Elija McClain, Ketamine and Criminal Negligence ⎮A Paramedic's Perspective⎮
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- Опубликовано: 23 дек 2023
- *Views expressed in this video are mine alone and do not reflect those of my employer or their partners*
The criminal trail for the two paramedics involved in the death of Elija McClain has come to a close and both have been found guilty of criminal negligent homicide. This video is my opinion of the trial and the tragic situation.
The liability isn't just the med error. The liability is also the lack of patient care. They were in a position where they had a duty to care for Elijah, and they were negligent in that duty. Their inaction by providing post IM monitoring could reasonably be understood to cause his death.
Issues for EMT's:
1. initially, they gave to police their authority as licensed EMTs to diagnose & treat on the scene. #1 error & may be considered abandonment of care. (Were EMTs afraid of the cops, too?)
3. emt's did not perform an initial physical evaluation but tragically & illegally gave med first - egregious error
4. excited delium is not recognized by medical community as a legitimate condition but police are trained to use it because it gives them excuse to escalate violence or cover up police errors. Medical professions do not use the term only LEOs do.
5. 500 mg dose is too high, a significant & possibly lethal drug error.
6. The first hour is golden; they were S L O W to begin
7. follow up care started after many minutes of talking, that's professional negligence
8. They should have been courageous enough to confront the police about their excessive use of force & filed complaints. EMT's must have noticed the blood. But that won't happen becase hell hasn't frozen over yet.
@@hypatiaalexandria1164 👏🏽
@@hypatiaalexandria1164YES YES TES & YES!!!!
The last few minutes are pivotal. I have had some awful interactions with police attempting to “order” or intimidate my actions as a paramedic on scene. It’s so important the police understand where their authority ends. Our actions, scope of practice, protocols, clinical guidelines, standing orders, duty of care, etc. carry with them the force, weight, and consequence of law. Most states have codes or statutes that tie EMS providers’ responsibility to lawful verbiage.
A LEO “ordering” an EMS clinician to perform an intervention is absolutely an unlawful order and could, in itself, be considered a criminal act.
I agree, However that didn’t happen in this case. All the officer said was “he is definitely on something” but the cops didn’t even ask for sedation as far as I can tell.
I am a retired paramedic. Seen and lived the same thing you describe. As for the video we are commenting on, I agree, when you administer a medication, you have to be ready for any negative side effects and monitor your patient. Remember from long ago when in school.... right drug, right dose, .....
Great points. This is a reason drugs have indications, contra indications and side effects listed.
@@PrepMedicdidn’t the police man get convicted though?
Well said my friend. I’m an CCRN, EMT-P. Don’t EVER sedate without monitoring the patient.
On the one hand I do not want EMS providers to work knowing a slip up lands them in jail.
On the other hand, this is an example of gross negligence that isn't due to lack of training, it is due to a long history of bad habits, overconfidence and laziness. There are a minority of people in EMS who think rules don't apply to them and are super careless with their patients.
I really wonder how many times patients went unsupervised by these guys. You can get perfect training all day long, but when you don't play as you train...... These guys didn't make just any mistake, it was a very basic thing that they can't claim to not have known or forgotten. It should have been the most basic thing they were trained to do: pay attention to your patient.
The mentality of these guys needs to be dealt with. But putting them in prison will not help anyone, it will just elevate stress levels across all health care providers.
When someone dies due to your absolute negligence then someone belong in jail!! Why should paramedics cops or firefighters be treated any different than anyone else?? They already get away with almost everything they do thanks to qualified immunity!! Shall we add another “depends on your job” immunity??
I have a friend who was a combat medic and is currently a civilian surgical tech. He always laughs at movies and TV shows like Dexter where they inject people in the neck with tranquilizers like ketamine. He says that injections into the neck are not used in real life. In the brief video clip that you showed it does show that they are injecting the patient in the neck. Are neck injections used like that?
You ask the question about when a case should become criminal. "Where's the line?" In my mind you pretty much answered that in the video. The line wasn't that they made a med error and got a dosage wrong. The line was that they were grossly negligent and didn't give any of the the required care afterwards. They didn't do any of the things that you said you're supposed to do when you administer ketamine. They didn't clear the airway. They didn't check vitals. Like you said they had a supine patient with vomit in their mouth. I have no formal medical training and even I know that's bad. They basically jabbed him with a needle, tossed him on a stretcher and then carried him into the ambulance. Like he was a slab of meat and not a person whose life was literally in their hands. The fact that they didn't do all the things they were required to do with any dosage of ketamine, while also getting the dosage wrong, that's gross negligence. Gross negligence, that leads to death or great bodily harm, should have criminal charges.
He was not injected in the neck…it was his shoulder/upper arm. Watch the video again at 2:47
@@jimfitz1432 it could be but looking at a screen grab of the injection it looks like it would be very high up on the shoulder, like near the joint, which seems odd. Still looks more like the base of the neck or between the neck and the shoulder.
@@ANIMOUS8
The body cams distort perception. I can assure you it was not his neck but upper arm/shoulder. And yes it is close to the joint but not in it either.
Spot on. Negligent when after care wasn't administered. And you have to also look at historical actions by pd and Para. But they should not be Para any more period..IF all the facts point that way.. criminal prosecution leans toward intent. Negligence leans into protocol. GREAT VIDEO.
Great verdict
This was the perfect storm, and a young man died from it. Negligence was the star of this show... Jail time was appropriate in this situation.
I'm halfway through paramedic school. And legal chase like this make me worried about paramedics having the same public image as law enforcement. I hope the media doesn't villainize us. It makes me a little worried about the future.
You won’t have that problem because most people have never heard of a paramedic. They now what an emt but not a medic.
Dont drug and kill people,,,,,no one has the right to give drugs against their will .......that is murder
In many situations they actually do have the right to give medications against someone’s will. These situations include when the patient is a threat to themselves and others and when they lack decision making capacity.
@@johnniecameron8829 BEEP... wrong. Try again.
There is always time to double check your interventions before you proceed, this is especially true at night when you are tired and during high stress scenarios. There is never an excuse for not providing proper patient care post sedation.
EMT here - med errors happen. They do. But it is what you do post error that makes the difference, right? You gave the dude 500mg of ketamine, cool, dude is going to have a fun ride (maybe?). I am perfectly happy breathing for that patient while the medic sorts their shit out and has a solution to take care of the patient. But then you fail to reassess after a treatment is given? Dude, that's one of the first things you should be thinking of after an intervention is done. I do that after doing a simple sling and swathe. Seems to me they just dumped drugs in the patient, and was waiting for the transport agency to show up to pick up the mess (ask me how I know). Lazy, lazy, lazy providers. Do better.
"PD ordered me to-" lol wut? PD can pound sand, this is my patient, and what I say goes. You want to do x or y, get your license, then show up. Until then? Take a hike.
I agree that the demonization of ketamine is stupid, but failing to PROVIDE CARE to your patient is an extreme screw up. Especially when you're playing with drugs that COULD compromise someone ability to breathe. You're a medic. You SHOULD know this, or you should not be screwing around with the stuff. Absolutely strip them of their license to practice, and I certainly think some sort of legal action should be taken.
To those bringing up being tired and being stressed, no shit. That's the job, and a problem of the job in itself that I would love to have a conversation about. Know when to take a break, or to walk away, and these services having ways to assist or alleviate said things. Also not taking any medic or EMT and just saying "Yup, they have a pulse, they can provide patient care". It's senseless.
As far as the criminal implications go: I don't know if there is any precedent that has been set for something like this to say 100% what the course of action should be. However, in my mind, something needs to happen. Actions have consequences, and in this case, INACTION should have consequences. Make it known that if you're going to be a shitty provider and kill someone, shit is going to happen to you. It's simple. Do your job. Follow your training, your protocols, the 100 different algorithms you have for the 100 different things you GET TO DO that help you not even think about what you're doing because you just do it. You go through that checklist that is beaten into you since you were in basic school. We unconsciously assess ABCs in our everyday life, how is it you missed (according to an eyewitness) what may have been vomitus in/around the airway? Don't ya think you should check your patients airway? I'll take "Shit you learned first few weeks of basic school" for 500, Alex.
Medics and basics always talk about expanding scope of practice, or getting upset by being limited, well here is the reason why. Lazy providers. Police your own folks, call out shitty care. Always do better. There is no such thing as completing your education in medicine, even for an entry level certification like mine, strive for more. And expect that of others.
Amen.... I see so many people just stop learning after they pass boards and just do the bare minimum of ce's to keep their license. They have poor assessment skills and seem to be more interested in what color figs they're wearing and how much they are making...
I guess I am centering this more around RN's, but I have seen apathy in all aspects of Healthcare.
Went from working SAR and two big cities... to coming out of retirement in a rural area. Training to many medics was good, but, many did not have "City Sense". They often had emotions go wild, had State Troopers & LEO take total control, have the "God syndrome" and believed they could do whatever with no accountability - who should have retired a decade earlier. I went back to being retired, as the system was broken and saw something like this coming. I hate being right this time. Be cafeful out there people. Thank you for this report. Happy holidays all.
Yeah we definitely see that is some of our bigger municipalities here in Colorado. New guys come in thinking that being jaded/mean is a sign of an experienced provider and strive to emulate it until it is actually is how they are. Being an adult and regulating your emotions is absolutely huge.
Where I am there are plenty of medics with god complex. They think they’re doctors
Pyggies are absolutely also at fault and to blame for this death.
They did go off protocol. They didn't monitor. That is the problem. That is what is criminal.
It's a scary prospect to be a "patient" with iatrogenic causes being 3rd leading cause of death in USA.
As someone who’s been in multiple accidents and was a firefighter for three years, I appreciate your meticulous professionalism. You’re obviously well studied and care a lot about knowing your trade as well as comfortable patient care, and that’s HUGE! God be with you
It boils down to negligence vs gross negligence.
I would say that criminal negligence is appropriate here due to the fact they did not do reassements. Its pretty easy to tell if your patient is slipping and they didn't even know if he had a clear airway. It seems like they showed up, pushed a lot of ketamine, and just sat around waiting for the transport company. Its not like they got the medicine mixed up in a very chaotic scene or were somehow hindered. They didn't do even a 15 minute follow up. Even if I have a patient whos only got a broken toe I am going to do a reassement every 15 minutes as a baseline incase I missed something like they didn't tell me they're a diabetic. They didn't do that. Thats negligent, not just a simple mistake.
It’s negligence, but it’s not criminal negligence. There is a difference and they will not be found guilty.
@@Eric-oj5sj they have been found guilty. The trial is over. They're in jail now
@@Eric-oj5sj They were found guilty..
@@Eric-oj5sj boy then do I have news for you
That was a knocked-it-outa-the-park outstanding presentation. My experience in these matters is very limited, but it is far, far more than my opinion of the vast preponderance of those called to jury duty. Briefly as to my experience. Throughout my undergrad years in the mid/late 1960s, I worked as an orderly in a state mental hospital (as then they were called) and in the teaching hospital of a major medical university. I had certs in wilderness first responder, in the National Registry for EMT-B, in wilderness EMT-B, and in USCG Medical Person In Charge. For four years I volunteered as a tactical EMT with the county sheriff's office in a mega metropolitan area. With that as prologue, I will assert unequivocally that the vast preponderance of those called to jury duty and the vast preponderance of any statistically random sampling of the adult population in any of the western first world nations has no idea of the chaos, ambiguity, and extremis of urgency of a rapidly evolving medical/trauma emergency. No idea.
I think this incident with Elijah has two major problems. The first one is the police officers had no reason to contact this person at all he didn't do anything or there was no call for service. Then you get paramedics on scene who are basically feeding off of the god complex at the police officers have and they think they can do what they want as well, so they decided to violate protocol and go straight to ketamine instead of taking a history and the ABCs. Personally I think everybody got what they deserve the police officers were found guilty and sentence and the paramedics have now been found guilty. I've been in EMS most of my adult life and police and EMS are doing things now that I will tell you we wouldn't have even considered doing back in the '80s and '90s because they would have dug the jail up put you underneath it set the jail back down on top of you and you never been heard from again. This God complex the police and everybody else has It's starting to perpetuate and is ridiculous, everyone that works has rules and the rules are there for your protection as well as ours and when you don't follow those rules bad things happen as we can see here. Personally to me there's no way I would let a paramedic work under my license and give a paralytic or fentanyl in the field it just wouldn't happen. I think ketamine is an excellent analgesic and anesthesia drug for pain control and sedation but when not used properly it will kill you. Now I don't work in the state of Colorado so your practice is out there are whatever the OMD allows and you can do what you want but I'm certain after this your scrutinization is going to be much higher and it needs to be. To me personally these paramedics got out and they had the god complex and they thought they could do whatever they wanted and they killed the man. You have to remember paramedics are not doctors You have protocols to follow and that's what you follow You don't do anything on your own You're OMD is allowing you to work under their license and those protocols are set up step by step for you to do what they say, this kind of hot dogging is going to do nothing but cause problems in the pre hospital care profession. Now I think paramedics do an excellent job there's a lot of very professional medics out there but this hot doging has got to get stopped and stopped now or it will spread like a virus once you get away with it one or two times you start doing it more and more, I've seen it personally. I've actually witnessed a paramedic losing his license because he would not listen to orders from the ER doctor, and he was told if you respond to one more call in this state you will be arrested. However in this case what they did rose to the level of criminal action This wasn't simply a malpractice case This was a criminal case, and just like a doctor doing something they shouldn't do they get criminally charged paramedics get it too. You commenting on this fact that this situation was a medication administration error shows me why you have protocols to follow. You're a paramedic not a doctor So you're medication errors are simply failing to follow doctor's orders or failing to follow protocol but this person in this case blatantly gave too much of a medication outside of his level of training and outside of his protocols and this rose to a criminal act. And if you blatantly do something wrong you should face criminal court and jail time and be taken away from your family, your medication is plainly written on the bottle and you plainly have a drug dose to give and I understand there's the heat of the moment and emergencies and things like that I get all of that But the reference to the nurse that you gave The reason she was brought up on criminal charges is she blatantly gave the wrong drug so by not reading by not paying attention and just blatantly doing what you think is right can be held to a criminal case just like if a doctor does something blatantly wrong. Where do you think that paramedics should be shielded from legal ramifications. You've got qualified immunity that protects you most of the time but sometimes things happen outside that and you need to be held accountable, so pay attention to this so while you're working make sure you're doing the right thing a mistake is a mistake but a blatant act is different than a mistake.
Your best video yet. Thank you bro.
Our medical direction and protocols actually have both kg dosing and “approved simplified dosing” with small, medium, and large. I’m not advocating for not knowing the kg dosing, but it is a thing. Great video!
Fatigue and stress also play a big role in EMS.
What bothers me most is the ignorance exhibited about the medication and the possible complications. I would like to see the city review their system (maybe the$$$$ they will payout for this will motivate them)
Are they medics to be providers or to get a raise? IYKYK
These two medics and their actions have compromised the safety of all street medics in the state of Colorado. I’m split on the sentencing, but watching that medic roll up, reach over, inject the med… it is infuriating. I didn’t see him identify himself to the patient, he didn’t tell the patient what he was doing. They roll on scene like “ okay boys we got this” ..
I don't know of its already been mentioned or not, but I'll go ahead and say it. A couple of very real issues I noticed during my career:
1. Firemen become firemen to fight fires. Very few have any desire to provide EMS care and do so ONLY because it's a requirement. Nearly all ALS FDs I've seen have significant faults in policy and training.
2. Private ambulance (transport) services are most often governed by a board and are in the business of making money. That is always priority #1, therefore not uncommon to hire new medics with minimal training
I agree with your sentiments here. I think a lot of firemedics view working on the ambulance almost as a punishment, I even saw a sketch to this effect once, so I think fire-based EMS dilutes the quality of the medics somewhat. Most of them are in the career for the fire aspects, as you said. Where I work, EMS is a completely separate entity to fire. We're straight up paramedics and train as such.
@kingarthur5110 same where I used to work. Obvious difference in caliber of medic and in patient care
Sam, your video and explanations are spot on. I 100% agree with the points you make and opinions you bring up. Bottom line, any med we give has the potential to kill a patient, even if given correctly and appropriately. Any and every patient, regardless of their complaint(s), symptoms, etc, always require the same level of attention to detail in our assessment, reassessments, monitoring and plain, straight up patient advocacy. This case is a perfect example of a poor outcome made exponentially worse by a court of law and court of public opinion. This case should cause every provider to take pause and rethink why they got into this line of work.
Thanks for an outstanding analysis.
a young man is dead because of the criminal negligence of these people. With civil suit the city would just be paying off the family. Someone is responsible.
Prep Medic!!! I appreciate you taking the time to talk about this incident.
As a 30 provider this tragic situation could’ve been prevented I know we can both agree on that!!!
It doesn’t cost anything to double check to reassess the ABC’s !!! Double check, triple check and check again!!! NO excuses…….
Also I would like to follow up on your comment at 25 minutes into the video of you stating it’s challenging to show up in a chaotic situation. Well, that the profession we chose to be in it’s not gonna be a calm situation all the time!!!
Also, we see all these police officers on this young man not that big adult compared to all these police officers!!!
This young man did not need to be given this truck he just needed restring and for everyone to calm down with their emotions all he needed, was to be transferred to the hospital and safely transported without harming himself or anyone else!!!
I like taking the holistic approach, providing a low dosage, ensuring that we are accurate with the patient’s weight and double checking !!! it doesn’t hurt to start with a low dosage and build upon it !!!! Even if that means they’re screaming and we need to secure them in restraints!!!
At least they will arrive at the hospital alive and we can have the physicians at the receiving facility take over care!!! And give these drugs in a controlled environment with everyone ready to respond in an in-hospital team response!!!!
If things go bad!!!
And in my humble opinion, I don’t believe the providers that choose the holistic approach our bed not at all at the end of the day it’s about the patient. We are the advocate we are the professionals it’s our duty to ensure our patients receive the best professional care that we can provide in our scope of practice!!!!
God bless, stay safe !!!
And let’s not forget to show compassion on every single car we go on we chose to be in this profession, the profession of helping people !!!!
No matter the time and day !!!
We are here to help the people ✌️✌️✌️
Why do they give that drug to people that don't take drug ?
The slippery slope with criminal charges is that if that was applied across healthcare there are many many negative outcomes from poor patient care. If they all become criminally negligent thats a huge problem. Great video and on point for the issues.
That's basically what I mean when I say I will roll on by if I see a black person in need of help. I'm not willing to go to prison for trying to help, that's for sure!
@@BeRightBack131 if *that* is your takeaway from this incident, I'm really sorry for you and hope you're not a first responder or other healthcare provider. that attitude does not belong in this profession.
Hey Sam! I appreciate your videos. I have a question about carrying an item. I'm so glad that Narcan just became available OTC. I'm trying to figure out a way to carry it that isn't either bulky (like the hard cases available), or easily crushable (like the soft sided cases). I currently carry mine in a soft-sided case clipped to a fanny pack. I'm a social worker and work with the homeless population. I appreciate any ideas that you have.
This situation absolutely breaks my heart.
IMO, As an EMT in medic school, I agree that things happen. Mistakes happen. And when providers own those mistakes and work to improve them, then it shouldn’t be criminal. However, gross negligence and lack of care for a patient should be considered for criminal. The med error alone shouldn’t be criminal. The lack of care for the patient post med administration and lack of care for the airway should be taken seriously. I’ve seen it all to many times in different services in different states where providers don’t care for their patients, and nobody is able to do anything because they haven’t killed someone yet and if they do insurance will take care of it. We need to get out of that mentality, especially for the reputation of the good providers that do care for and to genuinely treat their patients right.
I don't know about that. There's plenty of professions that you can be prosecuted in for making mistakes. By trade, I'm an aircraft tech. We can and will be prosecuted if a mistake results in fatalities. Whatever we do as a society, it should be the same for everyone across the board so if paramedics are given a pass, so should everyone else.
@@vinsanity982 No because this is why it's called practicing Medicine, it's always changing and errors always happen no matter what. What you would end up with having no EMS ever to do anything anymore. That is why for the most part they are covered.
@@johnchall6796 How is that different than aircraft maintenance? It is also changing all of the time
2 completely different things. You doing a maintenance on an aircraft and an EMS responder at 3 am in a deep sleep waking up immediately for a call and responding in less than 6 mins from up to on scene and properly treating a patient isn't nowhere near close.
It's the same reason doctors aren't, EMS is a branch from a MD, its why they work under their license.
I don't think this is going to set a precedent. If Elijah had fallen off a motorcycle and broken his leg and he was being treated and was a patient and they killed him then it becomes a civil case or malpractice. Elijah wasn't a patient. He was being arrested. If they were there to treat him for injuries he had sustained, that's one thing but they were there to sedate him to assist the police officers. That's not treatment. I don't think it's proper to administer drugs to someone while obtaining an arrest. Maybe paramedics or EMTs shouldn't be taking part in arresting citizens. If you take a DUI for instance, they can't draw your blood until they get a warrant. They can ask you to do with breathalyzer. They can ask you to do a lot of things but they need to get a warrant to stick a needle in you. Why is that not applicable in Elijah's case?
So in a lot of aspects you are correct but there are a couple things I want to draw attention to. Elija was a patient based off of the information the paramedics were given. He was "reportedly" under the influence with an altered mental status and showing sign of some kind of delirium. In addition to that he was placed in a carotid hold and required a medical evaluation per APDs protocols. While I agree that this information was not correct and ketamine was not an appropriate drug for Elija, the ketamine was not given to facilitate arresting him or taking him to jail. He was going to be transported via ambulance to the hospital for further care even if no untoward effects of ketamine occured. The reality of prehospital care is that the job of LE and EMS intersect a lot. Many people commit crimes but are also patients and both services have very different objectives.
@@PrepMedic you’re absolutely right, “both services have very different objectives”. With that in mind, one service should not be directing the actions of the other.
@@FarckewVerimucc and in this instance neither agency directed the actions of the other. Police may have discussed sedation prior to firemedics arriving on scene but it doesn't appear like the police officers even mention ketamine to firemedics upon their arrival.
As far as I see it, there are two possible events that could have occurred here:
1) The paramedics were so overstressed and unable to handle the case they had a total breakdown and they themselves needed medics.
2) The paramedics decided, for any reason (Goal to do harm, laziness) to not help the patient, gave him an overdose and didn't do any basic work on him
# 2
Wanted to add, on a personal note, I’m really happy you’re working here in Colorado. I see your helicopter frequently; many times when it’s going to/from the Boulder hospitals it flies over my house, and I think “hey, Sam might be on that one.” I’ve been following your channel for a little while now and I’ve rebuilt my emergency kits based on what I’ve learned from your videos. Over the holiday break I’m going to review your “stop the bleed” videos again with my daughter so she knows how to use the kit that’s in her car. Anyway, THANK YOU so much for the work you do and the videos you’re posting here. Many blessings and merry Christmas to you and your family.
Well that came off oddly stalker-ish. Whatever, I’m leaving it. I plane watch so I take note of many overhead planes and helos, I’m not stalking Sam specifically. 🙂
🎉greetings hugs from the Dominican Republic 🇩🇴 excellent presentation, professional Prehospital hug.
Hey Prepmedic, sorry it has no relevancy to the video or anything, but, I saw your video recently on your EDC, and I was wondering if you used the velcro backing on your HSGI riggers belt or not?
Thanks for the video Sam, quick question though. So what would have been the proper management for this patient in this scenario, would you have given ketamine in lower doses to achieve a partial sedation but keep him conscious, would there have been any other pharmacology or techniques you would've used?
My opinion is starting at a lower dose and monitoring. Ketamine is dose dependent as Sam mentioned. Start him at 250 (quickly becoming national standard for A.D.) and monitor airway, bp/pulse. Bring extra people if possible for airway control.
@@jayraymond9707 thank you
I think this is an impossible question to answer because only those medics were able to perform a clinical assessment.
If nothing else, adequate continuous physiologic monitoring and cross-checking dosage would’ve helped.
@@mackflickerson6722 at least mitigating the decline of the patients status
First of all, the paramedics should have made their own assessment instead of accepting the LEOs' "excited delirium" explanation. "Excited delirium" is a BS excuse LEOs use to justify deadly force. Secondly, they should have monitored McClain's vitals after administering the ketamine.
Im not sure if a distinction was made in the criminal case but it seems to me that the negligence is not reassessing and continuing medical care. I dont think the med error or protocol deviation should constitute criminal negligence but I can see how the failure to provide continuing care would be.
I appreciate your perspective.. I am not a paramedic, however I received Ketamine during and after a glossectomy in 2020. I was totally awake and aware after surgery and could tell that without the ketamine I would have been in trouble. I MUCH prefer it to Fentanyl! When the the Ketamine was taken down in increments I was able to come off it with no withdrawal or after effects. To blame this wonderful drug on this man's death when it seems negligence was the primary cause, is a travesty.
This is the reason why fire departments shouldn't force firefighters to become paramedics. You get paramedics that dont care about paramedicine and they give piss poor pt care because of it.
Agreed
Definitely
This is sort of tangentially related to the common law tort of Medical Malpractice. Where the standard is that the clinician did worse than a minimally competent provider. I cannot speak for the facts of this case but I agree completely with the conclusion of this video. The ketamine may have been miscalculated, but a minimally competent paramedic should know how to monitor a patient with a GCS of 3.
Very balanced take. I think you raise a good point about the potential value of ketamine (when properly used) being lost, when the real danger comes from negligent care resulting from poor training/practice.
similar conversation to what happened with the crumbley parents in michigan. legislation needs to catch up with this societal shift towards criminal prosecution of previously protected individuals on the periphery of tragedies. if we’re not going to charge them we need to reevaluate the felony murder doctrine too.
Re use of paralytics, do you routinely check for medic alert bracelets or dogtags before administering them? As someone who is anaphylactic to roc/vec/panc and never leaves the house without my medic alert tags, I hope it's standard procedure to check.
If they're doing a quick head-to-toe (which everybody should if they're following their training) then it should be found. I rarely check people's phones, I'll typically check their wallet at least for their name, DOB, and address, so I'll find stuff there but likely after things have calmed down. Wristbands I almost always spot, pendants are hit-and-miss but if a patient is sick enough to not be able to tell me any info then they're usually losing a good portion of their clothing in the back of the ambo anyway, so most things will be spotted there and likely before they receive too many drugs.
At least from my medical director and in most situations, a paralytic hypersensitivity will not completely stop us from giving it if the risk of not giving it is higher than the risk of prolonged paralysis. In your case, if it's only an allergy to non-depolarizing neuromuscular blockers (I'm presuming you're allergic to that specific family of paralytics since you named roc vec and pan) then I may give you succinylcholine if I don't see an allergy to it listed (which is from a different family of paralytics). There's also the possibility of giving a dose in the high-end of my dosing range for the sedative for intubation and perform a sedative-only intubation, which is riskier than no paralytic but if a patient is allergic to all paralytics and we've weighed the risks, it could be done.
At the end of the day, it's an ambulance, so even if you were to receive a drug you're allergic to, we have all the gear already there to treat anaphylaxis. Sometimes, people find out they're allergic to something we gave them for the very first time in the back of the ambulance! That's always (not so) fun 😅
Medic alert jewellery (and more recently tattoos) are something we're trained to look for.
Now that the Justice system has weighed in on who bears responsibility for the murder of Elijah McClain via three jury verdicts for five individuals indicted for their roles, only the small detail of sentencing for the three who were convicted remains. January for one. March for the other two. The very notion that a person convicted of criminally negligent homicide and assault could get probation for that offense is profoundly offensive to the memory of the victim here.
But the miscarriage of justice was apparent on both sides. As guilty as I believe the one Police officer convicted of this horrific crime was, the videos captured on Police bodycams convincingly show a well-orchestrated conspiracy among every public employee present to abuse an innocent victim and cover it up. Unfortunately, the zeal of that unruly mob to physically subdue Mr. McClain was only exceeded by its confidently held faith in the assumption that he was a dangerous criminal, and by the lack of integrity of every G-jobber on scene.The failure of any of the accused to take responsibility for their role in the murder and the acquittals combine to minimize the seriousness of all of the defendants' actions. A split verdict is an obviously imperfect result given the facts clearly seen in video evidence, but there is no way to deduce on which side jurors erred. Blatant CYA by the defendants seeking to reinvent this as a tragic series of misunderstandings and more CYA by a Prosecution that took years to even acknowledge that there was a problem were both trumped by the eventual entrenchment of the status quo. Police can continue to bully citizens they don't like, up to and including murdering them, and their paramedic conspirators can continue to provide zero medical aid with only an inconsequential risk of blame if their patient dies and none at all if they happen to survive.
The fundamental injustice remains unaddressed.
These facts served as a warning that neither of these institutions can be trusted to distinguish between the medically necessary and the frivolous administration of ketamine. That is why the CO legislature stepped in to remove the diagnosis of excited delirium as an excuse to practice anaesthesiology without a license.
The deeper question about the legality of the sick game of bullying random, innocent citizens by assaulting them for no reason and then interpreting their struggle to breathe as an assault on LE is left unanswered. The basic question of whether the actions and inaction of paramedics here was within protocol is still obscured by the distraction of the involvement of ketamine. The post-trial CO legislation seems to say that but for the mistake of allowing paramedics to prescribe and inject ketamine, the paramedics did everything else right, which is complete nonsense. Called to the scene purportedly to render aid to someone in Police custody, they never attempted to do anything beyond complying with a request to inject a deadly anaesthetic, from someone with absolutely no authority to do that. They never spoke to their patient. They never even observed their patient, despite the many desperate, failed attempts to lie their way out of those accusations. And they never took any vital signs until after he had stopped breathing, some six minutes after they had given him an overdose of ketamine. Additionally, these lying creeps noticed that Elijah had vomited but never made any attempt to clear his airway prior to injection.
One of the effects of this drug, well known to any paramedic certified to administer ketamine, is the loss of the gag reflex. So any fluid that happens to be in the patient's mouth can be involuntarily aspirated into the lungs. It also elevates secretion of saliva, which means that the patient's airway must be protected prior to injection and continuously monitored until it wears off. Beyond these precautions, and a few others, it is a very safe anaesthetic with a wide margin of safety between a therapeutic and a toxic dose. But ignoring those precautions because "it's good enough for who it's for" is no different than waterboarding a detainee. None of the First Responders, indicted or unindicted, had any authority to torture Elijah McClain or to ignore such treatment by their colleagues. They not only intentionally overlooked the crimes of LE, but participated in them.
@prepmedic the 2019 protocols are in my initial comment. 5mg/kg is the standard dose for it.
Hindsight and training going forward is the “salt the soup” method.
25:45 "you probably shouldn't be in this profession". thank you I'm on my way out. But this video is spot on. Great content as always.
Good video, great insight on a medical perspective vs a law/criminal perspective.
In my opinion, I’m not glad per say that the paramedics were found guilty criminally, but I’m definitely not upset that they aren’t practicing anymore. They showed up to a scene that the law enforcement mishandled, and I think the biggest mistakes that people make when working in the public sector is drawing conclusions and judgement.
It is not an officers job or a EMTs job to judge someone. It is not their job to be the judge, jury, or excecutioner. It is their job to solve and treat the situation at hand. If a paramedic shows up to a scene where there’s a patient with a GSW, should the paramedic assume they are involved in gang violence? Should they say to themselves hey, this is a bad neighborhood, this person is probably a gang banged and therefore I shouldn’t treat them? No. Their job is to help. Their job is to treat the injured and let the rest of the system work with the rest.
I think, in this case, the LEOs on scene had assumed Mcclain was dangerous (though dispatch said he was not threatening), escalated the situation, and when the paramedics showed up they immediately made assumptions and decided to let their own opinions take place in front of proper protocol. They didn’t do any post injection assessment, they didn’t manage his airways, and they completely neglected their purpose as caretakers.
I think this case is different than a lot of medically negligent cases because it isn’t a matter of misreading protocol or misunderstanding monitors/readings from the patient. It isn’t a matter of stress taking over and causing an error. They administered a drug that sedated the patient. After that, they completely ignored him and ignored the care he was supposed to receive.
TY for the great presentation
I heard that grapefruit juice potentiates ketamine.
Here a quote from a study through Pubmed: “Grapefruit juice increased the geometric mean value of the area under the plasma ketamine concentration-time curve(AUC0-∞) by 3.0-fold”
Shouldn’t this be considered a contraindication?
Grapefruit juice is a Cytochome P450 inhibitor. It prevents CYP450 from breaking down other drugs like ketamine. Granted a lot of drugs are metabolized by CYP450; we don't tend to contraindicate them with grapefruit juice unless they are super potent with grapefruit juice on board. In the case of Elijah, other interventions by the medics at this dose could've kept him alive, but they didn't do it.
No one will know that. Or what a person has taken they have to operate under the assumption this is a medical emergency and patient safety dictates chemical sedation
Your opinion is exactly what I thought it would be. In my opinion if Elijah was Caucasian and the medics were Black, your opinion would be different. What did Elijah do to deserve the treatment he got? What did the Police and medics do to deserve the treatment they got? Elijah life is worth more than money.
i know nothing of these cases, but i grasp your concerns. (nb, im in another country) thanks for the other information, i found it very interesting. a while back i was dismissed by four dr's re chest pain and other indicators, i went on to have what was called a massive heart attack. the paramedics and a dr seemed to need to go back to school.id have preferred morphine or ketamine and atropine. i did get atropine later but all they would offer was fentanyl and medazalin, the fentanyl was inadequate and i required three doses of it and each time they doubled the dosage, they also performed cpr despite me having a dnr order in place. my take on these situations is they are often politically motivated rather than medicinally driven. thankyou
EMT in training here with prior law enforcement experience. The fast paced, constant movement and long hours of this type of work is hard enough. Add disadvantaged scenes (Dark, loud, hectic and confusing) errors are VERY hard to avoid. 100% agree major CF situations should result in you leaving that job, I am very against criminal charges unless there was intent. Good EMTs, Paramedics, cops and firefighters quit every day and stats show they are not being replaced fast enough. I have seen many articles about departments relaxing requirements. That is dangerous. We need that open debrief in all of these jobs to get better every time, this will lead to coverups 100% I have seen it in law enforcement and I will never do that job again because the safety and training has been impacted so severely. I WILL go home, it isn't negotiable. I don't feel safe with my training and the experience of those around me and I will find a new job. Don't know the answer, this is far more complex than I can solve but the comments are pretty enlightening.
I agree with the concern about the criminal liability. I do wonder if he died in the ICU later could those providers have reversed the complications and could they also be held liable since he died in their care?
The paramedics need to treat African Americans like human beings who need care rather than things that they do not care about. I remember the way the paramedics who were called to Eric Garner in 2014 who didn’t carry out even basic assessment.
I only have EMT training so not a paramedic but I came to the exact same conclusions about this case: the paramedics failed on BLS skills here. When Elijah is dosed with the ketamine, they continue to hold him down without checking his ABCs. I suspect he stopped breathing shortly after being dosed. When they move him to the gurney about 3 minutes later, it appears that he has agonal respirations. If one of the dozen of EMR/EMT/EMTP-trained personnel had recognized his inadequate respirations they could have started bagging him and he probably would have been fine. I noticed the comment about vomit too, the airway/breathing was being completely neglected when it should have been #1 priority, especially in a sedated patient. Instead he was probably not breathing for 3-4 minutes by the time he was on the ambulance, and possibly even in cardiac arrest. They were moving slow so I'm guessing they didn't hook him up to the monitor for another few minutes at which point it would basically be too late. Very sad situation but a good lesson on the critical nature of BLS skills in paramedicine.
Okay so not related to the video but rather just a very subtle thing you can to make your videos better is to cut a piece of electrical tape and put it over the volume indicator on your microphone. Ik it’s such a small thing but as a viewer it can be slightly annoying/distracting. Love the videos and think it’s awesome how far you have come over the years.
So in these situations could you just titrate to effect? So assume you would normally give 400mg, give 300 instead and go from there?
Check what RSI is and doses for that. Idk how they got to 500mg that's for a horse
Can you dive a little deeper on how ketamine can cause hypotension? Currently going through paramedic school and my drug cards are saying one of the side effects is hypertension.
One way you can do it is catecholamine depletion. You have your own catecholamines in the body in addition to the ones we give. If we give too much ketamine, you can deplete the catecholamine stores and present hypotension. More common in really sick pts though. But excessive relaxation secondary to high doses of ketamine can cause vasodilation that not even increased heart rate (chronotropy) and strength (inotropy) can overcome). Hope this helps
In Scotland IDK if the protocol is change on it but only doctor who arrive on scene and if anesthetist is on scene can deliver ketamine to the patient.
Ah, yes. The UK has a very robust EMS system- critical care medics and docs go to wayyyyy more prehospital scenes. Here in the states, they rarely do. I think that's the biggest problem
Respiratory and pulse are like the two easiest things to correct. Anyone can squeeze a bvm and chest compressions. It’s an oversimplification, I know, because that doesn’t actually mean that oxygenated blood is circulating.
I commenting as the lead paramedic was just sentenced to 5 years today. As a FF/ EMT I gotta say that you hit all of the nails on the head. I agree 100%. One thing I always try to tell my newer guys is that we are there for patient care not to assist the police. More often than not we find that the police were actually the escalators and in the wrong so you can’t go in to a scene with a mind set of “backing the blue”. Just as this case shows, they will not reciprocate. Ultimately this poor kid died because of that mindset in my belief. Probably assumed he was some young thug fighting the cops and in return didn’t properly care for him. Lastly I also agree that this will set a precedent on criminal chargers for first responders and that is not good.
Hit the nail on the head with this one. Don't inject people that aren't moving. Put on the damn monitor and capnography. Watch the airway and vitals. Outstanding video.
500mg intramuscular is what some would call a heroic dose
Dosing is based on ideal body weight meaning we are roughly guessing there weight. Here sir I know your agitated but please step on the scale
Is putting some1 to sleep without an 8 hour fast, run the risk of chocking? especially if they suffer from gastro reflux? or like in this case, the patient was throwing up so isn't that more risky?
Yes, it’s more risky but that’s the difference between emergency medicine and a planned procedure.
@@PrepMedic How much of an emergency would it be for u to put some1 to sleep without an 8 hour fast, if they're not throwing up, but do have gastro reflux?
@@PrepMedic I posted a 2nd comment here 3 weeks ago, after u 1st replied.
did u not get it, or did i say something wrong, or what?
@@PrepMedic I wanted to know your answer to airrule's 2nd comment here, but now I'm even more interested in your answer to his 3rd comment, because why do people sometimes stop replying. Sigh. Peace.
First, cops started getting nitpicked...every little thing is critiqued...they're sued and protested constantly, making the good cops quit and turning the criminal/suspect/catalyst for the whole situation into the victim.
This looks like much the same thing but with paramedics. With prescient like this, it could very well go the same way that it has for LE...good paramedics become afraid to do what's right for fear of being sued into oblivion so they either quit or do the absolute bare minimum for patients. Hold bad ones accountable, of course, but this president could be absolutely DISASTROUS in the long run.
These were bad cops with bad paramedics. The cops escalated a situation that didn’t need it to force, tasering Elijah. The paramedics failed in dosing properly and killed him.
They killed a man who played violin to kittens in his spare time, for the crime of wearing earphones and a ski mask.
Ketamine is safe.. its like a pistol great in the right hands but you know the story
I really commend your tactful avoidance of the politics while focusing on the facts and what is relevant to your platform. Bravo, and thank you.
As for my opinion on the matter, I agree with you, this sets a very dangerous precedent that will allow genuine mistakes with no ill will or even bad training to ruin a person's life when they had no other control.
The result of this I believe should depend on their intent....and there's the crux. How do we know their intent. Was there prejudice involved? or were they simply poorly educated and complacent? Who knows. As always these issues aren't simple. I appreciate your input and I hope this doesn't prevent paramedics from providing necessary care in the future.
My biggest issue is that medical mistakes are the #3 cause of death in this country, why arent all those people going to prison for all the deaths caused. Medical mistakes happen, many times leading to the loss of professional licenses, and rightly so. These medics were negligent, they didnt assess the pt before or after, but mis judging his weight was a mistake that is easily made under the circumstances. Medics should never take "orders" from police, they should also make their own assessment. But the only reason they were prosecuted is because it was police related and made political. The cops should have never acted the way they did amd IMO were responsible, but the medics shoyld have been fired and lost any professional license for providing negligent care. Ketamine shoyld not be villianized. My 2 year old was given the med when bit in the face by a dog so they could suture him up. Holding a person down while they are fighting (Elijah wasnt at that point) is much safer than fighting them, for everyone. Then general public doesnt understand medicine and has a tendency to follow the media induced panic without even understanding fully how the practice of medicine works
Disciplinary action, retraining, termination and loss of licensure are powerful tools and should be used as appropriate. Holding criminal charges over people’s heads will not only lead to people covering up errors (or perceived errors) along with systems restricting tools in order to avoid liability. I belive criminal charges are only warranted when malicious behavior can be demonstrated not negligence or incompetence. I’m glad you did the deeper dive. People want a quick answer for their 30sec attention spans and then we get legislative overreaction in this case and a powerful tool gets removed.
Seems like if discipline, retraining, termination, etc had been a thing then Elijah might still be alive. Now we have a dead young man and the only reason we’re even having this conversation is because charges were brought and convictions won.
Drugging a person. Is not care,,,its absolute criminal ....imagine the Gov. Doing this to you..
So why ketamine versus something like versed? Wouldn’t versed help calm them down?
Ketamine has an onset of 2-5 minutes, versed has an onset of 15 minutes
@@PrepMedicI've had versed for procedural sedation and they definitely began the procedure much sooner than 15 minutes after administration.
@sbreheny you got versed through the IV route, not the IM route. There is a huge difference in onset
Tricky one (I'm not from the USA so my only knowledge of this case is from this video). Everyone in this field makes mistakes, it's inevitable, and being open about mistakes is crucial. Criminal charges risks that. However it's not the dosage mistake here alone, it's what appears to be gross negligence after the fact. It seems those paramedics created the conditions for this man to die, then negligently allowed it to happen (I'm not suggesting they deliberately intended to harm him to be clear). That crosses a significant line for me; mistakes happen, but the subsequent negligence isn't a mistake, it's a choice. However, how do you draw the line in law? Very hard to do.
My thoughts exactly. The dosage put the case on the map but there are so many other issues here.
Man this is a tough one to call. I think it is pertinent to look back at past history/performance of the medics as a contributing factor in criminal liability. I'm a big proponent also of respecting authoritative figures and the policies and protocols they have in place and teaching that respect to my children. If an officer finds your activity suspicious and asks you to stop and talk...stop and talk and be respectful. If you aren't up to no good than you don't have anything to hide, if you are up to no good than a certain amount of liability lands on your actions as well. There is a historical precedent that someone walking around with a ski mask on may be attempting to hide their identity. Someone hiding their identity may be up to no good.
I haven’t watched this entire video so forgive me, but why and how do you think they came to the 500mg dose? Even if you are using the dose for conscious sedation or RSI it’s only 4-6mg/kg IM and that dude does not look like he was even 100kg… what do you think happened? It’s wild they also didn’t do much of anything after administering it. Maybe I should watch the trial for more details, but this is truly mindboggling.
Sorry just getting to the end where you’re talking about this.. 🙈😢 this is wild. Paramedics I know are way better than this. Hopefully people have learned from this.
Ketamine is given in different dose ranges for therapeutic range, rsi, pain control and chemical sedation so different situations call for different dose ranges
23:58 Well this situation wasn’t a “things happen” this was gross negligence not just a passing mistake or oversight
I know its already been brought up in the comments here but I'll add to it. I think EMS absolutely needs to be a standalone profession across the board. With the responsibilities and the skills we have nowadays, it's inappropriate to piggyback EMS as a secondary role on another profession like we see in fire-based services. I did a practicum in a fire dept years ago and, while there were some good practitioners there, almost all of those guys were there to be firefighters, not paramedics. This was reflected in the fact that the most junior guys were the ones who staffed the ambulances, it was a sort of 'you have to put your time in doing the scut work to earn your place on the fire apparatus' thing. EMS and patient care are way too important for that mindset. You need people who are 100% committed to the job and not ones that see it as a hurdle to get through to do what they REALLY want.
Now, im not saying that necessarily contributed to this situation, but it's certainly not a shock to me that this was done by some ALS fire crew who did less than the minimum while waiting to hand it over to a transport crew.
Think the very first thing that should be done is better/more thorough testing/screening prior to licensing or promotion would help by screening out more of these substandard providers. Fair or not medical providers MUST be held to a higher standard simply because lives are on the line in many cases. But, I don’t believe that criminal is the way to go unless a gross misconduct can be proven. From what I’ve heard, this was a case of what I would term gross misconduct.
If you have had any surgery more than likely you have had ketamine.
It's used by a lot of anesthesiologist before they give you the anesthetic to put you under.
Did these guys not get any expert witnesses? Who was their legal defense?
Their “experts” were ridiculous. They made up stuff and did little actual research.
Here is my issue, the idea of prison is to prevent further harm to others/to punish those for a crime. Should these medics lose their jobs/licenses? 100%. But how does prison time do anything to improve the situation? These guys didn’t go out into the field with the intention of killing someone. It was negligence 100%. But prison time does nothing except appease those who just want to see punishment.
Can you do a video on the x8t tourniquet
It’s incredibly dangerous to give a patient any sedative without knowing some type of patient history!!!!!
True but giving medications and treatments with little to no information is a reality of EMS medicine.
@@PrepMedic I’m aware of that but give a dose of strong sedative to an already distressed man and grossly overestimating his body weight was definitely not a good decision!! They listened to the cops and it cost him his freedom and that young man’s life!!
Troponin level was 2.12 ng/ml, ejection fraction was 23.3%.!?
Those numbers mean next to nothing after a cardiac arrest, especially after unrecognized hypoxia and possibly an unrecognized pulseless state for a prolonged period of time.
Many opinions, many opinion holders do not work in critical / emergency care. If anything this is a teaching moment to realize we're ALL fallible human beings; and we all make mistakes. Should these two medics lose the privilege to practice due to negligence? Yes, probationally though for at least a year, while retraining and rewriting the exam to be reinstitated upon competency has been proven. Anyone can make mistakes, no one's exempt.
Do they deserve criminal charges and jail time? Absolutely not.
Thank you for your insight and response to this case @prepmedic. God bless you and yours. Merry Christmas.
Going on my 16th year in emergency care. You’re right.
You don't need to work in critical/emergency care to have an opinion. If Elijah was your family member you wouldn't be shrugging your shoulders stating *"meh!! emergency/critical care is tough and mistakes happen, no need for criminal charges."* Providers need to take their jobs seriously, you aren't flipping burgers at McDonald's.
@@Mister_Terrific806 Sir, what if you were those paramedics; maybe having come from a traumatic call or just a serious bad day. Would your harsh judgement stand if it were you!?
@@GinxHorneyes. It's called integrity.
Would you want a paramedic/EMT to administer medical aid if the Medic/EMT doesn't care if you live or die?
@@GinxHorne No, I don't feel bad for them , especially in a situation that was tame and controlled versus the chaos they typically deal with. The fact of the matter is they didn't care or value Elijah McClain's life, they were cracking jokes ("smoking and joking" ) completely detached from the situation in front of them. Elijahs death was heinous and uncalled for.
Furthermore, please don't respond with the excuse of this being a *"training issue."* AFD has an annual budget of 86 million, with in service training that's required daily, with these specific protocols involving Ketamine administration being touched upon at least once a month. This is a standard among paid, professional fire departments across the country.
Sorry bud, society is no longer going to say *"meh!! they had a bad day"* to this level of barbarism. It's time to for you and those who see nothing wrong with Elijahs death. To practice some of that personal accountability you perpetually preach, *as these Paramedics only have themselves to blame.*
Can you please Review the My Medic Scout Please Please Please!!
Retired psych nurse here. Very simple, you've performed an intervention of any kind on a patient (even basic assessment), therefore you monitor their health. That's fundamental. Nothing to do with what drug was used or how administered
As for the issue of criminal charges, I take your point, however there's a wider issue of public perception of accountability for emergency workers who cause harm.
In an ideal world, this would be a unique incident and retraining/demotion/deregistration after a full review would be acceptable. However this wasn't a unique incident and someone died, therefore the court system is the only possible way I see to maintain safety, not only for innocents who maybe look "sketchy" but for emergency workers. I remember when ambulance and fire crews in Northern Ireland had to change the colour of their uniform in order to avoid being mistaken for the police and risking assault.
500 mg?! Jfc....my infusion of 70 mg used to be terrifying, 500 is absolutely insane 😳
One of the most non-biased takes of this situation by an ems influencer.
The way doctors and especially police get away with negligence, I think these paramedics should NOT have been charged criminally but should pay a fine, get their licenses taken away and sent back to paramedic school. But criminal and can never work without schooling again is crazy
I watched this from beginning to end.
Once any medication is given medical care has began. Monitoring a patients airway also begins as every patient is very different. This child was a special needs. Plus the call came in as a suspicious subject.
Before the injection the monitor equipment should have been ready in event the airway of issues and or monitoring.
Bottom line negligence! As the Life Safety Net was not used as standard of care.
Retired 25 year critical care paramedic, flight paramedic, Fire Officer.
What happened to the Falk medic, ? he received the patient. Is he in the clear?
Nice videos. In the Netherlands (EU) we give midazolam to exited delirium as paramedics. 5 IV, 10 IM, 10 nasal. works fine. Fun fact though, we get all the room when we arrive and police is awesom here. There like looking @ us with help faces instead of all the ''god mode'' storys i read below here.
There’s making a mistake or having poor training, and then there’s negligence, which there are levels of too. I’ve seen medics who want to act like a hero, and ones who are a hero. Negligence isn’t always a lack of training, it’s thinking you’re WAY BETTER THAN YOU REALLY ARE without regard for the consequences which should be an indicator that something bad will eventually happen. So where’s the threshold between messing up in an understandable way you just didn’t see coming AND… oh man, that person should never have been allowed on the Department?
imho this will scare good people away from being paramedics
I don't disagree with you on most everything you've said here, especially the bigger key points. I think sloppy assessment is the main culprit here but isn't being treated like it by those outside of medicine. Having worked here in the Denver area as a paramedic and with Aurora Fire specifically, I can't say I was unsurprised at the sloppy assessment just as after hearing their name dropped. I don't think those paramedics went to work that day intending to be bad people and kill a patient, and the optics behind criminal negligence are blurred by ketamine, but on the other side of that coin an agency that seems colloquially known in this area to have poor medicine only had a matter of time until something like this happened because of it. It's why I take care to teach good patient assessment so much and so often to any students I have.
Then issue with Elijah and these paramedics is just the drug they administered. The issue here was Tue fact the EMTs did not do any assessment of the patient before administered drugs. After giving him an overdose due to the lack of an assessment, they did not follow up with any care or observation of his reaction to their treatment. It almost looks like the EMTs were either lazy or afraid to do their jobs.
First and foremost as prehospital providers we are patient advocates and second we should always train and educate ourselves continuously to provide the best patient care possible. LEOs do not have a right or should be given the right by any prehospital provider to determine how we conduct patient care just as we don’t have any authority to determine when LEOs use or do not use their firearm
Both EMTs have been found guilty of criminally negligent homicide.
Yeah, that’s why I put that up on the screen during the video. They are also paramedics, not EMTs.
bro I was given ketamine - caused hospital delirium and made me trip out for almost a month, ruined my life. It's not a cool med.
I’m glad they were convicted. Their negligence was so gross that it caused a young man to die. We can forgive honest mistakes, but this was much worse than that.
True and I’m not necessarily arguing with you but what if I told you that mistakes in healthcare causing death happen every day and are almost exclusively dealt with in civil court. What line do you draw for criminal over civil?
@@PrepMedic
It's a good honest question. I work with nurses directly every day via general surgery and trauma surgery. Many times the fine lines are concent forms and even that gets blurry in extreme situations. To be honest I believe maybe somehow if it was half of the dose given (250mg) maybe everything would be different.
Side note, it could have been the routine go to amount. For like violent drunks, I have no idea man.
Is that really that much ketamine? Thought it was a lot safer than that.
Have you done a video on excited delirium and cases of it? I know its something we were taught to identify and treat as a sheriff deputy while waiting for EMS to arrive on scene. More and more videos of sudden death from what appears to be force on force use looks to be excited delirium in conjunction with drug use/abuse.
But, I'm not a medical professional and would love to defer to your knowledge and experience. Would def watch that video.