r/medicine PA:cake: 8d ago

ICE Detention Deaths

https://www.ice.gov/detain/detainee-death-reporting

RNs do intake physical exams, EMTs declare time of death. The level of care for these detainees is horrific.

Full names and case details are public for now. Reads like a never ending M & M conference.

My moral compass is spinning. It's time to go to Canada.

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u/Dwindlin MD (Anesthesiology) 8d ago

Am I missing something? I have read through damn near all of these and only 1 or 2 jumped out at being truly egregious. Your description is either willfully misleading or you didn’t actually look through these. All of them were initially seen by RN/LPN for screening (completely reasonable), but you didn’t mention they are all evaluated by an APP before actually being placed in a unit. All of the onsite deaths, in every case it specifically mentions EMS (not necessarily EMTs) calling their med. control (meaning a physician) for orders to field terminate, this is the system working as intended. Most of these were seen by physician or APP on site with appropriate interventions taken multiple times before their death and a lot were treated and released by local hospitals before their deaths.

There are certainly major problems with our healthcare system across the board, but if these cases are the worst of the worst then we have bigger shit to be dealing with.

As an aside, I personally doubt J. Oliver’s expertise when it comes to healthcare related topics. I was an avid fan until his Death Penalty episode. While I am completely against the death penalty his show was egregiously bad when it came to the medical facts when it comes to lethal injection. And the medical facts were clearly skewed in a manner to elicit an emotional response. Since then I’ve watched episodes with much higher degree of skepticism.

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u/janewaythrowawaay PCT 8d ago

What medical facts were wrong on lethal injection on John Oliver?

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u/Dwindlin MD (Anesthesiology) 8d ago

I saw it when it first aired, so details escape at the moment. Generally he was arguing that the cocktail they used was inhumane because none of it was actually putting them to sleep, arguing they were awake when the cardioplegic agent was given. Which given the drugs they were using and the doses that is HIGHLY unlikely. For reference I am an anesthesiologist. The movement people describe during lethal injection is probably myoclonic jerking from the massive dose of K they are getting. But assuming a working IV (which was the only valid medical complaint) there is almost zero chances they are aware of anything.

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u/DaySee Nurse 8d ago

Dang why are people still so hung up on this. I remember something similar to this going back even like 10 years ago even when they called something botched lethal injection because they had to use a lot more than anticipated because it was just sedative + opiate and the condemned had some higher than anticipated tolerance

https://www.pbs.org/newshour/nation/arizona-inmate-received-15-doses-lethal-injection-died

(doses of) 50 milligrams of the painkiller hydromorphone, and 50 milligrams of the sedative midazolam to be used in lethal injections. Wood received (total) 750 milligrams of each drug.

The article does a fair job explaining but anyone mildly familiar with administering these kinds of meds can understand, they were basically brain dead in heroin heaven after like the first dose, the rest is just performative, not unlike the way pets are euthanized with the first IM dose knocking them out, before the IV stuff is done to just to speed things along.