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I am a retired paramedic who worked 36 years for the EMS agency that responded to the George Floyd call. While still involved with that agency doing occasional quality assurance work, I have purposely not used my access to review this case. All information I have comes from training, experience, and public news reports.
This is my take.
1. Found behind the wheel of a minivan, Mr. Floyd was intoxicated with alcohol, fentanyl, and meth on board. He was a smoker and the autopsy reveals he had underlying medical issues that he may not have been aware of. He was also a very big guy – not obese, but tall and muscular. Police had reason to be wary.
2. He was properly arrested and handcuffed. The problems started when they attempted to place him in the squad car. Stating that he was claustrophobic and couldn’t breathe, Mr. Floyd dropped to the pavement and actively resisted for some minutes. After officers finally got him in the back seat, they inexplicably dragged him out the other side and dropped him to the pavement.
3. Here is where the police made a series of errors that may have resulted in Mr. Floyd’s death. When officers handcuff someone it is their responsibility to protect that person from harm. George Floyd stated 16 times (actual count) that he could not breathe. At what point should the police have taken those pleas seriously? Police did call for an ambulance but only due to Mr. Floyd’s bleeding from the mouth.
4. All four officers forgot their training. Positional asphyxia and excited delirium are real dangers. Minneapolis police have been trained to recognize the potential danger of this phenomenon and how to react in a manner to lessen the risk of cardiac arrest. In fact, during the time they had him pinned to the pavement, excited delirium was mentioned at least twice by officers on the scene. Despite that, they did not place the patient in a position that would allow him to adequately ventilate.
5. Excited delirium is a syndrome which is a group of symptoms that consistently occur together, or a condition characterized by a set of associated symptoms. George Floyd demonstrated several signs and symptoms as seen on multiple videos. Due to the struggle with police, his underlying health issues, and the intoxicants in his system, Mr. Floyd was certainly a candidate for this malady.
Specifically what happens is that the blood becomes acidotic. This is a common response to exertion. The body’s mechanism to correct this is a largely respiratory effort. Mr. Floyd had his hands cuffed behind his back which, in and of itself, restricts ventilation to a certain degree.
6. Again, Minneapolis police have been trained for years to recognize this danger. The patient needs to be rolled to his side and no pressure applied to the thorax. Even if the patient continues to struggle, this gives the cuffed patient the best chance to breathe and hopefully limit blood acidosis. Police had George Floyd face down on his stomach.
7. Did the knee to the neck hinder respirations? Yes, but not the way most think. In my opinion, the patient’s airway was not occluded it was the positioning that was the problem. What many are missing is this: Where were the other two officers? While the video most have seen does not show it, I’m willing to bet that one of them was compressing the patient’s back.
8. In my 49 years of EMS experience, I’ve seen a lot of people die in front of me. I believe that George Floyd died on the pavement. Again, the police forgot their training. They did not recognize the patient had gone unconscious and likely suffered cardiac arrest in front of their very eyes. Once a person is cuffed it is the responsibility of law enforcement to protect the patient the best they can and be mindful of the person’s well-being. It appears to me that they failed miserably.Published in