Dozens of deaths reveal risks of injecting sedatives into police detainees
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I've been a volunteer EMT for 20 years and in that time I've been punched, cut, choked, and bit on multiple occasions-- and I'm in one of the most affluent counties in the US. People in poorer areas have it 10x worse than I do.
I'm a very tall, very strong, fully grown adult man. Most of the paramedics I work with are very small, not particularly strong, women. Practically everyone I work with is young.
If forced sedation is banned the critical nationwide shortage of EMS personnel will become much worse than it already is.
Have you ever had a 30-year-old man who's lying on the ground bleeding behind a vape shop at 3am try to repeatedly bite you every time you come within biting distance?
It's either: I hold him down and the medic gives him 5mg of midazolam or he's the cop's problem.
The person you're replying to is, assuming they're not lying, a medical professional.
> Do you think that, in an environment where simply not following directions promptly to the full satisfaction of the arresting officer can result in being tased or even shot
Are you suggesting that a person trying to bite folks is on equal legal footing with a college professor tapping an officer on the shoulder? In any case, sedatives are unquestionably less lethal than guns (and probably tasers, where Google suggests hundreds of people die in the US from being tased by the police each year). Putting aside whether the officer's discretion in such a situation is being wielded appropriately, sedation (by the numbers) is essentially never a worse option than what police have at their disposal already, no?
Medical professional, sure... But not a doctor. Not a nurse. And often facing immense pressure from LEO (even nurses get pressured).
Are you suggesting that a person trying to bite folks is on equal legal footing with a college professor tapping an officer on the shoulder?
You missed the whole point.
The local EMS Medical Director. https://www.ncbi.nlm.nih.gov/books/NBK526093/
It is impossible to consult with the medical director, or even medical control, on all cases so you rely on protocols and standing orders to perform your duty.
All jurisdictions have standards for sedation.
If any clinician feels pressured by the police to do something contrary to the standard they should call their ems supervisor— they’re paid to be mean to cops and charge nurses.
People have thought of all of this already.
I expect systems to be as perfect as I am, so “im-“.
Nationwide shortage gets worse because people can't kill other people without consequence? Fine. At least I won't be worked on by people that have no concern[s] about killing someone - just because they're scared.
To whit: What is the point in being an EMT/EMS, if you do not care if you're killing people, as is demonstrated by the article? It seems entirely antithetical to the entire point of your role/job, does it not?
Your policy would result in more deaths.
Did you RTFA? Are EMTs/EMSs - entirely - incapable of telling police to not put their body weight on the backs of "certain people" (to use your vernacular), which clearly contributes to the issue of them dying -- negating the levels of the drug being another contributing factor?
There is shared culpability in these scenarios but, sure, no one could handle these people for hundreds of years before sedation was used, so they killed them all, right? That's your and the OP's rationale, from what you're saying.
> Your policy would result in more deaths.
My policy? More deaths? Give me the numbers/statistics on how this policy has saved _more_ lives. I'll wait...
I think it's telling of how pernicious the racial propaganda is, that you changed my "of any race" to "minorities".
(We do have a lot of immigration, but I don't see the relevance.)
Ballpark, but under Australia's 264 per 100,000, more than England and Wales at 227 per 100,000 and less than Scotland at 318 per 100,000.
The numbers are quite variable between different countries. I presume partly because the definition or role varies?
The UK and Australia have similiar policing roles and behaviours, quite different to the US - more uniform within the countries, significantly less use of guns and force, etc.
Damn near half the population of Australia has used illicit drugs at one point or another:
According to the 2022–2023 National Drug Strategy Household Survey (NDSHS), an estimated 10.2 million (47%) people aged 14 and over in Australia had illicitly used a drug at some point in their lifetime (including the non-medical use of pharmaceuticals), and an estimated 3.9 million (18%) had used an illicit drug in the previous 12 months. This was similar to proportions in 2019 (43% and 16%, respectively) but has increased since 2007 (38% and 13%, respectively) (Figure 1).
What Australia does have is proactive health policies, prison terms with rehab, a decent chance of drug use not marking a person for life, etc.
That's unacceptably dangerous without knowing what drugs the bleeding person is on. Even alcohol makes the risks of giving midazolam increase significantly.
It's either that or he bleeds to death.
The only contraindications for midazolam in my protocols are:
(1) Hypotension (See below for ET bucking) (2) Known hypersensitivity to midazolam
In the case of Elijah McClain they gave him a 500 mg dosage when the maximum dosage was 350mg. He stopped breathing shortly thereafter
Is there not some way to start with a dosage that would be safe for a smaller person and to give additional drugs if needed. Is there a way to give a drug that doesn't cause death (THC maybe)?
I understand the need to calm people down, but giving them a drug that where 1/10th of a gram of error is the difference between life and death seems reckless.
Simply put, if your intervention ends in death when death wasn't a possible outcome before, I would much rather that you and the cop just drive away and leave this to professionals who are able to handle this without accidentally killing people.
Presumably there is somewhere on earth where this is a solved problem, what are they doing?
Perhaps you are.
In fact I do volunteer to be in similar situations for different reasons, and part of that decision is the acknowledgement that as the only guaranteed willing participant, it is my responsibility to bear the risk of the encounter.
I don't get where cops and, apparently, some EMTs find the mentality of "I choose to be here, so I may harm you to ensure my safety." Simply choose not to be there! Do something else with your evenings my man.
> Gowens rushed to the hospital 500 miles away, where she was told he’d been injected with ketamine. She searched online and was stunned to read it’s used to tranquilize horses.
Medicines are used on both humans and animals all the time. Verbiage like this does nothing but spread fear, uncertainty and doubt about a medication, when used in a controlled, safe manner is absolutely helpful for humans. The fact that it’s also used as a horse tranquilizer is completely irrelevant and is really just lazy reporting intended to incite fear.
Note that I am not saying I agree with the medication’s use at all here. But the fact that it’s also used on animals for some purpose is completely irrelevant.
We've had to warn you about breaking the site guidelines before. If you keep this up we're going to have to ban you, so it would be good if you'd review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here.
sometimes pointing out people are being dumb is completely valid - if you buy horse dewormer from a vet to treat yourself ineffectively you kind of have it coming
That doesn't make mockery the right approach either. But let's not kid ourselves that they were one friendly ear away from listening to the overwhelming majority of scientists. This is just one piece of a decades long conflict.
People were getting and/or stealing ivermectin dosed for horses, and using it on themselves
> Ho was a leading researcher on Taser safety and an expert witness for the company in wrongful death lawsuits. In a 2007 deposition in one such case, he argued for a potentially “life-saving tactic” of having sedative injections quickly follow Taser shocks, saying the combination could shorten struggles that, if prolonged, might end in death.
> Some doctors at his public hospital in Minneapolis were using “something called ketamine, which is an analog to LSD,” he said. “It’s sort of an animal tranquilizer.”
> The drug became more common outside the hospital in 2008 when Hennepin County paramedics were given permission to use it.
> An American College of Emergency Physicians panel that included Ho said in 2009 that ketamine had shown “excellent results and safety” while acknowledging no research proved it would save lives.
These people come off as a bunch of clowns, holy cow.
Ketamine is an LSD analog much in the same way that caffeine is an analog of C4 explosive
Perhaps there are legitimate uses of appropriate doses where there is immediate risk of harm, but reckless and unregulated use of using serious medications like ketamine to control people violates informed consent and the spirit of the hippocratic oath.
It is true ketamine doesn't affect breathing as badly as those drugs, and has fewer interactions, and is sometimes used in medical emergencies for sedation when the airway is a concern. That seems to have been what gave people the idea it could be used in paramedic settings, but less is not the same as no risk.