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So just so I'm understanding you, you think it is appropriate for people with ~90 days of training to be administering sedatives on the side of the road under orders from law enforcement, with no doctor involvement?
Lmao, I appreciate your concern because no that would not be appropriate in any way shape or form. However an EMT cannot administer sedatives. A paramedic can. One needs to have the 4 months of EMT school plus a minimum of one year of paramedic school, to be a paramedic. The program I teach at starting from no training through paramedic school is two years.
Additionally, I understand the general population doesn’t understand or is not exposed to what the capabilities of EMS is or how it works but id be happy to answer and explain any details that you’d like. But to start no, none of this happens without a physician. The physician is present in this situation in the form of protocols which are essentially a prescription that paramedics are authorized to follow without talking to a physician in real time.
But, I will agree I think the two years is a fairly small requirement for the invasive procedure and access to anesthesia medications that we as paramedics have and are authorized to use without having a doctor near us. It gets even crazier to think that I in my current roll am authorized to perform some emergency surgeries, such as cricothyrotomy and finger thoracostomy, as well surgically placing chest tubes and even perform a pericardiocentesis.
So sure it sounds bad from the outside if I say after one year of paramedic training I can cut a hole in someone’s chest on the side of the road to stick my finger in, or stab a needle into their heart, after I sedate then paralyze them, intentionally stopping their breathing just to place a breathing tube before putting them on a ventilator. That is stuff that all requires very specific training, any sort of surgery is generally only performed by doctors, paralytics and intubation is more specifically an emergency physician or anesthesiologist and ventilators are generally a respiratory therapist’s job. But that’s the beauty of paramedicine, we can do anything as long as we are acting in good faith trying to help someone. BUT systems that allow us to do pretty much anything I just listed are not “get hired out of school” programs. The minimum is generally 3 years as a paramedic in a busy system, but most require five years. In addition to the minimum experience, the extra skills are taught to us on the job by physicians, who individually validate that we are competent and capable to perform them. If the agency is associated with a hospital more often then not we will be required to work with our medical director and perform the skills on real patients before we are allowed to perform them on our own.
If you have any more questions or would like any more information just ask! I love my job and enjoy teaching others and advocating for the profession.
Hi - I'm not the original commenter, but your text is very thoughtful and insightful. I appreciate you writing your comment, I think it cleared up at least a few of my misunderstandings in a very clear and understandable manner. Thank you for your post, internet stranger :)
Absolutely! If you have any questions or want anything explained differently, just ask!
I get and appreciate what you're saying, but I still have a problem with EMS being able to sedate people just walking home on the orders of the police.
It is literally insane to me that the police can just tell EMS to dose someone with ketamine. You might be able to convince me it was justify with a known dangerous person, in the process of fighting everyone off, maybe. But this case shows, all it takes is a cop convincing a willing EMS person to just do it and then we get dead innocent people.
It is not our job to determine who is innocent and who is guilty. Law enforcement does not direct medical care, if the medic gives meds it is their responsibility to ensure they are giving them appropriately.
In this situation, there was a patient fighting with law enforcement and EMS was requested. They don’t know what the patient was doing before they showed up but they have to make a decision about what to do with what they see and what they are told. A sign that someone has a brain bleed is becoming combative. If they let a patient with a brain bleed continue to fight with law enforcement, the patient will die, which means failing to act will result in the death of an innocent person. Appropriately sedating and managing a patient with a brain bleed and they might live. We don’t get the details of what’s doing on with someone the same way doctors in a hospital do.
Do not apply what happened in this situation as if it is a common occurrence, it isn’t. The negligent actions of these medics lead to them being charged criminally. I don’t know everything that happened so I do not want to comment on what I this is or is not appropriate in this case, however a jury that was given the details of this case determined that they were negligent and cause someone’s death and convicted them of that.
You don’t need to like that it is part of our job and our training but it is and we do it appropriately every single day. This time they did it in a way that lead to a jury convicting them of charges after their actions lead to a patients death. Go spend some time around EMS, we might be a bit strange but most of us joined this profession to help others, not force our will on others.
That's the contention, that's why they're going to jail, there is no proof this man was fighting anyone. The police put him in a choke hold seconds after the encountered him then order paramedics to sedate him!
That this as a default in our system where they "just follow orders" and sedate people is troubling and I don't know why you don't understand that...
Because that is not why they were convicted. They were convicted because they did not assess the patient before administering sedation, then continued to not assess or monitor him in any way after administering sedation.
The “just follow orders” to sedate someone is not how this works. When we give a med it’s on us, that’s why they were convicted.
I would love to remain impartial without seeing all the evidence but the more I see and learn about this incident I’m losing that ability. Partially because I don’t think I could stomach all the evidence due to how grossly negligent these individuals were. They are a disgrace to paramedicine.
I will continue to stand by my previous comments as I was speaking in terms of how things should work, situations like this are part of the job. However these two assholes should be ashamed to have ever called themselves paramedics.