Kentucky Lethal Injection Protocol


Notify Department of Corrections of receipt of Governor's Death Warrant (immediately).

Begin a special section of condemned's medical record for all medical actions (X-14 days).

Nurse visits and checks on the condemned each shift, 7 days a week, using the special medical section to record contacts and observations (X-14 days).

(Redacted) personally observes and evaluates the condemned five (5) days per week, Monday through Friday (X-14 days).

Place the (redacted)'s documentation in the permanent record immediately after personal contact. Department of Corrections (redacted) or his designee reviews and initials nursing documentation in #3 daily (X-14 days).

(Redacted) reviews nursing and doctor’s documentation weekly.

Physical examination is completed by the (redacted) or his designee no later than seven (7) days prior to execution.

Place the physical in the permanent medical record upon completion.

(Redacted)'s evaluation is completed by (redacted) no later than seven (7) days prior to execution. Place the psychiatric evaluation in the permanent medical record and send copies to the Warden. (Redacted) or his designee personally observes and evaluates the condemned’s medical condition weekly.

Place the (redacted) or his designee notes in the permanent record immediately after personal contact.

Notify all medical staff to immediately notify the Warden, (redacted) or designee and (redacted) of any change in the inmate’s medical or psychiatric condition.

Sequence of Events

At (redacted), the Warden orders the condemned escorted to the execution chamber and strapped to the gurney.

The IV team members will be the members of the execution team who site and insert the IV lines.

The team enters the chamber and runs the IV lines to the condemned inmate, site and insert one (1) primary IV line and one (1) backup IV line in a location deemed suitable by the team members.

The insertion site of preference shall by the following order: arms, hands, ankles and/or feet, neck. To best assure that a needle is inserted properly into a vein, the IV team members should look for the presence of blood in the valve of the sited needle.

If the IV team cannot secure one (1) or more sites within one (1) hour, the Governor's Office shall be contacted by the Commissioner and a request shall be made that the execution be scheduled for a later date.

The team will start a saline flow.

The team will securely connect the electrodes of the cardiac monitor to the inmate and ensure the equipment is functioning.

The team will then move to the hallway and stand by.

The team leader will recheck all restraints and determine they are secure and so advise the Warden.

The Warden will confirm that all is ready.

The Warden will make one final check with the attorneys stationed outside the chamber.

The Deputy Warden will open the curtain and turn on the microphone.

The Warden states, "At this time we will carry out the legal execution of (condemned's name)."

The Warden asks the condemned if he wants to make a final statement (two (2) minutes allowed). Upon the Warden's order to "proceed" and the microphone turned off, a designated team member will begin a rapid flow of lethal chemicals in the following order:

1)Sodium Thiopental (3gm). NOTE: If it appears to the Warden that the condemned is not unconscious within 60 seconds to his command to "proceed," the Warden shall stop the flow of Sodium Thiopental in the primary site an order that the backup IV be used with a new flow of Sodium Thiopental.

2) Saline (25 mg).

3) Pancuronium Bromide (50 mg).

4) Saline (25 mg).

5) Potassium Chloride (240 meq).

A designated team member will begin a stopwatch once the lethal injections are complete. If the heart monitor does not indicate a flat line after ten (10) minutes and if during that time the physician and coroner are not able to pronounce death, the Warden will order a second set of lethal chemicals to be administered (Sodium Thiopental, Pancuronium Bromide (sic), and Potassium Chloride). This process will continue until death has occurred.

A designated team member will observe the heart monitor and advise the physician of cessation of electrical activity of the heart.

The curtain shall be drawn when the Physician and coroner enter the chamber and confirm death by checking the condemned's pulse and pupils and so advise the Warden.

The will then be opened. The Warden turns on the microphone and states: "At approximately ___ p.m. the execution of _______ was carried out in accordance with the laws of the Commonwealth of Kentucky".

The microphone is turned off and the curtains will be drawn.

The witnesses are escorted out of the witness room, first the media, inmate's witnesses, and then the victim's witnesses.

The team will prepare the body for departure.

Release body per prior arrangements.

Funeral director completes death certificate.

Not more than one (1) day after the execution, the Warden shall return the copy of the judgment of the court pronouncing the death sentence, of the manner, time and place of its execution.

Close out inmate account during next business day.

Contact individual designated to receive condemned's personal property for pick up of property the next business day.

Compile all documents pertaining to Execution and place in inmate file.

Execution Team Qualifications

1)The following people with at least 1 year of professional experience may be on the IV team:

a)Certified Medical Assistant, or

b)Phlebotomist, or c)Emergency Medical Technician, or

d)Paramedic, or

e)Military Corpsman

2)Prior to participating in an actual execution, the member of the IV team must have participated in a least two (2) practices.

3)Members of the IV team must remain certified in their profession and must fulfill any continuing education requirements in their profession.

4)The execution team shall practice at least ten (10) times during the course of one (1) calendar year. 5)Each practice shall include a complete walk through of an execution including the siting of two (2) IVs into a volunteer.

6)Execution team members, excluding the IV team members, must have participated in a minimum of two (2) practices prior to participating in an actual execution.

Stabilization Procedure After The Execution Has Commenced

1)In the event that a stay is issued after the execution has commenced, the execution team will stand down and medical staff on site will attempt to stabilize the condemned with the below listed equipment and personnel.

a)The Warden will arrange for an ambulance and staff to be present on institutional property.

b)A medical crash cart and defibrillator shall be located in the execution building.