Elijah McClain - medics charged

FiremanMike

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So I read an article that the medics were charged in relation to this man's death. The news story I read is that the cops wrestled him to the ground, medics arrived and administered 500mg of ketamine (which the article states is in their protocol for chemical restraint). McClain subsequently died and now the medics are in charged.

Our dose here is 3mg/kg, so for most folks 500 would be high, but doesn't seem to be critically high. Are there other mitigating reasons that you all know of which led to the charges?
 

Aprz

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I've been reading different things everywhere. My understand of it was that they failed to assess and monitor the patient post Ketamine administration, which lead to them not recognizing respiratory failure. The varying stories from media and their own interpretation, mainly criminalizing Ketamine, makes it too hard to accurate assess what happened.
 

E tank

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So I read an article that the medics were charged in relation to this man's death. The news story I read is that the cops wrestled him to the ground, medics arrived and administered 500mg of ketamine
...what a way to go...
 

DrParasite

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from the article:
The indictment is in sharp contrast to prosecutors' initial conclusions in the case. In 2019, Adams County District Attorney Dave Young declined to bring criminal charges because he said prosecutors lacked evidence to prove the officers caused McClain's death or that their force was unjustified.
But McClain's story gained renewed attention last June after the police killings of George Floyd and Breonna Taylor and the rise of the Black Lives Matter movement. Spurred by protests in Aurora and a viral online petition, Gov. Jared Polis announced a re-examination of the case last year. Weiser was appointed as special prosecutor and opened a grand jury investigation into the case in January.
Translation: the facts/evidence haven't changed, but the Governor is going to put these officers and paramedics through hell to score political points during the next election. and when they are found not guilty based on the facts, more protests will happen, unfounded claims of racism, and it will further cause divisions between certain groups in this country, which will further aid in fundraising for the governor's PAC.

While his death is a tragedy, the facts didn't support indictments then, and likely don't support them now. But since a prosecutor can get a grand jury to indict a ham sandwich, it's great for media clicks, so the political pundits can get further cause division, and at the end of the day, 5 public safety professionals will have their careers ruined over this.
 

CCCSD

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I guess it’s true…ketamine is a racist drug. Ban all drugs.
 

E tank

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Not to sound cliché, but effective sedation is an 'art', it can't be achieved by rote algorithm and there are times and places for it. A fight with the cops isn't one of them.

That it was even available for consideration is at the root of this catastrophe. Progressive protocols are popular with a lot of folks in terms of job satisfaction, but they cut both ways. Can't speak for the cops, but the medics were put in an awful position, they were way out of their depth (if the dose was any indication) and the EMS medical director(s) should be ashamed of themselves. And they sure as hell better be subpoenaed for trial.
 

MonkeyArrow

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I have seen a lot of people speculate on this being an “overdose” of ketamine. 5 mg/kg rounded up to 500 mg is an increasingly common agitated sedation dose given in EDs, and there is some literature and FOAM etc. that supports the dosing.

Now we can argue the semantics of what an overdose means. Was it an overdose in terms of quantity of medication intended vs quantity delivered? Doesn’t look like it. Was it an overdose in terms of the quantity of medication causing untoward adverse effects? Maybe.

I think focusing on the quantity of medication delivered is the wrong avenue to judge the actions of these paramedics. It’s more relevant, IMO: 1. What prompted them to administer the med in the first place? (I.e. Did they push it because the cops told them to or because they independently assessed the patient and felt the patient met the indications for ketamine administration for sedation?) 2. What did post-sedative monitoring look like? Did their monitoring of their now-sedated patient meet standard of care or was it negligent? Even if you cause apnea due to ketamine/benzos/opioids, with prompt recognition, you should be prepared and able to manage the airway: position the airway and bag through it.

The latter point is the critical one to me. Agitated delirium, even though that’s an umbrella diagnosis that has problems with definition, has a reportedly high morbidity and mortality in the literature. It is conceivable that the patient could still arrest due to his primary agitated delirium, and not secondary to respiratory depression/arrest from medication administration. Obviously, I wasn’t there, so who knows if we’ll ever know what happened.
 

SandpitMedic

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What a load of ****.
 

silver

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I have seen a lot of people speculate on this being an “overdose” of ketamine. 5 mg/kg rounded up to 500 mg is an increasingly common agitated sedation dose given in EDs, and there is some literature and FOAM etc. that supports the dosing.
Still is an overdose when you realize he weighed <65kg.

I've used substantially smaller IM mg/kg doses as my induction dose for general anesthesia.
 

Carlos Danger

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Still is an overdose when you realize he weighed <65kg.

I've used substantially smaller IM mg/kg doses as my induction dose for general anesthesia.
But NO! Aren’t you aware that ketamine is the best option for everything and has zero negative effects?!? Even in very large doses??

If you didn’t know that you seriously need to start spending more time listening to FOAMed. Weingart, et al would be disgusted by you.
 
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FiremanMike

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But NO! Aren’t you aware that ketamine is the best option for everything and has zero negative effects?!? Even in very large doses??

If you didn’t know that you seriously need to start spending more time listening to FOAMed. Weingart, et al would be disgusted by you.
For the record I wasn't supporting the dose, and I did not know his weight, I was merely sharing that I've seen 500mg IM given before without resulting in death.
 

Carlos Danger

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For the record I wasn't supporting the dose, and I did not know his weight, I was merely sharing that I've seen 500mg IM given before without resulting in death.
I know. My sarcasm wasn’t directed toward anything anyone posted here. Just the general (false) notion that has taken hold in the past handful of years in the ED/EMS community that ketamine is the solution to every problem.
 

VentMonkey

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I know. My sarcasm wasn’t directed toward anything anyone posted here. Just the general (false) notion that has taken hold in the past handful of years in the ED/EMS community that ketamine is the solution to every problem.
The tide is turning in the prehospital world regarding Ketamine’s favorable profile.

I’ll let everyone get back to the politics regarding this thread now and continue to keep my opinions private. All of it is pretty deplorable and old in general. Society, blah.
 

Kevinf

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The transcript I read shows poor handling of an anxious but non-violent neurodivergent individual by what should be trained professionals. He appeared to have been stopped for walking while black because there doesn't seem to be any other reason for the stop than, "you were outside and that's suspicious". While he was nervous and anxious, that isn't a reason for slamming a patient with a large dose of ketamine because anyone would likely have been nervous and anxious if placed into the same situation.

The whole thing was handled poorly by the professionals involved, and that resulted in the death of someone in their custody and care. The only failure of justice here was the fact that it was initially swept under the rug. There doesn't appear to have been good cause of this person to have been stopped, restrained, and sedated at all and it appears to have resulted in a needless death. Based on my read of the facts at hand, negligence and involuntary manslaughter sound appropriate here at minimum.
 

Bullets

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From reading the documents available it seems that the real issue here is that the medics: Failed to perform an initial assessment, administered a medication that wasnt clinically indicated, failed to monitor that patient appropriately, and then missed a decline in patient status due to that lack of ongoing assessment.

Are these things professionally inappropriate? Id say yes. Are the negligent? id also say yes. Do they amount to a crime? I think theres a case to be tried. If half of what is claimed is accurate, these guys screwed up
 
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FiremanMike

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He appeared to have been stopped for walking while black because there doesn't seem to be any other reason for the stop than, "you were outside and that's suspicious".
This is factually incorrect. There was a call made to police that there was a black man with a ski mask waving his arms and acting suspicious. The first officer in the area of the call found a black man wearing a ski mask and made contact based on the call and the description.
 
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FiremanMike

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I just read through the part of the 157 page report that addressed fire/EMS involvement and honestly I think everyone needs to sit down and really ponder the implications of criminal charges filed against the medics.

The determination of giving ketamine is unclear, as the report seems to contradict itself by simultaneously saying McClain wasn’t moving before giving ketamine while also saying he was still actively resisting and required force to sit still for the injection. What I can say from my own experience is that when we roll up on a dogpile of cops holding someone down who’s still squirming, I’ve never questioned them “are you sure he was resisting?” - and I’d bet that’s the case for you all too, if you’re being honest.

After the ketamine was given, the next few minutes played out the way ketamine runs usually play out. Let him calm down, ensure he’s sedated, move him to the truck to start monitoring. Unfortunately, McClain arrested when they got him to the truck and that was it.
 

Kevinf

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This is factually incorrect. There was a call made to police that there was a black man with a ski mask waving his arms and acting suspicious. The first officer in the area of the call found a black man wearing a ski mask and made contact based on the call and the description.
This is literally "walking while black" because it's NOT illegal to wear a ski mask OR wave your arms in the air to music OR to be outside doing those things. Also in my opinion it is not particularly suspicious because; does someone with ill intent walk around with a ski mask on and draw attention to themselves, or do they keep the ski mask hidden away and try to draw as little attention as possible until just before they are ready to commit their nefarious deeds?

Let's not forget that a black man had the police called on him by a Karen for walking in the park in broad daylight and it made national news and became a meme. Another black man out for a jog was killed by two vigilantes and the DA is now under arrest and investigation for covering it up. Context matters.
 
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ffemt8978

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This is literally "walking while black" because it's NOT illegal to wear a ski mask OR wave your arms in the air to music OR to be outside doing those things. Also in my opinion it is not particularly suspicious because; does someone with ill intent walk around with a ski mask on and draw attention to themselves, or do they keep the ski mask hidden away and try to draw as little attention as possible until just before they are ready to commit their nefarious deeds?

Let's not forget that a black man had the police called on him by a Karen for walking in the park in broad daylight and it made national news and became a meme. Another black man out for a jog was killed by two vigilantes and the DA is now under arrest and investigation for covering it up. Context matters.
Your opinion as to why walking around with a ski mask waving your arms around not being suspicious is just as valid as those who think it is suspicious behavior. Race may or may not have played a factor into why someone called the police to report it, but once they were called law enforcement has an obligation to at least check on him.

The rest of your post has absolutely nothing to do with this particular case. If you think race played a part in the medics actions in this case, prove it. Otherwise save it for Reddit.
 

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