Ketamine is only used to prevent the use of more force or injury in scenarios where there is potential for higher levels of force or injury to be occur. It is a mitigating agent for higher levels of force.

Well, apart from in the Elijah McCain case; or do you mean that ketamine mitigates the willingness of the responders to use lethal force?

If someone doesn't get ketamine, the alternatives are:

- they get tased, pepper sprayed, and thrown around by law enforcement officers

- they get a less safe drug like midazolam, lorazepam, or haloperidol

- they get restrained and fight against the restraints which puts them at risk of sudden death and rhabdomyolysis

....if there’s a real, imminent threat.

In some of these cases, it seems like the officers could have tried to de-escalate the situation while keeping these options in reserve in case that failed. The choices don’t have to be either immediate compliance or overwhelming force.

Even with animals—-where the use of drugs is a lot less ethically fraught—-ketamine isn’t necessarily the first option.

Sure, the indications for using it can be clarified. EMS would go for chemical restraint (i.e. ketamine) for someone where "excited delirium" is suspected. This doesn't mean literally anyone being ornery with the police - and generally we aren't even involved in those calls. A person in a normal state of mind won't break their arms or dislocate their shoulders when they're put in handcuffs. Someone who took too much meth very easily could.

In this case, it says they used 500 mg of ketamine in an injection, so basically they killed him with an excessive dose. Even though ketamine might have a higher LD50 you can't compare drugs without knowing the dose they are using.

https://en.wikipedia.org/wiki/Death_of_Elijah_McClain

500mg? Might as well just shoot (someone) in the head. Total unprofessionalism.

"normal" dose would be something like 10-30mg

My protocols for excited delirium say ketamine 100-200mg IV/IO or 200-400mg IM.

That doesn't sound like a very safe protocol to follow considering the max dose in a controlled environment for depression treatment is 1mg/kg.

It's worth noting "excited delirium" is a controversial diagnosis.

True. Administering many drugs without the proper knowledge can be dangerous.

Well for Elijah McClain it was either given after police suffocated him or directly contributed to his cardiac arrest. He apparently was restrained when it was delivered. This does not seem to jive with what you're saying. Were they planning to extra kill him if the Ketamine wasn't there?

He can struggle while restrained, severely injuring himself, and even to the point of killing himself. Handcuffs are temporary restraints and a struggling individual can severely hurt themself or defeat them.

Also, this scenario does jive with what I'm saying. Ketamine is generally safe. Would you rather have a shot of ketamine, mechanical disablement (multiple broken bones), or a shot of 9mm? These officers could have moved higher up the force continuum without the ketamine, even killing him in other ways (intentionally or accidentally). Are you saying tasers should never be used also?

I believe the vascular restriction (that they shouldn't have used) is the reason he was brain dead.

You probably shouldn't inject Ketamine into someone who has suffered cardiac arrest or brain death after being forcibly restrained. I am not sure how Ketamine is at all a hero here, or helped provide an alternative to save Elijah McClain from excessive force by the police. If anything it may have complicated his chances of resuscitation, or possibly further contributed to his death.

Forcible injection is up there with taser and pepper spray. I don't think anyone wants to be forcibly injected with an unknown substance.

When Elijah said he's different, perhaps they could have asked how he's different? Is he autistic, does he suffer from anxiety and panic attacks? Instead you suggest the only plausible alternatives to forced Ketamine injection is him getting his bones broken or 9mm bullet in his body. That mindset is exactly the problem.

"You probably shouldn't inject Ketamine into someone who has suffered cardiac arrest or brain death after being forcibly restrained."

Pretty sure the ketamine was before cardiac arrest and brain death. Isn't that the claim - the ketamine caused those issues...

"Instead you suggest the only plausible alternatives to forced Ketamine injection is him getting his bones broken or 9mm bullet in his body. That mindset is exactly the problem."

What mindset is that? What are you suggesting as an alternative once someone has started fighting, (reportedly) grabbing for a weapon, and continuing to struggle once restrained?

It would be great if we had video to confirm that the injection was justified in this specific case. I would have also liked to see what the actions were leading up to the encounter.

I think some of the confusion is people saying the hold killed him, but he appears to actually have regained consciousness after the hold, and was then given Ketamine, then shortly after the administration of Ketamine he went into cardiac arrest.

If he was actually killed by the chokehold, then no way should someone be injecting Ketamine into someone unconscious or without pulse, especially under the guise of them resisting or being a threat.

If he lost his pulse shortly after being administered too high a dose of Ketamine, then that kinda indicates Ketamine could have been a cause or contributed.

Regarding mindset, while Elijah did resist, the transcript suggests he was eventually compliant and pleading with officers.

> I can't breathe. I have my ID right here. My name is Elijah McClain. That's my house. I was just going home. I'm an introvert. I'm just different. That's all. I'm so sorry. I have no gun. I don't do that stuff. I don't do any fighting. Why are you attacking me? I don't even kill flies! I don't eat meat! But I don't judge people, I don't judge people who do eat meat. Forgive me. All I was trying to do was become better. I will do it. I will do anything. Sacrifice my identity, I'll do it. You all are phenomenal. You are beautiful and I love you. Try to forgive me. I'm a mood Gemini. I'm sorry. I'm so sorry. Ow, that really hurt! You are all very strong. Teamwork makes the dream work. Oh, I'm sorry, I wasn't trying to do that. I just can't breathe correctly.

He was on the ground for an extended period of time and threatened with dogs. An officer determined his "need" for Ketamine before emergency medical personnel arrived, not the medical personnel themselves. The medical personnel then gave him overdose based on his actual body weight.

The police tunnel visioned into the guy being whacked out on drugs, completely ignoring his pleas and explanations, and the medical personnel were complicit in unquestionably following orders of the officers and then administered an incorrect dosage of Ketamine.

Police should consider they might be dealing with someone neurodivergent, that someone "acting suspiciously" might just be anxious or panicking, and may not actually be a criminal or on drugs. Fight or flight and adrenaline are a hell of a combo on their own.

Vascular constriction can have latent effects, such as causing a stroke which results in brain damage or brain death. I haven't seen the duration for the two instances of cardiac arrest to know if they were long enough to cause brain death, especially if they were performing compressions, etc.

Did he have any diagnosed conditions? If not, then the part about being neurodivergent wouldn't be applicable (but yes, more training on that would be good). It's possible the random language and topics in his pleas were seen as a sign of intoxication, especially with the officer's comment about strength in the struggle. Also, the incoherence could indicate the beginning of a stroke from that hold.

I also think people should look at the Karen involved in this story. You have no reason to report any crime or threat, but you call the police anyways?

Is Ketamine advisable to inject into someone who has had deadly force used against them which could lead to stroke?

Did they ask if he had any conditions before grabbing him and instigating the struggle? Did they ignore his explanations while on the ground, and his breathing complaints? It certainly is applicable, the entire point is to find ways for people to survive interactions with the police, not excuse away deaths caused by police intervention.

There are plenty of instances where 911 calls are outright lies or incomplete information is provided. It is up to the responding officers to take the reports with a grain of salt. Again, your focus seems to be to find ways to redirect blame away from the officers who directly contributed to Elijah's death.

https://en.wikipedia.org/wiki/Shooting_of_John_Crawford_III

https://en.wikipedia.org/wiki/Shooting_of_Tamir_Rice

https://en.wikipedia.org/wiki/2017_Wichita_swatting

What explanation did he give? Why would they ask if someone has a condition as soon as they approach someone (and did he have even one)? Most people won't answer that because it's none of their business. The breathing complaints are common and with the right training (which it sounds like they didn't have), you are supposed to know which ones are legitimate.

I'm not making up excuses. As I've said in my previous comments, I believe the vascular constriction killed him, via a stroke or stroke-like event. What I am saying, is that you seem to be living in a fantasy land where you have some aversion to drugs being part of the force continuum and don't understand reasonable suspicion standards as well as the obligations and rights of citizens during an investigation.

He said he was an introvert and asked the officers to respect his boundaries. Do officers not know what an introvert is? Do they not know some people react poorly to bring touched? He also had asthma, which might be good to know before you decide to chokehold someone. There's tons of people in this world, who act differently to different stimulus, and mental healthcare in the US has historically been poor, so there are probably plenty of undiagnosed people walking around. Most people don't announce they're introverts during a police stop, this should have been a clue.

It seems a lot of police have trouble spotting the "fakers". Literally they did a chokehold on him, how much training do you need to understand that causes harm? More excuses from you.

You seem to live in a land where just because it's written on paper and police can legally kill people, that it makes it okay. Maybe policies need to change in light of so many of these tragedies, and the willy nilly use of Ketamine and chokeholds should actually be reconsidered. Hopefully this pilot program is a success, and we can avoid the amateur hour antics that lead to Elijah's death.

You clearly haven't been reading my comments.

From what I understand of ketamine, it would take several grams to kill a man while Elijah was given half a gram (which was evidently more than he should have been given, but should still have been well short of lethal.) It seems to me he was killed by the chokehold. If somebody fed you a pot brownie then kicked you in the face, would you say weed broke your nose?

Do you think the Ketamine helped his chances of survival? Even at therapeutic levels drugs can cause adverse effects. Why are EMTs injecting Ketamine into effectively dead people at the behest of the police?

Ketamine not helping is not the same as ketamine killing. If paramedics had instead applied bandaids, those bandaids would not have helped him, but that's no reason to claim he was killed by bandaids.

On one hand, you have cops trying to pull the man's head off, starving his brain of oxygen. On the other hand, you have a sedative that is renowned for being safe, administered in a quantity that should be safe a few times over. How in the world people look at this situation and blame ketamine instead of the cops is completely beyond me.

In this case though it actually looks like he was given an overdose when considering his body weight, and he suffered the cardiac arrest enroute to the hospital, not on site. Coroner suggests drug reaction, the hold or asthma attack might have all played a role in the death.

Also the recorded audio sounds like he was pleading with the officers and compliant, not that he needed further restraint or sedation.