Saturday, July 19, 2008

Like the Taser, the drug Versed should not be in the hands of police

Here's yet another police abuse, currently occurring in Nashville (although I'm sure that it will soon arrive to a city near you):
For at least two years, the Nashville PD have been recklessly endangering citizens by using emergency medical personnel to forcibly inject Versed -- a powerful prescription medication with side effects including agitation and confusion -- into agitated, confused people. This potentially lethal stupidity is what we can expect when people who go to work with guns on their belt decide to play "doctor".

To compound the dangerous stupid, Versed's side effects include the same behavior the geniuses in Nashville seek to control.

Reactions such as agitation, involuntary movements, hyperactivity and combativeness have been reported in adult and pediatric patients. Should such reactions occur, caution should be exercised before continuing administration of midazolam.

In addition to making agitated patients more agitated, Versed can (and does) cause respiratory depression. What's respiratory depression - a case of the sighs? Nope - respiratory depression is the fancy doc talk for what happens when the nerve cells in our lizard brain get so sedated they forget to tell us to breathe - and we suffer severe brain damage, or even die. Because, amazingly enough, our brains require oxygen to survive.

Midazolam is a potent sedative agent that requires slow administration and individualization of dosage. Clinical experience has shown midazolam to be 3 to 4 times as potent per mg as diazepam. BECAUSE SERIOUS AND LIFE-THREATENING CARDIORESPIRATORY ADVERSE EVENTS HAVE BEEN REPORTED, PROVISION FOR MONITORING, DETECTION AND CORRECTION OF THESE REACTIONS MUST BE MADE FOR EVERY PATIENT TO WHOM MIDAZOLAM INJECTION IS ADMINISTERED, REGARDLESS OF AGE OR HEALTH STATUS. Excessive single doses or rapid or intravenous administration may result in respiratory depression, airway obstruction and/or arrest. The potential for these latter effects is increased in debilitated patients, those receiving concomitant medications capable of depressing the CNS, and patients without an endotracheal tube.

These deadly side-efects make Versed a drug that cannot be safely used without full capacity and opportunity to intubate the patient. In many teaching hospitals, use of Versed outside the ICU seting is restricted or prohibited: the risk of iatrogenic (treatment-caused) respiratory depression leading to brain damage or death is judged to be too great.

Of course, this concept may be lost on many whose co-workers insist that choke holds killed black people not because the victims couldn't breathe, but because of the victims' ethnicity.

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