a litre of the decontaminant, a fraction of what was usually required. While it is difficult to be critical of any individual in relation to the question of delay, it is hard to escape the conclusion that delay had a significant role to play in what transpired here. The deceased, because of time, had suffered a significant deterioration. Attempts at appropriate decontamination were frustrated at just about every turn and the delay meant that it had become a non-viable option. The appropriateness of supportive measures Dr Buckley and Dr Murray were unanimous in their view that in any poisoning or overdose scenario, supportive care is a matter that has to be accorded high priority. Dr Murray went so far as to say that supportive measures should take precedence over decontamination. Dr Buckley explained what was meant by supportive care in these terms: 'Supportive care in an overdose situation particularly refers to just monitoring a pulse and blood pressure and saturation of oxygen and level of consciousness. And earlier intervention to make sure that problems with those things which may be minor at first are detected earlier and treated appropriately. So, for example, if his blood pressure dropped a bit, some intravenous fluids would be given to him to ensure he had an adequate blood volume. If his oxygen saturation dropped then he would be given oxygen. If his level of consciousness dropped significantly he would be intubated. And if he had seizures he would be given anticonvulsants and intubated.' (T190) Dr Murray stated this: for me the most important principle is to recognise that an overdose is potentially '…And life-threatening and the mechanisms and the consequences of the overdose is that may – be a threat to life and that life support measures always take precedent (sic) over decontamination.' (T229) Concern was expressed about the delayed intubation of the deceased. It is to be remembered that at 2:45am, the level of consciousness was seen to have deceased’s deteriorated. He had a seizure at that time and a further seizure at about 3:00am. He was intubated at about 3:38am or a few minutes earlier. In this regard, Dr Murray stated the following: 'For me the appropriate it could have been anticipated from that dose that Shaun was – almost certainly going to have seizures and that they may well have been recurrent and difficult to control. The moment someone is having recurrent seizures if affects their
a litre of the decontaminant, a fraction of what was usually required. While it is difficult to be critical of any individual in relation to the question of delay, it is hard to escape the conclusion that delay had a significant role to play in what transpired here. The deceased, because of time, had suffered a significant deterioration. Attempts at appropriate decontamination were frustrated at just about every turn and the delay meant that it had become a non-viable option. The appropriateness of supportive measures Dr Buckley and Dr Murray were unanimous in their view that in any poisoning or overdose scenario, supportive care is a matter that has to be accorded high priority. Dr Murray went so far as to say that supportive measures should take precedence over decontamination. Dr Buckley explained what was meant by supportive care in these terms: 'Supportive care in an overdose situation particularly refers to just monitoring a pulse and blood pressure and saturation of oxygen and level of consciousness. And earlier intervention to make sure that problems with those things which may be minor at first are detected earlier and treated appropriately. So, for example, if his blood pressure dropped a bit, some intravenous fluids would be given to him to ensure he had an adequate blood volume. If his oxygen saturation dropped then he would be given oxygen. If his level of consciousness dropped significantly he would be intubated. And if he had seizures he would be given anticonvulsants and intubated.' (T190) Dr Murray stated this: '…And for me the most important principle is to recognise that an overdose is potentially life-threatening and the mechanisms – and the consequences of the overdose is that may be a threat to life and that life support measures always take precedent (sic) over decontamination.' (T229) Concern was expressed about the delayed intubation of the deceased. It is to be remembered that at 2:45am, the deceased’s level of consciousness was seen to have deteriorated. He had a seizure at that time and a further seizure at about 3:00am. He was intubated at about 3:38am or a few minutes earlier. In this regard, Dr Murray stated the following: 'For me the appropriate – it could have been anticipated from that dose that Shaun was almost certainly going to have seizures and that they may well have been recurrent and difficult to control. The moment someone is having recurrent seizures if affects their
EVANS%20Shaun%20Michael.docx