Colo. bill would require patients be weighed before administration of ketamine

The bill would also bar medics from administering certain drugs to assist law enforcement


By Laura French

DENVER — A bill introduced into the Colorado state legislature Tuesday would restrict paramedics' use of ketamine and drugs considered "chemical restraints." 

House Bill 21-1251, sponsored by Reps. Yadira Caraveo (D-Adams County) and Leslie Herod (D-Denver), would require that ketamine, haloperidol, or any other medication "that is severely dependent on the weight of the individual or may result in a severe or adverse reaction with improper dosage in a nonhospital setting" only be administered when personnel are able to weigh the patient and monitor their vital signs, according to the bill summary

Colorado legislators have introduced a bill that would restrict EMS use of ketamine and other drugs considered chemical restraints. The bill was written following the death of Aurora man Elijah McClain, 23, who was administered ketamine after being restrained by police.
Colorado legislators have introduced a bill that would restrict EMS use of ketamine and other drugs considered chemical restraints. The bill was written following the death of Aurora man Elijah McClain, 23, who was administered ketamine after being restrained by police. (AP Photo/David Zalubowski)

The bill would also bar EMS providers from administering ketamine or other drugs considered chemical restraints under Colorado law "absent a justifiable emergency," adding that "excited delirium is not a justifiable emergency." 

Much of the bill focuses on preventing the involvement of law enforcement in the administration of ketamine and other drugs considered chemical restraints. The bill bans peace officers "compelling, requesting, causing, directing or influencing" EMS providers to administer chemical restraints and requires that EMS providers report peace officers who violate this rule. 

The bill text also states that anyone who is directed to assist an officer in helping to arrest, detain, restrain, transport, punish or prevent the escape of a person, or "to facilitate ease and convenience in law enforcement encounters" cannot administer chemical restraints under this direction. 

The legislation was written following protests over the 2019 death of Elijah McClain, 23, who was administered ketamine by an Aurora paramedic after being restrained by Aurora police. Paramedics and officers reportedly believed McClain was experiencing excited delirium at the time of the incident. A county coroner said McClain's cause of death was undetermined and did not classify the death as a homicide. The case is under investigation by the Colorado Attorney General and led the state health department to review its ketamine waiver program

The city of Aurora approved a temporary ban on EMS use of the drug last September. A city-commissioned independent review of the case stated that police and paramedics made errors during the incident, including by administering a higher dose of ketamine than recommended for someone of McClain's weight. 

The National Association of EMS Physicians (NAEMSP) released a statement last year in response to increased scrutiny of prehospital ketamine use, stating in part, "The suggestion that ketamine is routinely being used for 'non-medical' purposes is dangerously misleading." 

The NAEMSP also released a position statement on the management of agitated patients in October 2020, which made recommendations for the pharmacological management of excited delirium.

Read the full bill text below:

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