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Elijah McLain

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If you’re gonna give ketamine 500mg to a 130lb vegetarian massage therapist after choking and taunting and threatening him for 15min, you better know how to deal with it’s effects. My old residency director would have called it an anesthesia clean kill. My delightful, loving Aspy nephew waves his arms too.



His last words.....

B1A89B3E-1F7F-4913-AF57-9A5CB959CE2D.jpeg 23B0B4B7-0200-4BEB-A590-929FA0180A9D.jpeg

Say his name.
 
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AdmiralChz

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did the responding paramedics really administer 500 mg of ketamine? as a sedative for acute agitation?!
they obviously have no clue about the dosing and indications for giving ketamine..

Many agencies including mine locally provide only a 500 mg 10mL vial for a 25 mg dose. I am sure that’s how the excessive dose occurred.
 

Mad Jack

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If you’re gonna give ketamine 500mg to a 130lb vegetarian massage therapist after choking and taunting and threatening him for 15min, you better know how to deal with it’s effects. My old residency director would have called it an anesthesia clean kill. My delightful, loving Aspy nephew waves his arms too.



His last words.....

View attachment 310759 View attachment 310760

Say his name.
This is brutal murder for literally no reason, jesus christ
 
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Eagles6389

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My first thought was that the ketamine is horribly overdosed. However, a lot of sources online list 4-6 mg/kg for IM acute agitation dosing. Idk how much he weighed, but the 500 mg may not have been that far off from the 4-6 mg/kg

When I read that he had two MIs on the way to the hospital though, first thought was the sympathomimetic actions of ketamine and myocardial depressant effects combined with the fact that this dude was just put in chokeholds restricting oxygenation to his brain... a bad, bad combo
 
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crash2500

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My first thought was that the ketamine is horribly overdosed. However, a lot of sources online list 4-6 mg/kg for IM acute agitation dosing. Idk how much he weighed, but the 500 mg may not have been that far off from the 4-6 mg/kg

When I read that he had two MIs on the way to the hospital though, first thought was the sympathomimetic actions of ketamine and myocardial depressant effects combined with the fact that this dude was just put in chokeholds restricting oxygenation to his brain... a bad, bad combo

He weighed 140 lb. That's almost double the dose.
 
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chocomorsel

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Many agencies including mine locally provide only a 500 mg 10mL vial for a 25 mg dose. I am sure that’s how the excessive dose occurred.
Come on man. That is a sorry as s excuse. We all get given the 500mg vials because not many places have the smaller doses. But we know how much to give because we are educated on those matters. We all know that the 500mg dose is induction dose for a small cow.

Come on, they shouldn’t use drugs they are unfamiliar with.
Totally a clean kill.
 
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chocomorsel

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If you’re gonna give ketamine 500mg to a 130lb vegetarian massage therapist after choking and taunting and threatening him for 15min, you better know how to deal with it’s effects. My old residency director would have called it an anesthesia clean kill. My delightful, loving Aspy nephew waves his arms too.



His last words.....

View attachment 310759 View attachment 310760

Say his name.
There are so many of these cases. If you start digging there will be no end in sight.
Grab a f ucking big ass shovel and start mofos!!!
 
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pjl

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Come on man. That is a sorry as s excuse. We all get given the 500mg vials because not many places have the smaller doses. But we know how much to give because we are educated on those matters. We all know that the 500mg dose is induction dose for a small cow.

Come on, they shouldn’t use drugs they are unfamiliar with.
Totally a clean kill.
They are ****ing idiots, however ketamine is the worst packaged drug we use. Most other drugs paramedics use are not going to kill someone if the whole vial is given. Add in a stressful situation, and you have stupid mistakes.
This is another terrible case made worse by lack of education and professionalism.
 
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Eagles6389

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He weighed 140 lb. That's almost double the dose.

Yeah. So if going by the high end of dosing I saw quoted online at 6 mg/kg, that’s still about 80 mg overdosed.

The article mentioned that “they found no error in the dosing of the ketamine that the paramedics used” which seems odd to me, as it’s clearly over. I get that the police escalated this situation inappropriately, but also gotta take a serious look at the paramedics culpability here: the guy most likely lives if he isn’t hit with a massive dose of ketamine like that.
 
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AdmiralChz

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Come on man. That is a sorry as s excuse. We all get given the 500mg vials because not many places have the smaller doses. But we know how much to give because we are educated on those matters. We all know that the 500mg dose is induction dose for a small cow.

Come on, they shouldn’t use drugs they are unfamiliar with.
Totally a clean kill.

No excuses, was just saying that’s how they administered so much. EMS just got ketamine here to use for the first time 3 months ago, I could easily see this happening here locally. I am one of the medical directors so I am (peripherally) involved. Don’t take my comments the wrong way.
 
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deleted480308

If you’re gonna give ketamine 500mg to a 130lb vegetarian massage therapist after choking and taunting and threatening him for 15min, you better know how to deal with it’s effects. My old residency director would have called it an anesthesia clean kill. My delightful, loving Aspy nephew waves his arms too.



His last words.....

View attachment 310759 View attachment 310760

Say his name.
Dude, the video was 3hr.

i watched a lot kf officer 2 but it was primarily a view of the grass. Can you timestamp the taunting? What i saw was an initial approach of a guy who didn’t stop when told , then resisted cuffing, then I couldn’t see the following struggle (didn’t watch long enough to see theketamine)
 

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Not trying to say that 500mg Ketamine was not the primary cause of his death.

When I was in residency, I had a pt in PACU who just could not wake up after EGD. He was 50ish, cancer pt with a weight of 40kg.

Later I found out that he received 300mg Ketamine! However he maintained spontaneous breathing, VSS and was discharged 6 hours later.
 
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Mad Jack

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My first thought was that the ketamine is horribly overdosed. However, a lot of sources online list 4-6 mg/kg for IM acute agitation dosing. Idk how much he weighed, but the 500 mg may not have been that far off from the 4-6 mg/kg

When I read that he had two MIs on the way to the hospital though, first thought was the sympathomimetic actions of ketamine and myocardial depressant effects combined with the fact that this dude was just put in chokeholds restricting oxygenation to his brain... a bad, bad combo
He weighed 59 kilos
 

nimbus

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Not trying to say that 500mg Ketamine was not the primary cause of his death.

When I was in residency, I had a pt in PACU who just could not wake up after EGD. He was 50ish, cancer pt with a weight of 40kg.

Later I found out that he received 300mg Ketamine! However he maintained spontaneous breathing, VSS and was discharged 6 hours later.

Yeah many people will survive. But don’t do that to random people on the street with unknown medical history if you are incapable of supporting their ventilation and hemodynamics. I think most people on this board could keep this guy alive even after 500mg of ketamine. Those paramedics were apparently not up to the job. I wonder how much training they received and how many times they actually administered ketamine. Is it their standard protocol to give the whole f**king vial to everybody? The ketamine “program” started in 2019.
 
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nimbus

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My first thought was that the ketamine is horribly overdosed. However, a lot of sources online list 4-6 mg/kg for IM acute agitation dosing. Idk how much he weighed, but the 500 mg may not have been that far off from the 4-6 mg/kg

When I read that he had two MIs on the way to the hospital though, first thought was the sympathomimetic actions of ketamine and myocardial depressant effects combined with the fact that this dude was just put in chokeholds restricting oxygenation to his brain... a bad, bad combo

He probably had cardiac arrests, not MI’s, enroute to the hospital. The press often confuse the two.
 
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chocomorsel

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He weighed 140 lb. That's almost double the dose.
It’s 1-2 then 3-4 then 5-6 for IV, IM and Oral. I don’t use it much but those numbers I remember
And also, those are induction doses. Not sedation doses.
I was of course thinking in IV doses but this is way overkill.
 
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chocomorsel

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disgusting. the lack of education, lack of knowledge, lack of pure damn common sense and shoot first mentality of our police forces is abhorrent. it's clear that police officers often play off of one another to escalate a situation. fire those involved.
Fire and charge them. Is there a statute of limitation for murder? Or is that set state by state? If so then get the Feds involved because his civil rights were violated.
 
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coffeebythelake

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It's easy to say that with the weight right there. The paramedics may not have known it and just estimated.
I agree this is super wrong, and a kill. But i've given 250mg IV in <30 minutes in MAC case and patient was still wide awake...

Difference, u titrate to effect and not bolus
 
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GASPER20

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Pediatric Ketamine IM dosing is 3-4mg/kg with up to 10mg/kg. Adults is 6-13mg/kg. He was given ~8mg/kg IM dose. Alone, it probably didn't kill him, but with everything else that happened to him, it definitely didn't help.
 
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MediMike

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Pediatric Ketamine IM dosing is 3-4mg/kg with up to 10mg/kg. Adults is 6-13mg/kg. He was given ~8mg/kg IM dose. Alone, it probably didn't kill him, but with everything else that happened to him, it definitely didn't help.

That dosing is manufacturer recommendation for induction. Not for managing agitation, agitated delirium, acute psychosis etc as those are all off label uses.

Would assume that the vast majority of individuals you are inducing with ketamine aren't in the midst of a catecholamine surge. The generally accepted dosing of IM ketamine for prehospital use (in my experience) is around 4-6mg/kg with a max of 500mg.

Dude got way too much.
 
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kmurp

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So what are you saying? Ketamine hardly contributed?
I don’t really know. I made a mistake once (a bad one) working in an unfamiliar hospital where the ketamine was 100/ml and I was used to seeing it in 10/ml. Used it for induction in a septic patient and they survived. They needed some pressors and ETT though.
 

chocomorsel

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I don’t really know. I made a mistake once (a bad one) working in an unfamiliar hospital where the ketamine was 100/ml and I was used to seeing it in 10/ml. Used it for induction in a septic patient and they survived. They needed some pressors and ETT though.
They survived because YOU were taking care of them and know how to take care of a patient who drops their pressures, or goes apneic with those drugs. You think these EMTs know what to do? Hell did you see how nonchalantly they put Mr. Floyd on the stretcher when he clearly needed CPR and Oxygen?
 
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Brick Majors

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Paramedics should not be using ketamine. A, that’s too high of a dose. B, ketamine is not always completely predictable. Use it enough, you’ll see some things you weren’t expecting. Not a good medication for people of that skill level.

Most importantly though, cops and paramedics shouldn’t be murdering people.
 
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chocomorsel

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They say he looked suspicious.
Because Mr. Pena thought he shouldn't be wearing a mask. So what we can't wear masks in public? That's suspicious? I mean, can we stop calling police on black people?
Would not be surprised if this guy is gonna get some hate phone calls or mail. What a jerk.
 
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AMEHigh

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If this story doesn’t make you angry and see the need for change, then nothing will. He should be alive today.

But there was also Tamir Rice, John Crawford, Eric Garner, etc etc, etc, so we’ll see.
 
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If this story doesn’t make you angry and see the need for change, then nothing will. He should be alive today.

But there was also Tamir Rice, John Crawford, Eric Garner, etc etc, etc, so we’ll see.
Agreed, when you take someone into custody it should be a bare minimum standard that they get reasonable medical care
 
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chocomorsel

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There was no reason to take him into custody. The officer who looks to be in charge is asking if "there's no other suspicious.... nobody else was under attack.... "
He didn't seem convinced the guy needed to be arrested.
Totally disgusting to arrest him. I can't imagine what his parents went through and nothing happened to the cops or paramedics.
People get scared and act erratically when being arrested. This kid should be alive.
 
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Ezekiel2517

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Here's the video of Elijah actually getting injected w the ketamine. He does not appear to be in a state of agitation at all and is restrained by multiple officers. There was no need for him to get it. You can see they definitely inject the full 10 cc syringe. I once had to emergently ketamine dart a young dude w no IV access going thru DT's and on a rampage going after people. Probably weighed 250 easy, most of it muscle, gave the full 500mg. It was lights out.
 
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chocomorsel

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Here's the video of Elijah actually getting injected w the ketamine. He does not appear to be in a state of agitation at all and is restrained by multiple officers. There was no need for him to get it. You can see they definitely inject the full 10 cc syringe. I once had to emergently ketamine dart a young dude w no IV access going thru DT's and on a rampage going after people. Probably weighed 250 easy, most of it muscle, gave the full 500mg. It was lights out.
What is gonna cause a heart attack in a 23 year old kid who's not on Meth or Cocaine or Speed or whatever uppers people like to enjoy?
The marijuana?
The Medical examiner couldn't determine the cause of death? Are you serious? How about the police tell him what they think happened and he/she goes along with his/her friends.
Disgusting.
If a white boy had been walking around in a ski mask, would Mr. Pena have called the police on him? A sshole.
 
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abolt18

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True story here. When I was in 6th grade, had a friend over. My older brother (9th grade, on the wrestling team), thought he was being funny when he put my friend in a choke hold. My brother was startled when my friend went limp a moment later so he let him go. My friend fell face first onto the kitchen floor unconscious. Busted his chin open and broke his jaw. Got his chin glued and his jaw wired shut after he had to have a surgical repair of his broken mandible...

This whole story is just to remind us all that teenagers can be idiots. And if they go limp, set them down gently.
It’s actually fairly high as well - as long as you let go once the dude goes limp.
 

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This whole story is just to remind us all that teenagers can be idiots. And if they go limp, set them down gently.

The video is shocking. Elijah is immobile and subdued, and they ketamine dart him? Wtf for? This has the look of someone giving a lethal injection.

Everyone should be aware that if you call the cops on someone "acting suspicious" or whatever, *especially if black/brown* that night be the first step in getting them killed. The "Central Park Karen" case comes to mind.
 
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chocomorsel

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Why do you write like this? How old are you? Maybe try some complete sentences?
Do you suppose paramedics are well versed in propofol?
I am no expert but I think titrating midazolam to be able to estabilish Iv, and then giving propofol once you have iv, plus a complete monitoring, intubation and even na if bp eventually goes down, should be the more optimal choice then ketamine. I mean giving ketamine in the middle of an adrenergic storm is at least counterintuitive to be politically correct.
 
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chocomorsel

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I am sorry I probably didn’t express myself correctly. My point is I personally think ketamine was not used appropriately here.
Also ketamin in my opinion is not a good medicine even in the rare case of a suspected excited delirium.
Thank you. That is so much better to understand. Completely agree.
He needed no drugs at all. He needed to be left alone from the get go.
How do these officers sleep at night? Are they just full on sociopaths who don't give a damn about who they kill?
 
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abolt18

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The video is shocking. Elijah is immobile and subdued, and they ketamine dart him? Wtf for? This has the look of someone giving a lethal injection.

Everyone should be aware that if you call the cops on someone "acting suspicious" or whatever, *especially if black/brown* that night be the first step in getting them killed. The "Central Park Karen" case comes to mind.
I was talking about my brother being an idiotic teenager. Not Elijah.
 

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Thank you. That is so much better to understand. Completely agree.
He needed no drugs at all. He needed to be left alone from the get go.
How do these officers sleep at night? Are they just full on sociopaths who don't give a damn about who they kill?

@chocomorsel I have often thought about this when I watch yet another video of a person exterminated by the police who posed no real threat. Have you ever worked with a doctor or nurse who just does not appear to care anymore when something terrible happens? I remember this one shift I was working when a child came in after being beaten to death by an adult. Worst **** I’ve ever seen in my life. Literally every single person in the room beside themselves- doctors, nurses, everybody. ER doc cold as ice, no emotion, no reaction, even made a flip remark that was just so crazy to me. I’ve worked with many people like this over the years l. I think some people are either sociopaths as you said or they become so desensitized to death and destruction of other humans because they see it so much that they turn into someone who could kill another person and not lose a wink to sleep. I do wonder if some of these police officers have hit that point of no return. Is it PTSD? Is it a personality disorder?
How do you kneel on a human being’s neck until they die while they’re begging for their life and calling for their mother?? I have seen some terrible stuff but I’m so glad I haven’t become so disconnected that I have no emotion anymore when something awful happens or is happening.
 
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chocomorsel

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@chocomorsel I have often thought about this when I watch yet another video of a person exterminated by the police who posed no real threat. Have you ever worked with a doctor or nurse who just does not appear to care anymore when something terrible happens? I remember this one shift I was working when a child came in after being beaten to death by an adult. Worst **** I’ve ever seen in my life. Literally every single person in the room beside themselves- doctors, nurses, everybody. ER doc cold as ice, no emotion, no reaction, even made a flip remark that was just so crazy to me. I’ve worked with many people like this over the years l. I think some people are either sociopaths as you said or they become so desensitized to death and destruction of other humans because they see it so much that they turn into someone who could kill another person and not lose a wink to sleep. I do wonder if some of these police officers have hit that point of no return. Is it PTSD? Is it a personality disorder?
How do you kneel on a human being’s neck until they die while they’re begging for their life and calling for their mother?? I have seen some terrible stuff but I’m so glad I haven’t become so disconnected that I have no emotion anymore when something awful happens or is happening.
That kid could technically have been my son, if I had started in my teens. He just looks so kind. I just don't understand. His face looks so sweet and innocent as well his videos. He certainly was quirky. And no one can come here and say that "Well, he had a criminal record, or he stole some CD's" bull****, basically trying to justify what happened to him. I can't imagine what his mother went through and when she found out about no charges in January, I bed she was crushed.
This is just as bad if not worse than George Floyd. He was literally walking and minding his own business, bothering no one. No "counterfeit" $20 to call the police about. I don't remember hearing about this on the news at all when it happened. Why?
If we start turning over some rocks we are gonna find mass graves of people who should be alive today.

I am thinking the police force attracts a high number of sociopaths. And the ones who are not sociopaths, you are right. They get jaded and become cold. It's disgusting.
 
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