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They were certainly negligent in not properly assessing McClain (who was already restrained) prior to ketamine admin. Once ketamine was given, they then also failed to monitor and recognize cardiac arrest.
This case will likely lead to change in paramedic emergency care protocols.
I sort of feel sorry for the paramedics in the sense that they were too complacent and should have told the cops "no" when they tried to dictate patient care (as in, 'you need to sedate this dangerous person'). I work in healthcare too, so I'm familiar with cops trying to dictate medical care and the importance of advocating for your pt when that happens. It can be intimidating to tell a cop to fuck off, but sometimes you have to do it. If nothing else, it's your ass on the line.
I understand you work in health but I work as a paramedic and have a few thoughts. First, it is very common for us to go into a scene with law enforcement and sedate someone if we believe it to be appropriate. Excessive fighting with law enforcement and being tased repeatedly tends to be followed by death. So, it is much easier and safer for everyone to sedate someone.
What protocols do you think will change? Should we just let people die fighting with law enforcement? I have mixed thoughts on the details here if we as paramedics can be prosecuted if someone has a negative reaction to a medication, however, I don’t think that is the case here. It says they gave an extra 150-200mg of ketamine, not sure why, not sure what their protocols are but if their dose is something like 5mg/kg IM like protocols I’ve worked under then maybe they thought it was an appropriate dose because we are bad at estimating weight. Regardless, it is industry standard to monitor capnography when sedating a patient. If they didn’t because of complacency, that might be on them if there isn’t any extenuating circumstance but I can’t think of any that would reasonably justify not monitoring capnography.
In order for you to sedate someone, they must already be under control right? Or do you jump into the dog pile with a syringe full of ketamine?
Furthermore, you're unlikely to have been there for the initial encounter so who are you to judge whether someone is trying to hurt police versus someone who is being assaulted by the police after having committed no crime and is only trying to protect themselves from a bunch of roided-out criminals? These fights often involve police kneeling on people's arms and legs, immobilizing them completely, while shouting "give me your hands" or "stop resisting" so that it appears to bystanders that it's a two-way fight and not just a motionless person getting the shit beat out of them. I can't count the number of bodycam videos I've seen where you can clearly see the 'suspect's' hands pinned down by other police while being punched in the face for not putting their hands behind their back.
Sorry I missed this comment!
You might not like the answer to this. We don’t have the luxury of doing things the way they are done in controlled settings like doctor’s offices or hospitals. Law enforcement will restrain people and then all I need as a shoulder or a leg and about 3 seconds.
You are correct we are not generally there for the initial encounter. We do not make the determination if law enforcement is justified in fighting with people. Becoming combative is a symptom of quite a few medical emergencies. In situations like this I don’t decide who is right, that’s what court rooms are for. I do act in the way that I believe is best and safest for everyone. People in other comments don’t like this but even in this case, as a paramedic if I see someone fighting, throwing up, and going in and out of consciousness, I’m going to act as if they have a brain bleed. Which means aggressive sedation and airway management. Anything less or allowing fighting to continue significantly increases the risk of death for the patient.
Everything you described about law enforcement attacking people is why my personal philosophy is to stop the fighting. If law enforcement escalated a situation, who wins by me not doing what I can to stop the fighting? People can and do die from fighting with the police. People are much less likely to die if sedated and appropriately managed until they are discharged from the hospital.
That said, this case is an exception, the paramedics caused his death and were convicted as such. This is a very abnormal and unusual situation that disgraces the profession and it does not reflect how a competent paramedic would handle the situation.