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Colorado Adds Ketamine Restrictions Statewide
The Denver Post
The death of Aurora's Elijah McClain spurred national calls for restrictions on first responders' use of chemical restraints. His death also led to a new Colorado state law.
Signed by Gov. Jared Polis, HB21-1251 bans police officers from directing paramedics and other medical professionals to use ketamine on someone. It requires those professionals to weigh people (or make a weight estimate confirmed by at least two other experts) before injecting someone with ketamine. The law also bars medical providers from using ketamine to subdue someone suspected of criminal behavior except in a justifiable medical emergency.
All these changes are directly inspired by McClain, who was violently arrested by police in 2019 and injected by paramedics who estimated his weight at 220 pounds. In fact, he only weighed 140 pounds, suffered cardiac arrest and was declared brain dead. He was later taken off life support.
In a statement, Polis said that chemical restraints like ketamine should be used only in "true medical emergencies" and police should not try to influence paramedics' decision-making. He also noted the American Medical Association's position that "excited delirium" is diagnosed subjectively — further reason, he said, for caution by first responders.
"That is why (the Colorado Department of Public Health and Environment) will place a hold on all ketamine waivers at this time in the setting of excited delirium" and release research findings on the topic later this summer, Polis added.
An initial version of this law proposed limitations on other drugs, and lawmakers said they considered banning ketamine instead of just restricting it. The bill was amended several times as it moved through the Capitol.
Denver Democratic Rep. Leslie Herod, a lead bill sponsor, said she thinks the final version is in a good place.
"We took a significant step forward in our state to improve policing and end the misuse of ketamine, which has had dangerous and deadly consequences for Coloradans," she said in a statement.
This is one part of a broad package of laws on policing and public safety passed by the Democrats who run the state legislature this year.
REACTION: EMS WORLD'S MEDICAL DIRECTOR
The death of a patient in the care of EMS is a tragedy—we cannot make light of that. But other patients will be harmed by this pendulum swing of political grandstanding.
The political events in Colorado must serve as a reminder to EMS physicians that we operate in the public realm, and that the practice of medicine is sadly not immune from ill-planned political action.
Take-home lessons? Every system and every medical director should be closely monitoring and reviewing the use of all controls, including ketamine, and must be prepared to speak knowledgeably about it if asked. We must always strive to be politically involved and aware so that decisions about EMS interventions are made by physicians based on data, literature, and the needs of our patients.
—Michael W. Dailey, MD, FACEP, FAEMS, is chief of prehosptal and operational medicine and associate professor of emergency medicine at Albany Medical College in Albany, N.Y.
Comments
Sedation can prevent injuries from occurring by stopping the fight. I understand that Ketamine is weight based and we are just making an educated guess at the weight in the field, but I believe the the good out weighs the bad. I don't think this is a decision.
—Timothy Williams