Colorado strikes “excited delirium” from all law enforcement diagnosis, training documents

Stamau123@lemmy.world to News@lemmy.world – 334 points –
Colorado strikes “excited delirium” from all law enforcement diagnosis, training documents
cpr.org

Colorado’s law enforcement officers will no longer recognize “excited delirium” after a state regulatory board voted to strike the controversial diagnosis on Friday from all training documents starting in January.

The move, which was passed at the state Peace Officers Standards and Training board meeting unanimously and without debate, comes as two Aurora paramedics face felony charges for giving Elijah McClain, an unarmed, innocent Black man, an overdose of ketamine, in part, because they believed he was suffering from the condition.

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shouldnt the EMT be the responsible party to say 'no officer, this person does not have that problem'?

i wouldnt trust a cop with...well.. almost anything of mine personally. its outright terrifying they can make this medical decision.

Technically EMS doesn't diagnose. We assess and treat symptoms to keep the patient stable until we can get them to a medical facility. Of course there are things that are blindingly easy to diagnose and generally most doctors won't tell you "you can't diagnose that open femur fracture, that's my job". But officially the line has always been that we don't diagnose so when we are recording and reporting things we will typically say something like "the patient is showing symptoms of XYZ" rather than "the patient has XYZ".

When it comes to dealing with police officially they are the only people that can involuntarily commit someone (at least in my area). And officially EMS has to respect that decision however that doesn't always happen. There used to be a cop in my area that used to try to do that to anyone who "was problematic" and that officer got really used to hearing no from EMS. Other times EMS works with police is when there is a danger on the scene. For example if you're called out for a gunshot wound and it is suspected that the gunman is still there then you don't go in. You stage a block or two away and let the blue canaries clear the place first.

EMTs don't want to stand up to police because police officers like to threaten them if they don't follow what the cops say to do.

EMTs have no basis to stand up to cops on matters of security.

A cop deciding someone needs ketamine isn't security.

Go wash the boot polish off your face.

Lol what? Nothing in my statement aligns with your reply

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As a former firefighter and EMT, the very first rule you apply to any interaction/call/scene is "scene secure scene safe". The idea is to not walk into a dangerous scene and become an additional victim. (Consider walking into a traffic accident, or walking into a live electrical line).

It also applies to violent or dangerous situations. In each case we look to the expert to get us to the scene. For the traffic accident we look for firefighters or other units to block traffic. For electrical, we look for the utility folks.

For potentially violent spaces we look to police. They have the "security" authority.

So this gets ugly when cops flex authority, and in this moment we have no authority. Obviously we have professional candor, as we see these people on calls all week, but if they go hard we can't overrule them.

For potentially violent spaces we look to police.

In other words... you're looking to the people most likely to cause the violence.

Unfortunately yes but there's no one else with that authority on security especially

Well... that's the crux of the problem, isn't it?

Who would you recommend?

You mean you get a choice?

If you do, I'd suggest not trusting a violent institution that was perfectly fascist in nature long before Mussolini coined the term.

Of course... I know you don't. That's the whole point of police, isn't it? They are forced upon us no matter what we think.

Does the policy extend to when they want you to do something medically? You have no say when a cop tells you to inject an air bubble in someone's carotid? I don't believe it.

The cop wouldn't decide something like that no.

They would decide "this person is dangerous" type of stuff

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McClain was catatonic and not speaking at that time, but law enforcement officers can be heard on body-worn cameras telling the medics that he was exhibiting “crazy” strength and that he nearly did a push-up with all three officers holding him down at one time.

It's amazing what feats the human body can perform when trying to save its own life. A shame these folks were so determined to kill him. Don't listen to the audio from the bodycam on this one or read a transcript unless you want to weep for the cruel loss of a gentle soul.

nearly did a push-up

Sounds more like: couldn't do a push-up.

Why are cops in the US making diagnoses?

Why are cops in the US making diagnoses?

Because Excited Delirium is a fabricated condition meant to protect police and axon (tazer manufacturer.)

All about Excited Delirium part 1 and part 2.

IMO this is a huge win, and we should hope this gets repeated state by state.

Cops really are oppressive over there

Theres a damn good reason why historically everyone from backwoods rednecks to civil rights activists fucking hated cops. Hell both groups still do to some degree, sure a good number of boomer and gen x rednecks are boot lickers but silent, millenials, and gen z rednecks tend to still hate em. I shouldnt have to elaborate why civil rights activists still hate cops.

Cops are not trained of medical personnel, and have ulterior motives

When someone dies and police are involved the officers should be arrested and held with pay until we know it wasn't police brutality or other foul play on their part

I loathe cops as much as anyone, but you've proposed a fine way to cripple all law enforcement.

but you’ve proposed a fine way to cripple all law enforcement.

Good.

Fuck what the Pieces Of Shit Training Board says, why the fuck were paramedics giving someone ketamine?

There was another systemic failure here and this feels like smoke and mirrors.

Ketamine does have valid medical uses, namely pain killing and sedation, it's that in cases such as these it's completely unnecessary

That's my point. There are literally dozens of drugs that would have been more appropriate than ketamine in this situation.

Ketamine is widely considered one of the safest drugs, so safe that only cops could find a way to overdose someone on it.

I didn't say it wasn't safe...

You're confusing the chemical science of things like LD50s of substances, with recommended medical practice by medical bodies such as which specific medicines are appropriate in which medical situations.

Again: there are dozens of medicines that would have been more appropriate than ketamine in this situation.

Why would those other medications be more appropriate. What's the problem with Ketamine in the first place?

This is a question best answered by an actual doctor or pharmacist. My line of reasoning is about established medical procedure, not the pharmacology or psychopharmacology of each possible medicine or substance that could be used in this situation.

Ketamine doesn't carry the risk of respiratory depression and hypotension that other sedatives and pain killers do. No risk that you might have to immediately intubate someone.

Haloperidol is less risky still in terms of respiratory influence, though ketamine is faster acting.

But this doesn't really add anything, nor does it answer my question about why they didn't go with established medical procedure in this case that ended with the unnecessary death of a person, in no small part due to that break with procedure.

Sorry I was only addressing the reasoning behind paramedics being allowed to administer ketamine in the field and not other drugs. And reviewing this case, I don't see any indication for haloperidol either. They should not have drugged this person at all:

https://en.m.wikipedia.org/wiki/Killing_of_Elijah_McClain

But we should have teams of psychiatric professionals who are qualified to administer things like haloperidol responding to emergency calls that are specifically stated to be for psychiatric crises. I don't really want random paramedics in charge of choosing when to administer haloperidol, which can have significant and permanent side effects even after one dose.

Good. Slow progress, but progress nonetheless. The more we can prevent made up conditions like "excited delirium" from being used, the more protected we can be from police abuse.

Dumb knee jerk reaction. Having said that, cops are not medical personnel and do not have the training to identify ExDS compared to other presentations and uncooperative behavior.

They should not be calling any behavior that. They should just say the jumbject displayed hostile behavior and did xyz.

EMS has to get better about ketamine doses and when to use K verses just versed.

Excited Delirium is not a real condition and was made up by police to give themselves an excuse to use excessive force on someone the police deem as standard uncooperative

Symptoms are said to include aggressive behavior, extreme physical strength and hyperthermia. It is not listed in the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases, and is not recognized by the World Health Organization, the American Psychiatric Association, the American Medical Association, the American Academy of Emergency Medicine,[5] or the National Association of Medical Examiners.[6]

Kinda just sounds like the normal panic/fight-or-flight response that you might have if a cop was about to murder you for fun.

"Excited Delirium" was invented specifically to hide the cause of death when cops taser someone to death.

That's why it's not recognized by any medical source.

Excited Delerium doesn't exist. No actual medical body recognizes it as an actual disorder. It is a term coined solely by police to give an excuse for why someone died in their care.

So weird to think someone would be put into the position that they need to administer benzos to someone because they're in danger of violence from the cops for not promptly complying

They should just say the jumbject displayed hostile behavior

And that'll be coming from the people displaying "hostile behavior" on a daily basis, then?