Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Propofol, Michael Jackson, and CPR

Did propofol kill Michael Jackson or did an incompetent doctor kill Michael Jackson?

Propofol can be dangerous – in the wrong hands.

Propofol causes temporary apnea, which is not difficult for a competent medical professional to manage.

Is Dr. Conrad Murray a competent medical professional?

Unless some surprise evidence is revealed at trial, there is no good reason to suppose that Dr. Conrad Murray is a competent medical professional.

Does Dr. Conrad Murray know how to perform CPR?

He was staying with Jackson in the Los Angeles mansion and, according to Chernoff, “happened to find” an unconscious Jackson in the pop star’s bedroom the morning of June 25. Murray tried to revive him by compressing his chest with one hand while supporting Jackson’s back with the other.[1]

Gosh! I don’t have a CPR card, because CPR is too difficult for a doctor.

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Eventually, The AHA and ILCOR will recognize that there is no evidence that ventilation improves outcomes in the first several minutes of cardiac arrest, except when that cardiac arrest has a respiratory cause.

We should not be continuing to use bad treatment just because our prejudices agree with that bad treatment.

We should be eliminating treatments that are not supported by evidence.

If a treatment cannot be shown to work consistently, the treatment is a fraud.

Jorrie (lawyer Kathy Jorrie of concert giant AEG Live) said Murray had added to his contract a provision for a CPR machine when they got to London for the highly touted show that would include 50 concerts over nine months. “He needed to be sure if something went wrong he would have such a machine available,” she said. “He also told me it was customary.”[2]

This is one of the big problems with the CPR machines, too many people will see having a machine as an excuse for EMS to not be competent at CPR.

We could ask if the CPR machine killed Michael Jackson. Nobody suggested that any CPR machine was actually used, but not using it would be not using it according to the manufacturer’s recommendations.

Using propofol without monitoring equipment or supplemental oxygen is not using propofol according to the manufacturer’s recommendations.

Patients should be continuously monitored, and facilities for maintenance of a patent airway, artificial ventilation, and oxygen enrichment and circulatory resuscitation must be immediately available.[3]

The propofol was clearly not used according to manufacturer’s recommendations.

Why blame the propofol?

Why not blame the CPR machine that was not used according to the manufacturer’s recommendations?

Because we do not think things through and we have difficulty determining cause and effect.

The cause of Michael Jackson’s death was incompetence.

Dr. Conrad Murray could just as easily have killed Michael Jackson with too much IV fluid, or with too much of any of the other drugs that were present, or with too much of a combination of the drugs that were present.

We have an inappropriate fear of propofol, rather than an understanding of the appropriate way to use propofol.

Incompetence kills.

Ignorance kills.

Propofol does not kill without serious problems with the competence of the person giving propofol. Dr. Conrad Murray appears to have gotten away with giving propofol many times before. The other doctors before him may also have gotten away with incompetently giving propofol many times before.

The question people are not asking is –

 

How did Michael Jackson survive all of those incompetent administrations of propofol?

 

The answer is that it is not that difficult to keep someone breathing, as long as you are in the room with the patient when the patient tries to stop breathing. If nobody is there to stimulate respirations, and respirations do not naturally return (respirations generally do return with propofol), then death is not unexpected.

It wasn’t the propofol or the CPR machine that killed Michael Jackson, it was the incompetence.

Footnotes:

[1] Federal agents descend on Michael Jackson’s doctor
By Ken RitterR and Oskar Garcia Associated Press Writer
© 2009 The Associated Press
July 28, 2009, 12:08PM
The Houston Chronicle
Article

[2] Guard describes scene in room where Jackson found
September 28, 2011 1:11 PM
CBSNews.com
Article

[3] diprivan (Propofol) injection, emulsion [AstraZeneca Pharmaceuticals LP]
DailyMed
FDA Label

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