Paramedics Criminally Charged/Convicted

FolksBtrippin, BSN, RN · Mar 3

I think it still stands that you should do what's in the patient's best interest. Clearly that didn't happen in this case though. The guy died.
I feel like this paramedic is paying the price for a bad system. They've made an example of him. It's sad but also change is necessary and it wasn't going to happen without consequences.

Wuzzie · Mar 3

Is having paramedics chemically restrain out of control suspects a thing?! I've never heard of it and it wasn't part of my training. When did they start taking orders from LEOs? Ketamine seems like such a risky choice. Even in the ED we would have used a B52 or Haldol. This whole scenario sounds like a giant Charlie Foxtrot. I don't disagree with the verdict. Not sure how I feel about a long prison sentence. I hope the others involved are facing charges as well.

allnurses Guide · Mar 3

emtpbill said:

Just heard on the news the the medic who gave a patient ketamine and the patient ended up dying was found guilty. Facing a possible 18 years in prison. Just a reminder to keep tucked away in memory that even though the medic and a police officer thought they would have qualified immunity, they didn't on this call. Im sure they initially started out doing what they thought was in the patients best interest, after a lot of investigating, they weren't.

I can remember years ago an instructor telling me that if I were always doing what was in the patients best interest and could justify it, you would never get in trouble.

That went out the window fast.

Paramedics were convicted in Elijah McClain's death. That could make other first responders pause

I am surprised that Ketamine is stock on the rig.

Wuzzie · Mar 3

hppygr8ful said:

I am surprisED that Ketamine is stock on the rig.

Yeah, me too.

FiremedicMike, BSN, RN, EMT-P · Mar 3

Wuzzie said:

Is having paramedics chemically restrain out of control suspects a thing?! I've never heard of it and it wasn't part of my training. When did they start taking orders from LEOs? Ketamine seems like such a risky choice. Even in the ED we would have used a B52 or Haldol. This whole scenario sounds like a giant Charlie Foxtrot. I don't disagree with the verdict. Not sure how I feel about a long prison sentence. I hope the others involved are facing charges as well.

The switch from physical to chemical restraint in the field started about 10 years ago. You must not work in an emergency department, it's fairly common. As for why ketamine/versed instead of a B52, I can't answer that, you'd have to ask the medical director collective. I will say that ketamine/versed work MUCH faster than B52, which in a manpower/space limited environment like EMS, is very beneficial.

As to taking orders from LEOs, in this case this was a tangential factor, the bigger issue is that the paramedic in charge of the scene made the call to sedate without any assessment of their own. This was one of the key factors in this case.

hppygr8ful said:

I am surprised that Ketamine is stock on the rig.

It's been on and off backorder for years. Most protocols have ativan as a substitution for when ketamine isn't available.

I worked for 20+ years in an urban environment where our 3 most administered drugs were duoneb, narcan, and ketamine. We sedated a lot of high-risk behaviorals and had a solid and trusting relationship with our cops. In the last several years with hiring standards changing in law enforcement and especially after Mr McClain's death, our cavalier chemical restraint usage when wayyyy down..

emtpbill, ASN, RN, EMT-P · Mar 3

FiremedicMike said:

It's been on and off backorder for years. Most protocols have ativan as a substitution for when ketamine isn't available.

A lot of trucks do not have it. Medics have to take certain classes and have to be approved by their squad medical director.

About a year ago I was working as an RN in the ER and a squad brought a patient in that they used ketamine on. Well, ended up being a diabetic patient and instead of maybe an hour or two after waking him up, he ended up being in the ER for a lot longer than needed.

FiremedicMike, BSN, RN, EMT-P · Mar 3

emtpbill said:

A lot of trucks do not have it. Medics have to take certain classes and have to be approved by their squad medical director.

I'd say that's regional, in our state it is within the scope of practice and no additional training or approval is necessary. I am aware of some departments in the state where it is only carried on supervisor/coordinator vehicles, but I believe it is primarily supply chain and cost driven.

Wuzzie · Mar 3

FiremedicMike said:

You must not work in an emergency department, it's fairly common.

I don't at the moment but I have extensive ED experience as an RN and try to keep my knowledge base up to date. Chemical restraint must be a regional thing. It's not common here. I verified this with a friend who is our current fire chief.

toomuchbaloney · Mar 3

FiremedicMike said:

I'd say that's regional, in our state it is within the scope of practice and no additional training or approval is necessary. I am aware of some departments in the state where it is only carried on supervisor/coordinator vehicles, but I believe it is primarily supply chain and cost driven.

I would guess that standard of practice includes direct assessment of the patient and determination of safe dosage.

Trauma Columnist · Mar 4

I'm on a volunteer Fire/EMS dept. I run ALS calls and tonight I had to restock narcs. We do use ketamine for chemical restraint. That said, this is a rural dept that covers a lot of area and we do NOT transport. We have a protocol for chemical restraint. I'm also an APRN and feel comfortable with ketamine but would definitely error on the side of the low end of the amount given

Emergent, RN · Mar 4

The article says the victim was 140 lbs. The police should have been able to restrain this guy without drugs.