4 ms·

If someone doesn't get ketamine, the alternatives are: - they get tased, pepper sprayed, and thrown around by law enforcement officers - they get a less safe

If someone doesn't get ketamine, the alternatives are: - they get tased, pepper sprayed, and thrown around by law enforcement officers - they get a less safe drug like midazolam, lorazepam, or haloperidol - they get restrained and fight against the restraints which puts them at risk of sudden death and rhabdomyolysis

mattkrause 6y ago
....if there’s a real, imminent threat. In some of these cases, it seems like the officers could have tried to de-escalate the situation while keeping these options in reserve in case that failed. The choices don’t have to be either immediate compliance or overwhelming force. Even with animals—-where the use of drugs is a lot less ethically fraught—-ketamine isn’t necessarily the first option.
- goodells 6y ago
  Sure, the indications for using it can be clarified. EMS would go for chemical restraint (i.e. ketamine) for someone where "excited delirium" is suspected. This doesn't mean literally anyone being ornery with the police - and generally we aren't even involved in those calls. A person in a normal state of mind won't break their arms or dislocate their shoulders when they're put in handcuffs. Someone who took too much meth very easily could.
thatcat 6y ago
In this case, it says they used 500 mg of ketamine in an injection, so basically they killed him with an excessive dose. Even though ketamine might have a higher LD50 you can't compare drugs without knowing the dose they are using. https://en.wikipedia.org/wiki/Death_of_Elijah_McClain https://en.wikipedia.org/wiki/Death_of_Elijah_McClain
- giantg2 6y ago
  True. Administering many drugs without the proper knowledge can be dangerous.
- lstodd 6y ago
  500mg? Might as well just shoot (someone) in the head. Total unprofessionalism. "normal" dose would be something like 10-30mg
  - goodells 6y ago
    My protocols for excited delirium say ketamine 100-200mg IV/IO or 200-400mg IM.
    - pseudalopex 6y ago
      It's worth noting "excited delirium" is a controversial diagnosis.
    - thatcat 6y ago
      That doesn't sound like a very safe protocol to follow considering the max dose in a controlled environment for depression treatment is 1mg/kg.

mattkrause 6y ago

....if there’s a real, imminent threat. In some of these cases, it seems like the officers could have tried to de-escalate the situation while keeping these options in reserve in case that failed. The choices don’t have to be either immediate compliance or overwhelming force. Even with animals—-where the use of drugs is a lot less ethically fraught—-ketamine isn’t necessarily the first option.

goodells 6y ago
Sure, the indications for using it can be clarified. EMS would go for chemical restraint (i.e. ketamine) for someone where "excited delirium" is suspected. This doesn't mean literally anyone being ornery with the police - and generally we aren't even involved in those calls. A person in a normal state of mind won't break their arms or dislocate their shoulders when they're put in handcuffs. Someone who took too much meth very easily could.

thatcat 6y ago

In this case, it says they used 500 mg of ketamine in an injection, so basically they killed him with an excessive dose. Even though ketamine might have a higher LD50 you can't compare drugs without knowing the dose they are using. https://en.wikipedia.org/wiki/Death_of_Elijah_McClain https://en.wikipedia.org/wiki/Death_of_Elijah_McClain

giantg2 6y ago
True. Administering many drugs without the proper knowledge can be dangerous.
lstodd 6y ago
500mg? Might as well just shoot (someone) in the head. Total unprofessionalism. "normal" dose would be something like 10-30mg
- goodells 6y ago
  My protocols for excited delirium say ketamine 100-200mg IV/IO or 200-400mg IM.
  - pseudalopex 6y ago
    It's worth noting "excited delirium" is a controversial diagnosis.
  - thatcat 6y ago
    That doesn't sound like a very safe protocol to follow considering the max dose in a controlled environment for depression treatment is 1mg/kg.