A quick medication review. As a nurse, I cannot think of many things worse than paralyzing someone’s skeletal muscles while they lay conscious, aware, and helpless. Vecuronium bromide consistently and efficiently paralyzes and subsequently make it impossible to breathe. Before the administration of Vercuronium bromide, it is absolutely essential that unconsciousness has been induced (Prescriber’s Digital Reference, 2017).

On the other hand, the sedative action of Versed (Midazolam) is variable and inconsistent at best. It will cause sleepiness and and drowsiness and with the correct dosage, some amnesic affects will be experienced. Midazolam is a benzodiazepine. Xanax, Valium, and Ativan are similar benzodiazepines. The correct dosage of Versed is variable depending on the patient history. Versed is not reliable for inducing deeply sedating effects.

When a patient is unable to improve their potassium levels with dietary supplements, an IV containing potassium is given instead. A very small amount of the drug is mixed in a liter of intravenous fluid and the mixture is dripped slowly into the vein. Even with the extremely diluted mixture, patients will often complain of a deep burning in their veins. So much so, that nurses will turn the drip down even slower and take action to help with the pain the patient is experiencing.

When IV potassium is given in an undiluted and lethal dose, it causes deep and painful burning to the veins as the drug makes it way to the heart where it will eventually stop the heart from beating. “When injected into a vein, it inflames the potassium ions in the sensory nerve fibers, literally burning up the veins as it travels to the heart” (Dershwitz, 2007).

Arkansas Death Penalty. In Arkansas, the medication cocktail delivered to a condemned man began with a dose of Midazolam. This was followed with the paralyzing action of Vecuronium bromide and then by an undiluted IV infusion of potassium. The IV infusion of potassium causes excruciating pain in the veins, however, the reaction to the pain is completely masked by the inability of the victim to respond or move his skeletal muscles. In fact, a victim of this lethal cocktail is not even able to produce the movement necessary to draw a breath or to gasp.

Witnesses to the event may misinterpret this as a “peaceful” death, because the victim did not move or respond in a typical way that communicates pain or discomfort. The victim is unable to move – the victim is unable to gasp – unable to clench his fists, to grimace, to cry out, … to breathe.

As a nurse and as a human, I find it difficult to comprehend that in 2017, the human reaction to violent crime is to recreate that violence and subsequently end the life of another. “To take a life when a life has been lost is revenge, not justice” (Desmond Tutu).

All of that aside, I find it even more horrifying to realize that in Arkansas and a few other similar states, lives are terminated through protocols that induce incomprehensible pain and suffering.

Comments?

Dershwitz, M. (2007). Testimony of Dr. Mark Dershwitz in the case of Harbison v Little in Nashville, Tenneesse (pp. 39–40). US District Court for the Middle District of Tennessee.

Prescriber’s Digital Reference. (2017). Retrieved from http://www.pdr.net/drug-summary/Vecuronium-Bromide-vecuronium-bromide-804

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