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Wouldn't there be other more appropriate medications to calm someone without the possibility respitory arrest? Something like Xanax or Ativan for example? Not a pharmacist but Ketamine seems kinda hardcore.
Paramedic here, we don’t have access to a fully stocked pharmacy in our ambulance. Ketamine is pretty much the industry standard for situations like this. Its efficacy, safety profile, wide dose range, and rapid onset make it the ideal drug for managing violent behavior and sedation in a prehospital setting. I am not saying the medics made an appropriate decision in this situation but that is the appropriate mediation to use in situations like this. Versed would be a good runner up but is less effective in some situations with low doses and higher doses have a higher risk of respiratory compromise. Ativan is an option, if they carry it, I wouldn’t personally use Ativan in this situation because it has a longer onset/duration and higher chance of adverse reactions.
Ketamine might seem a bit excessive but it’s a very good medication for prehospital use. This is a situation that a lot of stuff went wrong and someone died. The cause of the death is more likely an adverse reaction that was not appropriate addressed by the paramedic, but that’s probably why they just got a conviction. But ketamine is used every day across the US without situations like this happening.
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I’m now smarter because of you. Thank you!!
Thank you for your kind words! I love that there is finally a topic that I can contribute to!
This may be completely wrong but I'm guessing ketamine so they can inject it rather than waiting on non injection medication. I'm not sure if the other two can be injected or if available but it was a thought I had for reasoning. Not that any of this situation was handled with reasoning, it's another tragedy in a long list of them. I have enough anxiety myself I can't imagine what that poor guy went through in his final moments.
Benzos have their issues, but I'd probably go there in case of something like a postictal psychosis, with Haldol being a second line. Ketamine and PCP have a similar mechanism of action, so it doesn't feel like a great med for someone with psychosis, but I'm also not a doctor or nurse, I just play one on ~~TV~~ the Internet.