I talked down one or two people from completely destroying their environment while in such a state, by using deliberately de-escalatory calming techniques.
I’m aghast the police would use such a substance because it is indeed a recipe for disaster when mixed with their expectations of behavior.
I really doubt the club kids to saw had taken anything like the equivelant of 300mg or 500mg taken IM (2x the bioavailability of intranasal), or even intranasally. If you are standing, 50-75mg taken intranasally can cause transient, trance-like states like you describe. 100mg taken intranasally (50g IM equivalent) is enough such that most people couldn't safely walk, and would have closed-eye visuals almost like a lucid dream. 150mg intranasally will guarantee a k-hole for most people, and 300mg plus would render all but those with extreme tolerances unconscious.
I should also add that the ones whom I had to talk down were probably also on heaven-knows what other substances at the time.
All I can say for what I did at the time was an intuition that I was confronted with a half-tranquilized, large confused ape and so acted as to prevent them from panicking and running amok with calm words, movements, and (most importantly I suspect in that state) caring touch.
Iv dose for induction of general anesthesia is ~3-5 mg/kg. Or ~5 mg/kg intramuscularly.
The main thing with ketamine is that it causes tachycardia/arrhythmias and increases blood pressure. While that can be desirable for people in shock, it is a big problem if the person is already under proarrhythmic drugs (e.g. cocaine).
In Europe, we use antipsychotics for similar situations (haloperidol).
Key point though: you wouldn’t give the pt 8 mg/kg in a fucking bolus. Time to onset for sedative effect is fast (10min or so); time to peripheral adverse effects can easily take an hour. You’d start way lower than 8, and work your way up if you needed to.
Well yeah, but as I understand it the goal is not to intubate in this case, right? So in my opinion, 6 is already way too much.
In fact, I don't think we can agree on a safe standard dose in this case. Which suggests that it's not the right choice of drug for that use case...
But yes, it’s a lot.
Never underestimate the degree to which racism is driven by actual, irrational terror.
Biologically, this is utter nonsense. But the belief that black people are tougher, stronger, and more capable of withstanding pain and drugs is a surprisingly common belief. Doctors are notorious for downgrading black pain in clinical situations as compared to white patients, and administer less pain killers.
Apologies to the HN users who will be incensed at the notion of race playing a role in this situation.
https://www.aamc.org/news-insights/how-we-fail-black-patient...
No apologies necessary, receiving a dose of reality is good for them.
I know how much I weigh, but I don't know how much anyone else weighs. I guess some other people don't even weigh themselves so don't even know how much they weigh.
How do you estimate it?
Practice. In theory if you're doing this a lot, you should be able do a decent job of estimating +/- 10%, which is more than accurate enough.
There are certainly other complications (some medications are dosed on "ideal body weight" (ignoring subcutaneous fat), etc...)
In fairness, we're usually estimating the weight of people of fairly fit builds, but with some practice estimating people of other builds, I agree that you'd get within 10%.
I don't think I've ever heard an adult male ever mention their own weight in public. You can see why it'd be hard to estimate when you don't have any data.
https://inpublicsafety.com/2015/01/tackling-the-obesity-epid...
and here:
"FBI: 80 Percent Of Police Officers Are Overweight"
https://dfw.cbslocal.com/2014/08/14/fbi-80-percent-of-police...
Why on earth would you come to challenge something without first checking if its true?
315 milligrams is still.. a lot. Especially injected into the bloodstream (I presume?) all at one time. Enough to really wrangle your marbles even if you're used to that kind of stuff.
edit: To expand, that's about the dosage most people would get delusions of some sort, but not be 100% immobilized. That is a recipe for disaster around angry cops.
edit2: It's bio-availability is actually twice as high intramuscularilly than insufflated.. well you wouldn't be fighting the cops but dear god I would not want to experience that.