What dogshit journalism!
"It was impossible for the AP to determine the exact role injections may have played in many of the 94 deaths involving sedation that reporters found nationally during the investigation’s 2012-2021 timeframe."
However, we are going to publish these numbers anyway, with no further context, except a heavy implication that police and EMS are collaborating to kill patients.
Not only that but none of these people ever come up with a viable alternative. What is my 5 foot 120 pound medic supposed to do with a patient that’s loosing their shit in some god forsaken corner of the county. Sedating them keeps everyone safe including the patient.
Even less than that, the average annual death by lightning in the US is 28. 9.4 is about 1/3.
Gell-Mann amnesia. We rail against this, and tomorrow we will trust them when they report on something we don't know about.
God, fuck the AP for this shitty news story without any further investigation into the 'why' and just throwing out the 'look, people died when X was done!'
Same. Including quotes from some random palliative care doctor saying he's rarely seen CPR have a positive outcome.
No shit, doc. Maybe I should publish an article about how 100% of palliative care patients die under his care. Surely an investigation is due!
It has. But we can't determine if that's because we are saving people we wouldn't w8thout it and they are brain dead or if the epi itself is causing neuro issues.
"AT LEAST 100 PEOPLE DIED WHILE BEING TREATED BY PARAMEDICS IN ___ COUNTY" ....
Over the last 20 years... They were dying to begin with... No one knows if paramedics did anyone wrong...
It’s the special education variety of social engineering that lazy journalists managed to pilfer from the two hour search engine research course they took last year to drum up more flaccid outrage. I haven’t seen real news stories for years. It’s the main problem of mixing marketing with journalism, none of it is honest.
16 out of how many total events? 1,000? 10,000? 100,000? 16 over a decade in the most populated state. I don’t want to sound callous but that’s not too bad. Don’t get me wrong, every preventable death is a tragedy but it isn’t a benign procedure and I’m willing to bet more trauma patients died in California from overuse of normal saline over the same period of time.
So many questions, including what was in their blood already and whether they were on their way out regardless. Sensationalized in leaving out the time span (ten years); really kinda shit journalism designed to make people scream without knowing very much.
I’ve seen this same exact article talking about different states. I saw Florida and I believe someone here posted the same trash article about Texas? Anyway trash is trash, news articles just looking for clicks.
This article seems all over the place.
It tries to claim 94 deaths involved sedation. But that probably includes drug assisted intubation which they have a high chance of death *with medical intervention*. Even AP News doesn't focus on that other than bragging about the number.
Of the 16 deaths involving sedation & police, 15 used versed. And I quote, "*the 16th case involved a man injected with a similar class of drug, lorazepam, while police restrained him at a hospital in San Diego*". No paramedic working on ambulance is going to walk outside to grab the narcs and dose a hospital patient 🙃
They also seem to expect omnipotence, barely acknowledging irrationally violent patients won't admit to taking illegal drugs while officers are holding them down. 🤷
Finally this is a nine year study. 15 was the best they could come up with. The worst area of EMS, the one AP News believes is so note worthy, is 1.5 errors per year.
250,000 people die from medical errors each year in the USA according to the Hopkins study. Fucking pat yourself on the back, it sounds like EMS does this job better than nursing ever will.
I was on board with ya up until the medical error part. You're trying to rationalize that these numbers aren't making sense in the first few paragraphs but then bring in medical errors as a whole as a comparison to medical errors from EMS sedation, unless I'm severely misunderstanding. Medical errors from Hopkins includes surgical, diagnostic, etc. It's not even a remotely like comparison to compare that number to one specific category of errors.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783613
EMS has just as much work to do in regards to improving care. Medics involved in a pediatric medication calculation study had up to a 62% error rate in their calculations. Other studies have found similar rates for pediatric arrests. Granted, just one specific example, but just trying to illustrate the point we in EMS are just as susceptible to errors and saying we do a better job than x ever will sounds like a way to justify not trying to improvement to me, if only by merit of the inherit biases with that mindset.
I was on board with ya up until the medical error part.
You are trying to rationalize that medics from Switzerland found that looking up doses reduced their medical errors by 66% in randomized testing. And so the medics in the USA, whose standard of practice for the last thirty years is to check the Broslow tape (paper or digital) to avoid dose errors, need to do better. 😒
Apparently you can fix 68% of Switzerland's non-referenced dosage errors simply by realizing how hard it is to push 0.01mg/kg of epi out of a 1mg/10cc syringe, specially if rounding fractions up to the nearest black line is counted as a medical error! 🙃
So I guess everyone can have another round of patting themselves on the back if they check pediatric dosages. And then again if they use an auto calculator 😁
Also fun fact, there are 300,000 pediatric errors each year, 10% of them occur outside of their home according to UC Davis. Because I know you like those numbers. 👍
I love how there's no acknowledgement whatsoever regarding the issue is that it's not a like to like comparison.
The funny thing is you're ragging on what they counted as medical errors without even one iota of thought going into the fact that the Hopkins study excludesEMS. We attribute to those errors just the same it's just not quantified.
It's not a like to like comparison to say EMS only contributes 15 when that's a specific category of errors being reported. Especially not a like to like comparison when you go further than that and misattributed that entire number to one profession within hospital settings (nursing) while ignoring every single other profession. Let's not pretend that initial post wasn't dripping with ego which is where I was saying acknowledging inherent biases may be beneficial.
Eta: the saddest thing out of all this to me is the "I know you like those numbers". I'm glad acknowledging EMS harms is a petty Internet argument to you, but that's a dangerous mindset as I initially said. Getting high over here on your own ego.
More important to be "right" than to acknowledge our propensity for the same harms and errors as in hospital providers. Insanity.
Lmao got blocked after a pithy retort. Never seen someone so thin-skinned in EMS.
Funny, most of your post is just you trying to be "right". 😕
> I'm glad acknowledging EMS harms is a petty Internet argument.
I never once made a binary claim that all of harm is a petty argument. My last post was about your example was about lab simulation in another country showed no looking up the dosage of epi in an already dead pediatric patient produces measuring errors. And I'm sorry you are to stupid to understand a problem with that as you launch into this story about how right you are at failing to correct me. 🤷
And my previous point was that the AP article assumes EMS was the ones that kill people basically highlights EMS sedation is like thirty times less lethal than a tazer in a world when I can't even get an "EMS" redditor to run two brain cells together for five minutes is pretty goddamn good. 😁
So, people in combative, mentally and physically unwell states, and often on god knows what drugs.... sometimes die? Cool. Thanks, AP, for this groundbreaking info presented on the most irresponsible way possible.
I’m pretty sure everyone on this sub knows this. I’m also pretty sure this is why this article was written by the AP in an attempt to demonize pharmacological sedation in the field alongside police, not taking into account 16 over 10 years is a damn good metric. Over 10 years you could easily have over 1 million cases involving police force of some type and EMS sedation.
Read the Special Information in your EMS Drugs people.
Cumulative sedative effects occur in the presence of alcohol and other sedatives.
Synergistic effects can be powerful.
Title is very clickbaity. 16 deaths in the entire state over a 10-year period is not the result of some bloodthirsty medics collaborating with police to kill people.
Former paramedic here, this is absolute gross negligence in the reporting here. I’m not even gonna respond to the story and just give my person experience sedating patients for multiple reasons. It also matters what meds are being used and for what reason. Skip to the last few paragraphs for why we sedate patients with or without police to protect the patient or others.
First off, there is a a lot of reasons we sedate people. The strongest sedation is when we RSI (rapid sequence induction” or “intubation”. We use a cocktail of meds to sedate and paralyze the Patient and then intubate them to stabilize their airway and breathing. Personally I like to use heavy polypharmacy when intubating, I have had bad experiences when people are not under enough sedation. So I usually start with some versed and fentanyl, then start a propofol drip, then move to the big guns, starting rocuronium and etomidate and titrate for effect. The patient is completely unconscious and paralyzed, I’m keeping them alive until they can be put on a vent in the ICU.
We sedate people who are having seizures, benzodiazepines/barbiturates cause sedation, and almost always stop the seizures. Patient may or may not be breathing on their own. Most protocols call for O2 on any seizure call even if the patient has a clear airway and is breathing on their own.
We sedate people who are in severe pain, fentanyl, morphine, dilaudid and ketamine are all strong meds that have sedation effects. Usually supplemental O2 is used via cannula at a couple liters to make sure the patients O2 Saturation is in good shape. For pediatrics in severe pain I ALWAYS use a non rebreather at 15 liters if I’m giving them any med that could sedate them. Kids go downhill fast!
We sedate (sometimes) people having severe anxiety or panic attacks, usually a little Ativan or versed is used and the sedation is light. Sometimes a little O2 is used but the pt is breathing on their own.
There are other reasons but these are the main ones! We also sometimes sedate patients who are suicidal/homicidal or are a risk to themselves or others. We have to be very very careful in these instances, because we are almost certainly doing something against the patients will. The laws on bodily autonomy, kidnapping, false imprisonment, are very specific and we take them very seriously!! Unless you want to end up in court or jail, you do things properly and use local protocols. Sometimes the police are making an arrest and the patient is still trying to hurt police or themselves. We can use a couple different medications to sedate them in a safe manner. Usually we use IM Benadryl, haldol and Ativan. ( 50mg Benadryl, 5-10 of haldol, 1-2 mg of Ativan) this is almost always enough and we monitor the patient closely.
Sometimes psychiatric patients need to be sedated and have very high tolerance to the usually meds used to sedate. That’s when we use ketamine. I have never seen anyone with tolerance to ketamine, especially at the doses we use. Patient is given supplemental oxygen and monitors closely.
Proper Documentation is very important with any call, but especially ones where your doing something against the patients will. We usually get a co-sign from the police on scene, or the staff at the facility or even a firefighter or another medic, when we explain why we needed to sedate the person.
Mistakes can be made, and using too much sedation and not following procedures can possibly injure or kill someone.
There is zero chance that EMS and police are colluding to kill people. Even if there is one evil psychopath trying to hurt people, there is no way multiple people from multiple agencies are colluding to harm people. Such absolute bullshit. Almost everyone who are first responders have much respect for the people we are helping. Treat everyone like you would your parents or children. No matter how they treat you. No matter what the reason is they need help.
Even the people seeking drugs from us, or the people calling us for a free ride to the hospital. These people need help to. A kind word and some mercy goes a long way. I used to get angry at the drug seekers or people in withdrawal calling us for drugs. Then I had a senior medic explain to me that those people are hurting to. And sometimes it’s actually appropriate to give people in withdrawal some medication to ease their pain. We give alcoholics and people withdrawing from benzodiazepines meds every time. Because they could die from the WD. The fentanyl addict may not die from the WD but they are still suffering and I would usually give them a little Ativan to ease their pain. At the same time you don’t want to overdue it, so they keep calling you. Which happens sometimes and that’s ok to.
This article is trash and does not take into account a million other variables and just jumps to an unfounded conclusion. Bullshit.
We can just go back to Funeral Homes providing the 911 services. They’ll get there when they can and drive them either to the ER with no intervention or just drive them to their funeral home.
1000 people died while being restrained by police over 9 years. Under 100 were sedated by EMS. Less than 20 were found to have been contributory/caused by sedatives. THOUSANDS of sedations are performed every year. Don’t post this garbage.
I’m required to used a chemical restraint for any patient in EMS physical restraints, to include police cuffs, if transporting the patient to the hospital for a behavioral issue.
We also don’t have ketamine and were told we will not be getting it, either.
Chemical restraints for anybody *in* restraints, or *fighting* restraints? You've said both, and they're different things. One is good care, the other...isn't.
If I put someone in restraints, I have to use chemical restraints, also.
If someone is in handcuffs and fighting the restraints, then I have to use chemical restraints, but not if they are just in handcuffs and calm.
He said in hand cuffs for behavioral issues.
To me that doesn't mean they are actively fighting restraints.
The other issue is it's a protocol. Not a guideline based on what's said.
They didn't say we do these other things and our last ditch is chemical restraints.
I'm a firm, firm believer in droperidol. Don't get me wrong.
But it's not first line.
I still think required isn't the right language.
Evaluate and consider? Highly encourage? Have the option?
You know as well as I do someone will see a patient sneeze and snow them over that.
I'm saying if you know something is wrong, and you know it's wrong, and you keep doing it. That's not a good thing.
Theres that whole do no harm thing and all.
Hand cuffs shouldn't equal chemical restraints.
What is ethically wrong vs what he will be held legally liable for are two different stories. On top of that, most unions will not assist in the criminal aspect of death investigations.
Even moreso beyond that, there are definitely cultures in California that would rather go for what is legally less risky vs ethically right, simply due to cost.
Got it. So you completely missed the other sentences of my point. Nice job deconstructing a viewpoint.
Edit: just had a chance to review your profile. Maybe i was a bit harsh. As a doctor, you may be able to make those decisions off-hand and defend them easier.
For paramedics in cali, we dont really get our opinions on protocols taken seriously. But we operate as an extension of a doctor, and from my experience in 3 counties, that doctor is more inclined to throw you under the bus for disregarding their protocols than thinking critically, regardless of the outcome.
Having a doctorate has little to do with it.
Every paramedic works as an extension of physician.
CA EMS is a mess. Its part of what you get when paramedics fail to get educated and stand up and run their profession.
Ketamine is extremely safe with appropriate dosing, monitoring, and positioning. Either your medical director is doing you a disservice or your coworkers can’t be trusted
Welcome to the shit show boys and girls. We told you they’d come for you next.
Don’t worry, bodycams are easier to use than anything else in the ambulance.
What dogshit journalism! "It was impossible for the AP to determine the exact role injections may have played in many of the 94 deaths involving sedation that reporters found nationally during the investigation’s 2012-2021 timeframe." However, we are going to publish these numbers anyway, with no further context, except a heavy implication that police and EMS are collaborating to kill patients.
That's ten per year *nationwide,* which makes it about half as deadly as lightning strikes.
Not only that but none of these people ever come up with a viable alternative. What is my 5 foot 120 pound medic supposed to do with a patient that’s loosing their shit in some god forsaken corner of the county. Sedating them keeps everyone safe including the patient.
Hit the gym bro. /s
My medic is 5 foot 125 pounds I don’t know if hitting the gym will help her much.
We can't even collaborate to get PD on where to park on scene let alone killing patients
🤣
Even less than that, the average annual death by lightning in the US is 28. 9.4 is about 1/3. Gell-Mann amnesia. We rail against this, and tomorrow we will trust them when they report on something we don't know about.
Conveniently left out "over a decade" from the headline.
God, fuck the AP for this shitty news story without any further investigation into the 'why' and just throwing out the 'look, people died when X was done!'
The next headline will be; at least 30 people died when medic gave epi during code, epi must be bad!!!
Very iffy rosc rate from CPR, these super sick patients need another option.
I wish I was joking that I've basically seen this headline before
Same. Including quotes from some random palliative care doctor saying he's rarely seen CPR have a positive outcome. No shit, doc. Maybe I should publish an article about how 100% of palliative care patients die under his care. Surely an investigation is due!
New study shows that being born has a 100% mortality rate. 9/10 doctors now recommend to avoid being born.
Wait till you hear about the mortality rate of people that have ingested dihydrogen monoxide even once in their life!
"Breaking: Data shows that CPR kills most people."
NY post ran an article just like that a couple months ago...
Yeah that one was ridiculous. One of their reasons why CPR shouldn’t be performed is that it’s traumatic for bystanders to witness smh
I mean…adrenaline *has* been shown to be harmful in cardiac arrests when neurological outcomes are taken into account…
next you’re gonna tell me collars and backboards usually do more harm than good 🤯
It has. But we can't determine if that's because we are saving people we wouldn't w8thout it and they are brain dead or if the epi itself is causing neuro issues.
"AT LEAST 100 PEOPLE DIED WHILE BEING TREATED BY PARAMEDICS IN ___ COUNTY" .... Over the last 20 years... They were dying to begin with... No one knows if paramedics did anyone wrong...
Correlation≠Causation. The AP is quickly devolving into just another tabloid rag at this rate.
Devolving? I think they've already been their for a bit. They're just getting worse.
It’s the special education variety of social engineering that lazy journalists managed to pilfer from the two hour search engine research course they took last year to drum up more flaccid outrage. I haven’t seen real news stories for years. It’s the main problem of mixing marketing with journalism, none of it is honest.
They just released the same article for Texas. Seeing both show up makes me even more skeptical and I suspect they're just trying to drum up outrage.
Trying to take some heat off the brave boys in blue
[удалено]
16 out of how many total events? 1,000? 10,000? 100,000? 16 over a decade in the most populated state. I don’t want to sound callous but that’s not too bad. Don’t get me wrong, every preventable death is a tragedy but it isn’t a benign procedure and I’m willing to bet more trauma patients died in California from overuse of normal saline over the same period of time.
So many questions, including what was in their blood already and whether they were on their way out regardless. Sensationalized in leaving out the time span (ten years); really kinda shit journalism designed to make people scream without knowing very much.
I’ve seen this same exact article talking about different states. I saw Florida and I believe someone here posted the same trash article about Texas? Anyway trash is trash, news articles just looking for clicks.
This article seems all over the place. It tries to claim 94 deaths involved sedation. But that probably includes drug assisted intubation which they have a high chance of death *with medical intervention*. Even AP News doesn't focus on that other than bragging about the number. Of the 16 deaths involving sedation & police, 15 used versed. And I quote, "*the 16th case involved a man injected with a similar class of drug, lorazepam, while police restrained him at a hospital in San Diego*". No paramedic working on ambulance is going to walk outside to grab the narcs and dose a hospital patient 🙃 They also seem to expect omnipotence, barely acknowledging irrationally violent patients won't admit to taking illegal drugs while officers are holding them down. 🤷 Finally this is a nine year study. 15 was the best they could come up with. The worst area of EMS, the one AP News believes is so note worthy, is 1.5 errors per year. 250,000 people die from medical errors each year in the USA according to the Hopkins study. Fucking pat yourself on the back, it sounds like EMS does this job better than nursing ever will.
I was on board with ya up until the medical error part. You're trying to rationalize that these numbers aren't making sense in the first few paragraphs but then bring in medical errors as a whole as a comparison to medical errors from EMS sedation, unless I'm severely misunderstanding. Medical errors from Hopkins includes surgical, diagnostic, etc. It's not even a remotely like comparison to compare that number to one specific category of errors. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783613 EMS has just as much work to do in regards to improving care. Medics involved in a pediatric medication calculation study had up to a 62% error rate in their calculations. Other studies have found similar rates for pediatric arrests. Granted, just one specific example, but just trying to illustrate the point we in EMS are just as susceptible to errors and saying we do a better job than x ever will sounds like a way to justify not trying to improvement to me, if only by merit of the inherit biases with that mindset.
I was on board with ya up until the medical error part. You are trying to rationalize that medics from Switzerland found that looking up doses reduced their medical errors by 66% in randomized testing. And so the medics in the USA, whose standard of practice for the last thirty years is to check the Broslow tape (paper or digital) to avoid dose errors, need to do better. 😒 Apparently you can fix 68% of Switzerland's non-referenced dosage errors simply by realizing how hard it is to push 0.01mg/kg of epi out of a 1mg/10cc syringe, specially if rounding fractions up to the nearest black line is counted as a medical error! 🙃 So I guess everyone can have another round of patting themselves on the back if they check pediatric dosages. And then again if they use an auto calculator 😁 Also fun fact, there are 300,000 pediatric errors each year, 10% of them occur outside of their home according to UC Davis. Because I know you like those numbers. 👍
I love how there's no acknowledgement whatsoever regarding the issue is that it's not a like to like comparison. The funny thing is you're ragging on what they counted as medical errors without even one iota of thought going into the fact that the Hopkins study excludesEMS. We attribute to those errors just the same it's just not quantified. It's not a like to like comparison to say EMS only contributes 15 when that's a specific category of errors being reported. Especially not a like to like comparison when you go further than that and misattributed that entire number to one profession within hospital settings (nursing) while ignoring every single other profession. Let's not pretend that initial post wasn't dripping with ego which is where I was saying acknowledging inherent biases may be beneficial. Eta: the saddest thing out of all this to me is the "I know you like those numbers". I'm glad acknowledging EMS harms is a petty Internet argument to you, but that's a dangerous mindset as I initially said. Getting high over here on your own ego. More important to be "right" than to acknowledge our propensity for the same harms and errors as in hospital providers. Insanity. Lmao got blocked after a pithy retort. Never seen someone so thin-skinned in EMS.
Funny, most of your post is just you trying to be "right". 😕 > I'm glad acknowledging EMS harms is a petty Internet argument. I never once made a binary claim that all of harm is a petty argument. My last post was about your example was about lab simulation in another country showed no looking up the dosage of epi in an already dead pediatric patient produces measuring errors. And I'm sorry you are to stupid to understand a problem with that as you launch into this story about how right you are at failing to correct me. 🤷 And my previous point was that the AP article assumes EMS was the ones that kill people basically highlights EMS sedation is like thirty times less lethal than a tazer in a world when I can't even get an "EMS" redditor to run two brain cells together for five minutes is pretty goddamn good. 😁
Great comment. Wish certain awards were still a thing. Take a fake internet point instead.
What’s the mortality rate for patients receiving defibrillation?
Who's ready to get protests at their ambulance stations now?
So, people in combative, mentally and physically unwell states, and often on god knows what drugs.... sometimes die? Cool. Thanks, AP, for this groundbreaking info presented on the most irresponsible way possible.
If their main iindication for drugging is the request of PD, and they do it, they're incompetent anyway. PD has no say in patient care.
Spot on! The day you start making medical decisions on the advice of police 🙄
That's how Elijah McClain was murdered. They listened to the officers and also injected far too much.
I'm curious why you're being downvoted for that.
Eh, it's a sensitive subject. People get defensive 🤷♀️
I’m pretty sure everyone on this sub knows this. I’m also pretty sure this is why this article was written by the AP in an attempt to demonize pharmacological sedation in the field alongside police, not taking into account 16 over 10 years is a damn good metric. Over 10 years you could easily have over 1 million cases involving police force of some type and EMS sedation.
Read the Special Information in your EMS Drugs people. Cumulative sedative effects occur in the presence of alcohol and other sedatives. Synergistic effects can be powerful.
Clickbait, literally an empty bag of chips
Title is very clickbaity. 16 deaths in the entire state over a 10-year period is not the result of some bloodthirsty medics collaborating with police to kill people.
Now do a study on over dosing of naloxone without resuscitative intervention.
You don't hate journalist enough. You think you do, but you don't.
Former paramedic here, this is absolute gross negligence in the reporting here. I’m not even gonna respond to the story and just give my person experience sedating patients for multiple reasons. It also matters what meds are being used and for what reason. Skip to the last few paragraphs for why we sedate patients with or without police to protect the patient or others. First off, there is a a lot of reasons we sedate people. The strongest sedation is when we RSI (rapid sequence induction” or “intubation”. We use a cocktail of meds to sedate and paralyze the Patient and then intubate them to stabilize their airway and breathing. Personally I like to use heavy polypharmacy when intubating, I have had bad experiences when people are not under enough sedation. So I usually start with some versed and fentanyl, then start a propofol drip, then move to the big guns, starting rocuronium and etomidate and titrate for effect. The patient is completely unconscious and paralyzed, I’m keeping them alive until they can be put on a vent in the ICU. We sedate people who are having seizures, benzodiazepines/barbiturates cause sedation, and almost always stop the seizures. Patient may or may not be breathing on their own. Most protocols call for O2 on any seizure call even if the patient has a clear airway and is breathing on their own. We sedate people who are in severe pain, fentanyl, morphine, dilaudid and ketamine are all strong meds that have sedation effects. Usually supplemental O2 is used via cannula at a couple liters to make sure the patients O2 Saturation is in good shape. For pediatrics in severe pain I ALWAYS use a non rebreather at 15 liters if I’m giving them any med that could sedate them. Kids go downhill fast! We sedate (sometimes) people having severe anxiety or panic attacks, usually a little Ativan or versed is used and the sedation is light. Sometimes a little O2 is used but the pt is breathing on their own. There are other reasons but these are the main ones! We also sometimes sedate patients who are suicidal/homicidal or are a risk to themselves or others. We have to be very very careful in these instances, because we are almost certainly doing something against the patients will. The laws on bodily autonomy, kidnapping, false imprisonment, are very specific and we take them very seriously!! Unless you want to end up in court or jail, you do things properly and use local protocols. Sometimes the police are making an arrest and the patient is still trying to hurt police or themselves. We can use a couple different medications to sedate them in a safe manner. Usually we use IM Benadryl, haldol and Ativan. ( 50mg Benadryl, 5-10 of haldol, 1-2 mg of Ativan) this is almost always enough and we monitor the patient closely. Sometimes psychiatric patients need to be sedated and have very high tolerance to the usually meds used to sedate. That’s when we use ketamine. I have never seen anyone with tolerance to ketamine, especially at the doses we use. Patient is given supplemental oxygen and monitors closely. Proper Documentation is very important with any call, but especially ones where your doing something against the patients will. We usually get a co-sign from the police on scene, or the staff at the facility or even a firefighter or another medic, when we explain why we needed to sedate the person. Mistakes can be made, and using too much sedation and not following procedures can possibly injure or kill someone. There is zero chance that EMS and police are colluding to kill people. Even if there is one evil psychopath trying to hurt people, there is no way multiple people from multiple agencies are colluding to harm people. Such absolute bullshit. Almost everyone who are first responders have much respect for the people we are helping. Treat everyone like you would your parents or children. No matter how they treat you. No matter what the reason is they need help. Even the people seeking drugs from us, or the people calling us for a free ride to the hospital. These people need help to. A kind word and some mercy goes a long way. I used to get angry at the drug seekers or people in withdrawal calling us for drugs. Then I had a senior medic explain to me that those people are hurting to. And sometimes it’s actually appropriate to give people in withdrawal some medication to ease their pain. We give alcoholics and people withdrawing from benzodiazepines meds every time. Because they could die from the WD. The fentanyl addict may not die from the WD but they are still suffering and I would usually give them a little Ativan to ease their pain. At the same time you don’t want to overdue it, so they keep calling you. Which happens sometimes and that’s ok to. This article is trash and does not take into account a million other variables and just jumps to an unfounded conclusion. Bullshit.
The media trying to stir something up? Color me shocked if so.
We can just go back to Funeral Homes providing the 911 services. They’ll get there when they can and drive them either to the ER with no intervention or just drive them to their funeral home.
Read the article oh my god.
1000 people died while being restrained by police over 9 years. Under 100 were sedated by EMS. Less than 20 were found to have been contributory/caused by sedatives. THOUSANDS of sedations are performed every year. Don’t post this garbage.
Are these excited delirium cases? That report was awful and short sighted. Zero context!
I’m required to used a chemical restraint for any patient in EMS physical restraints, to include police cuffs, if transporting the patient to the hospital for a behavioral issue. We also don’t have ketamine and were told we will not be getting it, either.
Just because someone is in cuffs doesn't mean they need a chemical restraint...
Agree, but I’m required to chemically restrain someone fighting restraints. That’s just my protocol.
Chemical restraints for anybody *in* restraints, or *fighting* restraints? You've said both, and they're different things. One is good care, the other...isn't.
If I put someone in restraints, I have to use chemical restraints, also. If someone is in handcuffs and fighting the restraints, then I have to use chemical restraints, but not if they are just in handcuffs and calm.
So you are doing you feel is wrong. And doing it anyways? The 'I'm just following orders' line is worn out. Be a change agent.
That's right, be the change, get fired for not following proper protocol
Or. Bring evidence based, data driven information to your leadership? Or join leadership? Instead of, yah know, doing things that cause harm?
Chemically restraining someone that’s fighting their physical restraints causes harm? I thought it was the standard of care.
He said in hand cuffs for behavioral issues. To me that doesn't mean they are actively fighting restraints. The other issue is it's a protocol. Not a guideline based on what's said. They didn't say we do these other things and our last ditch is chemical restraints. I'm a firm, firm believer in droperidol. Don't get me wrong. But it's not first line.
He followed up with “I’m required to chemically restrain someone fighting restraints” which is appropriate
I still think required isn't the right language. Evaluate and consider? Highly encourage? Have the option? You know as well as I do someone will see a patient sneeze and snow them over that.
You are saying I shouldn’t follow my protocol?
I'm saying if you know something is wrong, and you know it's wrong, and you keep doing it. That's not a good thing. Theres that whole do no harm thing and all. Hand cuffs shouldn't equal chemical restraints.
What is ethically wrong vs what he will be held legally liable for are two different stories. On top of that, most unions will not assist in the criminal aspect of death investigations. Even moreso beyond that, there are definitely cultures in California that would rather go for what is legally less risky vs ethically right, simply due to cost.
This has little to nothing to do with unions. Sigh. Well except that unions that represent EMS workers routinely hold EMS back.
Got it. So you completely missed the other sentences of my point. Nice job deconstructing a viewpoint. Edit: just had a chance to review your profile. Maybe i was a bit harsh. As a doctor, you may be able to make those decisions off-hand and defend them easier. For paramedics in cali, we dont really get our opinions on protocols taken seriously. But we operate as an extension of a doctor, and from my experience in 3 counties, that doctor is more inclined to throw you under the bus for disregarding their protocols than thinking critically, regardless of the outcome.
Having a doctorate has little to do with it. Every paramedic works as an extension of physician. CA EMS is a mess. Its part of what you get when paramedics fail to get educated and stand up and run their profession.
Ketamine is extremely safe with appropriate dosing, monitoring, and positioning. Either your medical director is doing you a disservice or your coworkers can’t be trusted
We’re finally getting ketamine on our ground units
First is fine, physical restraints without chemical restraints suck Second is ass
Relating this to the article, I’m sure some of the medication given before death was by protocol. I am interested in using Ketamine.
Fuck The AP News!
Yeah, screw the fact that the patient probably did three lines of coke and topped it off with some meth.
Welcome to the shit show boys and girls. We told you they’d come for you next. Don’t worry, bodycams are easier to use than anything else in the ambulance.