already uneasy about, but it saved real lives in obvious situations. This is absolute lunacy.

[deleted]

Re: Ketamine that's injected during arrests draws new scrutiny

#139

Post by jbnorth »

axaxs wrote: post #28
tomcam wrote: post #20

Earlier quoted context omitted.

Do you have any idea how many medical procedures cops are trained on? It’s a lot. They aren’t doctors but they are required to assist medically and stabilize until EMT arrives.

Specifically no, but I do know they are trained. That said, training is just that. If you see X, do Y. And sure, net, it's a positive thing. But again, they aren't medical doctors. It's not always IF THEN. Oftentimes it's IF AND NOT THEN. Either way, I don't want to go down a rabbit hole of arguing life saving procedures. My entire point is that we should not be injecting people with non emergency drugs like Ketamine…

Actually, we should be giving patients. Ketamine is an extremely safe drug for paramedics to give for the safety of the patient and those around them. Especially in cases of excited delerium where the person may actually die because of it. In these cases ketamine is absolutely an emergency drug.

Re: Ketamine that's injected during arrests draws new scrutiny

#140

Post by JohnBooty »

GhostVII wrote: post #107
mateus1 wrote: post #69

Earlier quoted context omitted.

Policemen without any medical training are injecting and murdering people with drugs. This is a disturbing (and new) phenomenon. At least for someone outside the US.

That is false, police are not injecting people with Ketamine. As the article says, paramedics are.

This is technically true and misses the point. Police are ordering paramedics to inject it.

(edit: to be clear, I am saying that yes, ordering somebody else to do it is morally equivalent to doing it yourself... if it's wrong to do it yourself, it's just as wrong to order somebody else to do it)

Pointing out that the police aren't injecting it themselves is like pointing out that [insert name of murderous dictator here] didn't actually kill anybody with their own hands.

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