Some patient presentations, much like a structure fire, worsen exponentially with time. William Mark Jones strikes me as one of those patients. A news report detailed the findings of an autopsy following Jones’ December encounter with police and cardiac arrest while in custody.
Sheriff’s deputies responded for a man behaving erratically and bleeding. Is this enough to trigger an EMS mutual or automatic aid response?
What is your diagnosis?
As you read the report, consider causes of a brain injury. Do you need to know the level of cocaine toxicity to consider drugs as a cause of his abnormal behavior?
I wish we had a body cam video of what the deputies saw. Like smoke billowing from the windows of a burning building, problematic signs and symptoms reported indicate a worsening medical emergency. The sheriff’s office reports Jones was “sweating profusely,” “not making sense” and asking for help but “did not respond to specific offers for help from the deputies.” It is not reported if Jones had a weapon, threatened to attack the officers or others, or actually attacked the officers.
Paramedic treatment of erratic behavior
Even more I wish that paramedics had been on scene to suggest potential causes, such as excited delirium or traumatic brain injury, of Jones’ behavior. Chemical restraint by administering Ketamine or another anti-psychotic medication may have been better than what happened next.
I don’t believe the TASER use, baton strikes, or “body weight” restraint were the cause of death. Rather those police interventions delayed the recognition and treatment of a medical emergency. Only after Jones was handcuffed, in leg irons, and a deputy realized he was not breathing was an ambulance called.
Deputies performed CPR and used an AED during the 14 minute wait for the ambulance to arrive. It may or may not have made a difference for Jones, but the call for mutual aid needs to be made well before the structure is fully engulfed and the roof collapses.