AURORA | Aurora Fire Rescue says its medics will soon be supplied with a new sedative that could be safer to use in situations where subjects are having trouble breathing.
The antipsychotic medication droperidol is commonly used by U.S. paramedics as a sedative. It does not have the same potential to cause breathing difficulties as ketamine, which experts said Elijah McClain was given an overdose of before his death, or midazolam, a slower-acting sedative that the agency uses now.
The agency’s medical director, Eric Hill, said Thursday during a meeting of the Aurora City Council’s public safety committee that the antipsychotic may be a better fit for situations where patients have consumed alcohol or sustained a head injury.
“There is no one, ideal medication that is always the best medication,” he said. “The changes to the protocol are not … changing the philosophy or the protocols for who needs to be sedated. It’s always been the same thing. When you cannot manage any other way, and you have to render aid to that patient in a safe way, that’s what those medications are for.”
During the controversy that followed McClain’s death Aurora Fire Rescue stopped administering ketamine, opting instead to use midazolam, with every use reviewed by the agency’s medical director after the fact.
McClain was tranquilized after being confronted by an Aurora police officer in August 2019 while walking home from a convenience store. The stop escalated into police wrestling McClain to the ground and placing him in a choke hold. Firefighters then tranquilized him. He suffered cardiac arrest and died days later, having never regained consciousness.
An assessment of whether McClain was suffering an episode of “excited delirium syndrome” – a controversial diagnosis that some experts dispute – is part of a pending criminal case against the medics who attended McClain.
When evaluating whether to use a sedative on a patient whose life is in danger but whose behavior is making them unsafe to treat, Hill said firefighters first determine whether the person is able to decide for themselves if they need treatment or not.
If a person can’t make that decision — due to intoxication or mental health problems, for example — firefighters would try to de-escalate the situation verbally first. If that did not work, only then would they administer a sedative, Hill said.
Hill said the firm hired to monitor a court-mandated rollout of police and fire reforms in the city, IntegrAssure, had reached out to an outside medical consultant who approved of Aurora Fire Rescue’s plans to use droperidol.
Councilmember Danielle Jurinsky, however, said during the committee meeting that she was uncomfortable with the idea of firefighters being exposed to liability by being expected to inject any sedatives, remarking on the criminal charges facing AFR medics Jeremy Cooper and Peter Cichuniec, including manslaughter and criminally-negligent homicide, for administering ketamine to McClain.
She said she’d prefer to see decisions about sedation left up to the city’s ambulance provider, Falck Rocky Mountain.
“I just am having a really hard time talking about our Aurora firefighters injecting anybody with anything while we have two up for murder (sic) right now, and in fact, I wish that Falck would go ahead and deal with this because I would like to see all of our firefighters and all of our police officers go home at night every night,” she said.
Both Aurora Fire Rescue vehicles and Falck private ambulances are regularly dispatched to crime and accident scenes in Aurora.
“I stand firm that we should not have our firefighters injecting anyone with anything right now, and I would encourage all firefighters to not do that,” Jurinsky said.
She also said the local firefighters’ union opposed the rollout of droperidol; a union representative did not immediately respond to a request for comment.
Aurora Fire Rescue spokeswoman Sherri-Jo Stowell later wrote in an email that the agency does not have a set timeline for putting the drug into use. She said firefighters are looking into ways of educating the community about the drug first and that fire leadership will discuss the new protocols and community input before it’s rolled out.