Wonder if they'll invest in an ultrasound for next time

[shepardsun]

Alan Miller claims AL prison workers looked for vein in failed execution for 90 minutes

According to the document, Miller is the only living execution survivor in the United States.

www.al.com

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[shepardsun]

"After repeated attempts to find a vein in Miller’s arms, hands, and feet, he claimed that the ADOC execution team started observing his neck for veins in an attempt to start a central line procedure. At one point they used a phone flashlight to look for his veins."

 

[zizzer]

Strategy before execution date: gain weight, be hypovolemic, put arms above head, lower your body temperature, and move around a lot during the procedure in "pain" making them miss. They're not likely to be physicians or nurses.

 

[drmwvr]

In California they could just put one in after they go to sleep....

 

[chessknt]

Just use an IO...

 

[IMGASMD]

Some comical stuff here.

Or just bleed him to death….. poked more than 90 times?! Yikes

 

[DocVapor]

I will resubmit my strategy of a huge pile of powdered cocaine and fentanyl and a short straw on a table in front of him.

 

[wholeheartedly]

if they can do the gas option and he wants the gas option, why not just do that instead of going through the whole legal rigamarole?

 

[coffeebythelake]

"Mr. Miller physically recoiled out of intense fear of the men trying to insert a needle in his neck" .. 🤡

 

[Ashers]

Just use an IO...

I'm sure that'd be deemed cruel and unusual as a way to execute someone.

 

[chessknt]

I'm sure that'd be deemed cruel and unusual as a way to execute someone.

Is it cruel and unusual when we place them in patients? I just don't understand that bizarre standard when it is used to fda approved medical devices. It is literally indicated when IV access is needed but unable to be obtained.

 

[DocVapor]

Is it cruel and unusual when we place them in patients? I just don't understand that bizarre standard when it is used to fda approved medical devices. It is literally indicated when IV access is needed but unable to be obtained.

I think the reason is important.

"We need to drill into your bones to save your life" is very different than "We need to drill into your bones to end your life."

 

[Ashers]

Is it cruel and unusual when we place them in patients? I just don't understand that bizarre standard when it is used to fda approved medical devices. It is literally indicated when IV access is needed but unable to be obtained.

I used it twice for inductions after conferring with others in my group (academics). No one could get IV access, and the patients refused central lines. It was cruel and unusual for them and everyone in the room.

This was after the rep came and told us it only hurt for the initial bolus. The rep lied. I'll never do it on a non-dying patient again.

 

[Angus Avagadro]

Maybe they should aerosolize midazolam and sufentanyl? That's what the Ruasians did at the Opera House Hostage situation

 

[MirrorTodd]

For anyone wondering, I have had an I/O placed on me for military training. It was the sternal I/O FAST1 system and it hurt...it hurt a lot. And that wasn't even the bone drilling type. Suggesting an I/O on an awake inmate is balls to the walls crazy.

 

[Ashers]

For anyone wondering, I have had an I/O placed on me for military training. It was the sternal I/O FAST1 system and it hurt...it hurt a lot. And that wasn't even the bone drilling type. Suggesting an I/O on an awake inmate is balls to the walls crazy.

That is my experience with it in awake patients. (It was kind of like the machine in the Princess Bride on induction.)

(Coding patient is different.)

 

[nimbus]

I used it twice for inductions after conferring with others in my group (academics). No one could get IV access, and the patients refused central lines. It was cruel and unusual for them and everyone in the room.

This was after the rep came and told us it only hurt for the initial bolus. The rep lied. I'll never do it on a non-dying patient again.

For anyone wondering, I have had an I/O placed on me for military training. It was the sternal I/O FAST1 system and it hurt...it hurt a lot. And that wasn't even the bone drilling type. Suggesting an I/O on an awake inmate is balls to the walls crazy.

Sounds like it should be part of rep training too

 

[Ashers]

Sounds like it should be part of rep training too

When the rep came back, I told him it was the worst experience, and he needed to stop saying it didn't hurt after the initial push. He didn't come back after that.

 

[GassYous]

Why not just IM

 

[coffeebythelake]

I used it twice for inductions after conferring with others in my group (academics). No one could get IV access, and the patients refused central lines. It was cruel and unusual for them and everyone in the room.

This was after the rep came and told us it only hurt for the initial bolus. The rep lied. I'll never do it on a non-dying patient again.

Pushing drugs through an IO is incredibly painful. All that pressure transmitted through jnto the bone marrow

 

[DirtDocMD]

Question—-Does it HAVE to be IV access?? Is there a reason why intra-ARTERIAL couldn’t be used??? Is vascular injury a concern in this case??

Intraarterial Injection of Anesthetic Drugs : Anesthesia & Analgesia

An abstract is unavailable.

journals.lww.com

 

[Angus Avagadro]

Could go PR too. I understand PR Brevital was used in kids years ago.

 

[gtb]

An intravenous line is required by protocol for executions by, 'lethal injection.' These protocols take years to get approved, and given the incredible politics and human emotions associated with intentionally killing someone, these legal protocols will be challenging to change. IM and SQ backup will need to be in the revised protocols. One state's execution protocol is provided as an example: https://files.nc.gov/ncdps/documents/files/Protocol.pdf

 

[drmwvr]

Question—-Does it HAVE to be IV access?? Is there a reason why intra-ARTERIAL couldn’t be used??? Is vascular injury a concern in this case??

Intraarterial Injection of Anesthetic Drugs : Anesthesia & Analgesia

An abstract is unavailable.

journals.lww.com

If an IO would hurt, can't imagine what intra-arterial hypnotic would feel like...sheesh...just shoot the poor guy if we're hell bent for leather to put him to death...stories like this are getting ridiculous...most of them end with finally finding something but at the cost of the humanity of everyone involved....

 

[nimbus]

If an IO would hurt, can't imagine what intra-arterial hypnotic would feel like...sheesh...just shoot the poor guy if we're hell bent for leather to put him to death...stories like this are getting ridiculous...most of them end with finally finding something but at the cost of the humanity of everyone involved....

An execution is still an execution despite our efforts to make them more palatable by medicalizing them. It’s still eating a bag of s***.

 

[gtb]

Question—-Does it HAVE to be IV access?? Is there a reason why intra-ARTERIAL couldn’t be used??? Is vascular injury a concern in this case??

Intraarterial Injection of Anesthetic Drugs : Anesthesia & Analgesia

An abstract is unavailable.

journals.lww.com

The legal proceedings define, "intravenous injection" to be the manner of execution. Given a famous but disbarred attorney once said, "It depends on what your definition of 'is' is," every single syllable is considered fodder for a new legal challenge. Some execution protocols specify two intravenous lines must be established, so even a single triple-lumen central line would likely be challenged as violating the legal protocol.

 

[pgg]

Is it cruel and unusual when we place them in patients? I just don't understand that bizarre standard when it is used to fda approved medical devices. It is literally indicated when IV access is needed but unable to be obtained.

It's indicated when competent people can't obtain access for a patient who needs it. Apart from the issue of whether these condemned people "need" it, is the larger issue of incompetence.

I don't know why everyone's focusing on techniques and methods (and the thread title referencing ultrasound) when the problem is that the people responsible for getting access are amateurs. They're not going to be any more successful with ultrasound or some other tool. They're untrained and unqualified to perform the task.

 

[chessknt]

It's indicated when competent people can't obtain access for a patient who needs it. Apart from the issue of whether these condemned people "need" it, is the larger issue of incompetence.

I don't know why everyone's focusing on techniques and methods (and the thread title referencing ultrasound) when the problem is that the people responsible for getting access are amateurs. They're not going to be any more successful with ultrasound or some other tool. They're untrained and unqualified to perform the task.

The skill required to place and use an IO in the tibia with success is inarguably the lowest of any access method as long as someone has at least watched a basic training video on it even with 0 real life experience. I am not convinced that the discomfort of expanding a marrow pocket meets the threshold of cruel/unusual but apparently many here do so I guess that would be unconstitutional.

 

[deleted875186]

It's indicated when competent people can't obtain access for a patient who needs it. Apart from the issue of whether these condemned people "need" it, is the larger issue of incompetence.

I don't know why everyone's focusing on techniques and methods (and the thread title referencing ultrasound) when the problem is that the people responsible for getting access are amateurs. They're not going to be any more successful with ultrasound or some other tool. They're untrained and unqualified to perform the task.

I go and donate blood and a Red Cross worker can put a 14G needle into peoples veins. Phlebotomists can do it. Why can these people not be adequately trained?

Probably just lack of funding to get some competent training.

 

[nimbus]

I go and donate blood and a Red Cross worker can put a 14G needle into peoples veins. Phlebotomists can do it. Why can these people not be adequately trained?

Probably just lack of funding to get some competent training.

Professional phlebotomist vs prison guard/executioner?

Why would anybody with medical skills decide to become an executioner? So they can go home and tell their kids, “guess what mommy/daddy did at work today!” Where would they get this training? In your operating room?

 

[pgg]

I go and donate blood and a Red Cross worker can put a 14G needle into peoples veins. Phlebotomists can do it. Why can these people not be adequately trained?

Probably just lack of funding to get some competent training.

?

Phlebotomists can do it because they do it 17 times every day.

In cooperative patients.

It's bewildering that y'all don't seem to understand why this is such a hard problem for the prisons.

 

[IMGASMD]

?

Phlebotomists can do it because they do it 17 times every day.

In cooperative patients.

It's bewildering that y'all don't seem to understand why this is such a hard problem for the prisons.

Are you saying……. What I think you’re saying?!