Ketamine Restraint by Law Enforcement/EMS

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Impromptu

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Police are having paramedics use ketamine to chemically restrain agitated people. While it might seem like a good use, they have a 24% complication rate, including a death. And their common diagnosis of 'excited delirium' seems questionable.

Now the Colorado Society of Anesthesiologists has issued a statement about the use of ketamine in this manner. They have asked for an immediate halt and review of the practice.

I do not like the idea of using our anesthetics for purposes like this. They are using a dosing high enough to induce general anesthesia. The high complication rate shows just how dangerous these drugs can be. The rapid increase in the number of times EMS has been asked to use it is also alarming. Finally, this use can undercut the public's trust in those that use these drugs for legitimate purposes, like the actual practice of anesthesia.

Colorado Society of Anesthesiologists statement on ketamine use by law enforcement

Denver Post Article

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Setup for Dunning-Kruger effect. Hopefully the ASA will weigh in too.
 
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Long and short of it is...(and I'm not trying to start a political debate) the police can BARELY be trusted to use their firearms properly, they sure as **** won't use this properly. "Give a man a hammer and he'll find something to hit."
 
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Police are having paramedics use ketamine to chemically restrain agitated people. While it might seem like a good use, they have a 24% complication rate, including a death. And their common diagnosis of 'excited delirium' seems questionable.

Now the Colorado Society of Anesthesiologists has issued a statement about the use of ketamine in this manner. They have asked for an immediate halt and review of the practice.

I do not like the idea of using our anesthetics for purposes like this. They are using a dosing high enough to induce general anesthesia. The high complication rate shows just how dangerous these drugs can be. The rapid increase in the number of times EMS has been asked to use it is also alarming. Finally, this use can undercut the public's trust in those that use these drugs for legitimate purposes, like the actual practice of anesthesia.

Colorado Society of Anesthesiologists statement on ketamine use by law enforcement

Denver Post Article

How are they using it? Syringe? Blow dart?
 
How are they using it? Syringe? Blow dart?

When I watched a video of this occurring, the paramedic walked up to an already restrained man on his side/belly and slammed an entire syringe into his arm
 
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The attention drawn to this issue is a good thing for us. Right before Michael Jackson's cardiologist induced death, there were many other physicians clamoring to be given the right to use propofol. Even on this website, the GI docs were especially loud about their nonanesthesiologist administered propofol protocols. That chatter disappeared overnight. Even now I have patients asking me regularly about what agents I will use and Michael Jackson comes up often when propofol is mentioned.

I'm glad that our societies are taking a stand against people misusing our pharmaceuticals. Anesthesiologists should advocate against amateurs attempting anesthesiology.
 
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Police have no business giving any meds other than Narcan and that’s ONLY because it can be lifesaving and given intranasally. This has made a huge impact on overdose deaths.

I’m a medical director for the local EMS agency (little random, but I enjoy it), and there is a huge clamoring for ketamine to treat “excited delirium” as it was in this case. I have long cautioned against giving mega doses of IM ketamine to folks with unknown history and possible illicit drugs on board. ASA should reach out to ACEP and other more-typical EMS oversight boards and come up with a joint position statement. But we can’t even agree on NPO or monitoring standards so unlikely.
 
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Cops need to learn to restrain a person with love and kindness. (JK)

But really, they need to learn martial arts and be better trained. That is what Jocko says, and if he says it - we should all listen.
 
Coloroado association? The ASA? Where the heck are the local EMS directors (physicians) and the state and national EM societies? Honestly, ketamine aside, witness the state of EMS in this country and one would wonder if physicians are involved at all....
 
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