Friday, December 18, 2009

We're the Only Ones Keeping You from Getting Hurt Enough

Ri...i...ight... [More]

Besides, there was "cause for concern," expressed as only the "Only Ones" can...

[Via Steven K]
Posted by David Codrea at 12/18/2009 11:17:00 AM

8 comments:

straightarrow said...

This happened two or three years agoBut as you no doubt notice cops are still reading from the same script

12/18/2009 1:52 PM
straightarrow said...

Oh, and don't forget they were afraid of a broken back kid

12/18/2009 1:53 PM
Drew Rinella said...

Hey David I'm a paramedic, and I can say that the injury pattern they mentioned in the video is consistent with a jump, not a fall. It's called Don Juan syndrome, named after the man who jumped from his lovers' windows when their husbands walked into the room. When you jump from a height and land on your feet, you sustain injuries to the feet, legs, and typically lower back. Sometimes if they then put their arms out to catch their fall after they land, they will get wrist fractures too.

The increased white blood cell count they mentioned may have come from a condition called excited delirium, which would account for his bizarre behavior even though he didn't have drugs or alcohol in his system. No one quite knows what causes excited delirium (also called in-custody death syndrome), but one thought is that it can be triggered by long term cocaine or meth use. It is defined by a hypermetabolic state, hyperthermia, and agitated, delirious behavior.

I can also say from an emergency services worker's perspective that this condition is very difficult to manage. On the one hand I cannot enter a scene until it is made safe. That means I have to call the police to enter the scene first and make it safe. In some circumstances it might not even be safe for the officer to touch the patient, and they must use other means of restraint including OC or taser gun. Situations that would warrant managing from a distance would be if the patient was covered in potentially contaminated blood, or was showing violent behavior. In at least one case I read about here in Oregon, the patient was able to shrug off several hits with a taser gun and the officers were forced to shoot him with lead bullets.

On the other hand we know that in cases of excited delirium, the patient's body systems are already maxed out; they can't take much more excitement. Patient's who are wrestled or tased rarely survive. We know that there are increased survival rates if we can sneak in there and inject them with some sort of sedative or hypnotic. This is extremely dangerous, however, as there is no such thing as the Hollywood style tranquilizer gas or darts that work immediately. This stuff takes at least a couple minutes to work, and in that time we can all be seriously injured, killed, or infected with AIDS or hepatitis.

So what is the solution? A bridging of EMS and police. Perhaps police could be trained in administering these medications if we can change the law and agency policies to allow them to administer drugs in emergencies. We also need more education about this little understood condition. But this solution is not going to be perfect, and there in fact is no perfect solution. Some patients are just going to die, and there is nothing we can do. That is our eternal struggle: sometimes we can't help people even though we really want to; we can only do our best.

I am a big fan of yours, but in this case I think it may be unfair to criticize the police too harshly because we were not there to see exactly what went on. It may have been that they felt they could not wrestle him safely without further aggravating the injuries he sustained in the jump, so they tried pain compliance with the taser gun. I'm sure other medical professionals in your readership will have other ideas. I am curious to hear them.

Drew Rinella
drew.rinella@gmail.com

12/18/2009 3:20 PM
David Codrea said...

Drew: 19 times?

12/19/2009 9:31 AM
Drew Rinella said...

Thank you for your reply. You seem like a person who appreciates directness. Here's what I know:

1) This article reeks of bulls....
2) The article contains a lot of wrong information.
3) People in excited delirium are motherf...... bats... crazy.

Nineteen times sounds like a lot, unless the alternative is an insane person running into the highway and causing a 19 car pileup, killing people/children or giving them life long injuries.

Of course I'm assuming a lot, and all of our commentaries are based on guesses about the missing facts. But numbers are deceiving. How often do we read sensationalized "urinalist" news stories about someone who has 1000 rounds of ammunition in their house, or whatever. Someone less-informed about guns would be inclined to think that only a backwoods homicidal loner would need 1000 rounds of ammo. You and I know that 1000 rounds is a weekend of plinking!

12/19/2009 2:52 PM
Kent McManigal said...

"Excited delirium"- Cop-speak for "I don't know how he killed himself by shooting himself twice in the head with a single-shot 12 gauge, but trust me, I'm a cop."

12/19/2009 9:16 PM
Drew Rinella said...

You have to be joking...

12/21/2009 1:23 AM
Drew Rinella said...

Bizzare behavior...
Don Juan injury pattern from jumping off an over pass...
High WBC count...
Hyperthermia...

How many more pieces of the puzzle do you need? This is a case of excited delirium! It is a documented medical condition!!!

Patients in excited delirium have been witnessed shrugging off multiple hits with taser guns.

Lets do some math:

If each hit with a taser gun lasts about 5 seconds (I think it is in fact less), and he was zapped 19 times... 5x19 = 95 seconds worth of being zapped. That's a little over a minute and a half. It takes an ambulance up to 8 minutes to respond in a city. Sounds to me like they kept him safely out of traffic with the lightest impact until the medics arrived.

Or they could have tackled him and broke his back more. I guess that would have been the politically correct way of dealing with it.

12/21/2009 1:31 AM

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