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Sjy ,

Paramedic here, we don’t have access to a fully stocked pharmacy in our ambulance. Ketamine is pretty much the industry standard for situations like this. Its efficacy, safety profile, wide dose range, and rapid onset make it the ideal drug for managing violent behavior and sedation in a prehospital setting. I am not saying the medics made an appropriate decision in this situation but that is the appropriate mediation to use in situations like this. Versed would be a good runner up but is less effective in some situations with low doses and higher doses have a higher risk of respiratory compromise. Ativan is an option, if they carry it, I wouldn’t personally use Ativan in this situation because it has a longer onset/duration and higher chance of adverse reactions.

Ketamine might seem a bit excessive but it’s a very good medication for prehospital use. This is a situation that a lot of stuff went wrong and someone died. The cause of the death is more likely an adverse reaction that was not appropriate addressed by the paramedic, but that’s probably why they just got a conviction. But ketamine is used every day across the US without situations like this happening.

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