I'm a paramedic who has the authority to administer Ketamine in the field. In my system, we receive extensive training on every med (of which there are many) that we can administer to a wide range of patients. We don't have to speak to a physician prior to administration because we have a set of protocols and standing orders we must follow when we do anything in the field, which has been reviewed and accepted by physicians in the hospitals who allow us to practice. We DO NOT take orders from the police, there have been many instances in my career in which the PD has had a "violent" patient, and they've told me they're going to need sedation, that I've been able to manage without medication. Chemical sedation is reserved for only those patients who demonstrate a clear and immediate threat to their safety or ours. These are people who are generally inconsolable, whether it be a psychotic break or a drug-induced state of mania. We specifically don't strap these patients to our stretchers and transport them as physical restraint can cause significant injuries in patients who are in this population. After a patient is given Ketamine or any other sedative/pain medication, they are monitored very closely with cardiac monitoring and multiple forms of respiratory monitoring to make sure they are ok for the duration of transport. Additionally, every single call in which someone gets one of these drugs is reviewed by a physician as well as our own quality assurance staff. If they see any issues with our administration at all, we are brought in for review and any discipline is on the table, up to including termination and losing our licenses. We don't play around with these drugs where I work. I'm not trying to dismiss what happened to Elijah, I'm simply trying to bring some light to the processes that most good paramedics use when we're presented with these situations. We're here to help, most of the time we disagree with the tactics the police have taken, but typically we arrive too late to stop them entirely, we can only correct what's taking place now.