Michael Jackson’s death continues to consume the news cycle.
There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol — similar to morphine . . . Shortly after taking the Demerol he started to experience slow shallow breathing . . . His breathing gradually got slower and slower until it stopped.”
Another report from the Times Online, noted that, “Family members [said] he had received his daily shot of Demerol at 11.30 am, but the dosage was ‘too much’.”
I would not want to be that doctor who administered the drug, and apparently, police are looking for him.
An overdose of Demerol, also known generically as meperidine, is a plausible explanation for what happened. Certainly more likely than coronary artery disease. In fact, he had undergone a 3 to 4 hour physical a few months before for insurance purposes, and was given a clean bill of health. Presumably, that exam would have included thorough cardiac testing.
The classic signs of a Demerol overdose include changes in mental status, constricted pupils, and a decreased respiratory rate, among others. However, those signs are not always 100 percent accurate, for instance, as studies have shown some cases of Demerol overdoses in patients having normal sized pupils. Of these symptoms, a respiratory rate below 12 is the best predictor of an overdose. Also of note, Demerol is somewhat unique among the opioids in that it is also associated with seizures at high doses.
As to how a Demerol overdose can lead to cardiac arrest, a slowing in respiration rate decreases the oxygen supply to the heart, causing it to eventually stop beating, or go into a life-threatening arrhythmia.
No different from most emergencies, focus on airway and circulation is critical in suspected Demerol overdose cases. Narcan, also known as naloxone, which is a short-acting drug that counteracts opioid drugs, is then given. Repeatedly, if necessary, until the respiratory rate rises above 12. Restoring adequate breathing is the leading priority. I could not find a report saying if Narcan was administered on the scene, or if so, how soon it was given.
An autopsy is scheduled for today, which may shed more light into the mysterious circumstances surrounding his death.
But I wouldn’t be surprised if a high Demerol dose was a mitigating factor in Michael Jackson’s cardiac arrest.
Related posts:
- How did Michael Jackson die, and the medicine behind sudden cardiac death
- Why did Michael Jackson have a heart attack, and CPR by Dr. Conrad Murray
- Did Michael Jackson’s doctor give propofol, a possible cause of death for the King of Pop?
- Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?
- Cardiac arrest and good business
- Did propofol, or Diprivan, kill Michael Jackson?
- Avandia, MI, and cardiac death
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Kevin,
I just feel it is too early to speculate on this.
Our hospital has already banned Meperidine for general use. It can only be used for very specific pain conditions such as cancer related pain. Meperidine does have very serious side effects. It is not a good idea to give it IV or intra-muscular outside hospital setting. We have seen several overdosage due to narcotics pain medications but the chances of survival are highest if patients are already in the hospital, so they can receive the antidote fast.
It is unfortunate how many talents we lose to drugs. We will miss his music.
Doctor: If you read KevinMD, the cops are looking for you. They have your car you left at Michael’s house. It is safe.
The police would like to find you to talk to you.
http://www.timesonline.co.uk/tol/news/world/us_and_americas/article6585015.ece
My thoughts last night: http://drjshousecalls.blogspot.com/2009/06/not-much-else-to-say-today.html
And this morning: http://drjshousecalls.blogspot.com/2009/06/my-prediction-on-michael-jackson-doctor.html
I probably won’t post any more on the subject. Nancy Grace & company have to had something to do;)
For what I understand it will take 4-6 weeks to know the actual cause of Michael’s death. When all is said and done we may know a lot more about why Michael was the Michael Jackson we came to know and not the young man from the Jackson 5
Maybe he
died from fibromyalgia
Any celebrity hangeroner cardiologist always brings plenty of Narcan and respiratory support to every visit. It was the 20 other things in his system competing and contradicting that caused MJ to crash.
http://www.tmz.com/2009/06/26/emergency-workers-felt-jackson-dead-at-scene/
When EMTs arrived at Michael Jackson’s home yesterday, the medics wanted to pronounce him dead on the scene — but Michael’s personal doctor refused to let them “call it” — this according to sources close to the situation.
When EMTs arrived there was evidence someone had been performing CPR on Michael for “quite some time.” There was evidence of Lidocaine — an old-school drug that can be used to treat disturbances in the heart’s rhythm. Medics took over performing CPR but determined Jackson was lifeless — and wanted to call the coroner to pick up the body.
We’re told Jackson was flat-lined when EMTs arrived.
But our sources say M.J.’s doc demanded EMTs continue performing CPR anyway, and demanded that they take Michael to the hospital.
Once they arrived at UCLA, we’re told Jackson’s doc continued to personally administer CPR — even though it was clear Jackson was already gone.
I’ve seen a couple people overdose on opiates(both survived, good ol’ Narcan) and they *completely* stopped breathing. CPR isn’t going to do much if you’re not giving mouth-to-mouth. In my opinion, it’s looking like this may be exactly what happened to MJ.
From my experience, most EMTs will have Narcan with them, though it may not be this way in other places. If only, if only…
Of course, opiates are the first thing to be blamed but for someone habituated to opiates, it would take a pretty hefty dose way above the norm to cause respiratory depression sufficient enough to cause cardiac arrest. Most likely, it was his lupus that did him in, as lupus predisposes its sufferers to heart problems due to inflammation of the arteries and heart and cardiac arrest does tend to be a leading cause of death in lupus patients. In either case, a shortened lifespan would not be inconsistent with lupus.
Mr Jackson had a damn good reason to be on opiates, as lupus can be as painful as hell. That’s probably why he stopped performing. It can also lead to psychosis and other mental problems, which might explain some of his weird behavior. Let’s dispense with the knee-jerk assumption that any celebrity on pain medication must be an addict and if anyone on pain medication dies, it must be due to the drugs.
Why would the doctor refuse to pronounce him dead at the scene? What would doing that entail?
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