Versed injection as a police weapon

[HallsofIvy]

So we'll take this then as your medical release to be injected involuntarily if necessary, at the diagnosis and sole discretion of someone who is not a trained medical physician?

Uhm, they "ARE" trained EMT's. Did you not read the article? The police are merely calling an ambulance and letting the EMT's take over. "THAT" is the change in the police policy. Police are now recognizing that some people may be having medical problems and calling for medical help instead of throwing the person into a jail cell. OY!

Evo, I tend to be with you but in fairness to LowlyPion, he did say "physician" not "EMT".

 

[LowlyPion]

These are now required on the London underground

In the US the sign would merely serve as a target that might as well read "Shoot Here".

 

[Moonbear]

Thanks Berkeman, going back it seems they ARE paramedics and not EMT's, so that would make the difference.

Not enough of a difference for me. Versed is given in controlled clinical settings normally, where there is resuscitation equipment available in the event of overdose (while paramedics have this equipment, it sure isn't make a situation better to need to use it in the field...resuscitation equipment is meant to stabilize an unstable patient, not to fix the mistakes of paramedics). Before one is administered Versed in a clinical setting, one would answer a lengthy questionnaire to assess any contraindications including both health conditions and other medications, sign a consent form for treatment, and have trained medical professionals with resuscitation equipment present in the event of an adverse reaction. Giving a drug of that class to someone in the field without knowing any history could very easily be a death sentence. They're trying to tout it as safer than physical restraint, but to administer it, they need to physically restrain the suspect...and the physical restraint to get someone hogtied in handcuffs or 4-point restraints to a guerney would be far less than to hold someone still enough to get an IV into them. Versed is administered IV, which is NOT easy to give to a even a squirming person let alone someone outright fighting and resisting arrest. If they can be restrained and need medical care, they can be strapped to a guerney and transported to a hospital where a medical team can evaluate what treatment is needed.

Just because they've been lucky so far and not killed anyone or caused birth defects when giving it to a pregnant woman doesn't mean it's safe or should continue to be used, or should ever have been used.

 

[Evo]

I'm not necessarily pro Versed use, as I mentioned before, is it really necessary to knock the person out or simply sedate them? I am all for the recognition that a person with a serious mental problem should be sent to the hospital and treated as a mental patient and not as a criminal and dumped in the county jail.

 

[Math Is Hard]

I was given Versed for sedation when I had my wisdom teeth surgery. They checked my weight and blood pressure a few days before and I had to fill out lots of questionnaires about my medical history and any meds I might be taking. I was restricted from eating after midnight the night before, and before I went under they hooked me up to machines to monitor my heart rate and blood pressure. It just seems like Versed isn't something to mess around with.

 

[LowlyPion]

Within the context of the OP and the title of the thread - Versed injection as a police weapon - I think there clearly are ethical issues inherent in such use.

This is not to say that there are not legitimate medical uses. Merely that the deployment of such drugs as a "weapon", and not in a situation in which the well being of the individual is the higher concern, that would seem to create a potentially unsolvable conflict in goals that should discourage its use in all public order enforcement situations.

 

[Evo]

Within the context of the OP and the title of the thread - Versed injection as a police weapon - I think there clearly are ethical issues inherent in such use.

This is not to say that there are not legitimate medical uses. Merely that the deployment of such drugs as a "weapon", and not in a situation in which the well being of the individual is the higher concern, that would seem to create a potentially unsolvable conflict in goals that should discourage its use in all public order enforcement situations.

That's the main problem with the article, it is sensationalist and misleading, well, it's downright false. The police aren't using it and it's not a "weapon". The title of the article makes it sound like crazed policemen are running loose carrying hypodermics full of the stuff and jabbing people with it.

My understanding of the article after you dismiss the phony headline, is that police are removing themselves and handing the person over to the paramedics. What I question is why Versed? isn't that a bit extreme? Does the patient need to be knocked out? Other than that, I think the drug of choice is too extreme, I think some sedation and moving the crazy person from a criminal handling to a medical handling is correct.

But like I said, I haven't read up on this enough to jump to any conclusions.

 

[LowlyPion]

My understanding of the article after you dismiss the phony headline, is that police are removing themselves and handing the person over to the paramedics.

Regardless, involving an EMT in a public order issue sets in motion a conflict in goals. Whether it is an EMT or a policeman wielding a hypodermic, the collision of goals - the Hippocratic Oath v. oath to uphold civil order is not necessarily a solvable problem given the extremely low likelihood of medical history availability or other chemical or drug factors present in the individual.

It's my opinion that neither the policeman nor the EMT are qualified to make a decision about involuntarily injecting drugs into a patient absent consent and full knowledge of suitability for the condition of the patient.

 

[Evo]

It's my opinion that neither the policeman nor the EMT are qualified to make a decision about involuntarily injecting drugs into a patient absent consent and full knowledge of suitability for the condition of the patient.

But they would be sedated as soon as they got to the ER if they were that violent, so you're only delaying the decision by a few minutes. At the ER, they would not wait for information on the patient for consent or a background either.

 

[LowlyPion]

But they would be sedated as soon as they got to the ER if they were that violent, so you're only delaying the deciosn by a few minutes. At the ER, they would not wait for information on the patient for consent or a background either.

You're apparently assuming facts not in evidence. You're presupposing an anecdotal in which everything works ideally. You're not accounting for the situation in which the individual lapses into seizure and arrives dead, and you have an "I didn't know he had any meth in his blood." as they wheel the body to the hospital morgue.

 

[Evo]

You're apparently assuming facts not in evidence. You're presupposing an anecdotal in which everything works ideally. You're not accounting for the situation in which the individual lapses into seizure and arrives dead, and you have an "I didn't know he had any meth in his blood." as they wheel the body to the hospital morgue.

What would be different the moment he arrived at the ER and they sedated him to get him off the gurney and into a hospital bed?

 

[LowlyPion]

What would be different the moment he arrived at the ER and they sedated him to get him off the gurney and into a hospital bed?

One thing that would be different is the facilities and resuscitation skills available to undo the harm they would have caused. The other would be that a doctor would have had oversight in the process.

 

[Evo]

One thing that would be different is the facilities and resuscitation skills available to undo the harm they would have caused. The other would be that a doctor would have had oversight in the process.

Do you know how little doctor oversight there is in crowded ER's? Several of my friends worked ER while going for their specialties to pick up extra cash.

 

[TheStatutoryApe]

http://forums.studentdoctor.net/archive/index.php/t-426437.html

Versed is apparently used often for chemical restraint and seizures and can be introduced intramuscular instead of IV which a lot of these responders state makes it quite useful when you can't get an IV in a patient. It's also apparently sometimes used in transport. That is to say, long before they have any history or test results on the patient.

This is not to say that there are not legitimate medical uses. Merely that the deployment of such drugs as a "weapon", and not in a situation in which the well being of the individual is the higher concern, that would seem to create a potentially unsolvable conflict in goals that should discourage its use in all public order enforcement situations.

I think that the wellbeing of the individual is the point. I think it is likely easier and more common to simply hogtie the person, throw them in a cell or truck, and leave them to their own devices whether that be bashing their head against something and injuring themselves or not.

How would you propose to keep a person undergoing a psychotic break from injuring themselves and others?

 

[LowlyPion]

Do you know how little doctor oversight there is in crowded ER's? Several of my friends worked ER while going for their specialties to pick up extra cash.

Again I'd say that's quite beside the point and a problem appropriate for another topic. It's hardly a justification to permit its use outside a medical setting and most especially not when weighed in the balance between public order or the potential for grievous bodily harm.

 

[LowlyPion]

How would you propose to keep a person undergoing a psychotic break from injuring themselves and others?

Whatever the solution, the use of drugs represents an unacceptable risk to the individual. How is it that a mean drunk might effectively be dealt a death sentence as a punishment, when if only taken to jail they might receive a little jail time?

It's use is to be tolerated until some EMT hits a snag and they are faced with respiratory seizure or cardiac arrest as a direct result of a misapplication? Will that then be the day that those that would defend its use now would be satisfied that it posed an unacceptable risk?

 

[TheStatutoryApe]

Whatever the solution, the use of drugs represents an unacceptable risk to the individual. How is it that a mean drunk might effectively be dealt a death sentence as a punishment, when if only taken to jail they might receive a little jail time?

A mean drunk is not a person suffering a psychotic break.

It's use is to be tolerated until some EMT hits a snag and they are faced with respiratory seizure or cardiac arrest as a direct result of a misapplication? Will that then be the day that those that would defend its use now would be satisfied that it posed an unacceptable risk?

And what is the risk that a person suffering a psychotic break may critically injure themselves or others while not properly sedated? How many times do you think such a thing has happened to result in the policy of sedation?