Re: 911:: Universal Precautions

[Guest guest]

> I know we have gone over this before, but does anyone have any " legal "

> information about voicing " universal precautions " over the air? Not

actually

> saying the patient has a CERTAIN disease...just to use " UP " because you

were

> given info during a phone call. Patients rights being violated because

> information was given over air/computer etc...

>

> Before you start yelling...I KNOW they should always be followed....but I

> need info on how you can get into big trouble when you say ANYTHING about

> them on the air.

>

********************************************************************

Here in Iowa, we have been " told " by a non-legal or law enforcement

division " that use of any descriptive language to alert to a certain medical

condition is prohibited. I asked if that related to Aids or Hep type C

patients, yes was the answer. I asked what about patients on Insulin or

other life assisting drugs. They didn't know. That was about 10 years ago,

I keep asking they keep ignoring me. One answer from this division was that

FBI NCIC had mandated it. I asked to see a copy of the language or the

memo....nope can't show you.

So you be the judge. Clear as mud right?

Oh this " division " is the one that controls our Iowa system teletype

functions.

Go figure.

Iowa State Patrol Communications, Cedar Rapids

Werling NØXZY

scott@...

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[Guest guest]

Here we are, back on this thread.

My thoughts are this....All who have gone thru Police Academy, and Ems/fire

training....should know when to glove up, etc...... All should treat every

incident as an intrusion on their body/defense systems.

IT is Not my job to tell them to do that. From having training on Both sides

of the issue...I shall leave it at that.

Give them the call. I know that when I go on a call....I should have sense

enough to know what to do. Don't place yourself in a negative situation, in

the dispatch sense.

My opinion only~~~~

Cin in Good Ole Ohio

Happy day, be safe

Pray for our troops~~

Semper Fidelis~~

[Guest guest]

>I know we have gone over this before, but does anyone have any " legal "

information about voicing " universal precautions " over the air?

Check with the city/county attorneys office that serves your agency. They

should be able to direct you to state laws, and possibly federal laws covering

this.

Medical information is private... I don't care if you're police/fire/ems

or a combination....

You have no more right to broadcast a persons private medical

information, than your doctor would have in broadcasting yours.

Why do it?

If you do so, and that person can prove they were harmed by

your negligence, you and your department are liable.

That's the way I understand it. (Could be wrong)

That's why I don't do it.

If others don't want to use universal precautions, that is

their lack of responsibility, I have no control over how they

do their job.

Weintraut

[Guest guest]

Here is a very good article, that may lead you to some

legal information...

http://www.emergencydispatch.org/articles/quietandcareful2.htm

It mentions The White Comprehensive AIDS Resources Emergency Act, or CARE

(Public Law 101-381), does not require nor allow the release of the patient

names, even after an exposure to one of the listed diseases. The Act allows

only notification that an exposure has occurred. In a legal opinion the NYS

Department of Health Legal Counsel, the emergency personnel who receives this

information are themselves bound by confidentiality restrictions on

redisclosure. According to 300ff-99 ( c), this statute " may not be construed

to authorize or require any medical facility, any designated officer of

emergency response employees, or any such employee, to disclose identifying

information with respect to an emergency response employee. " (Federal

Register, Vol. 59, No. 54, 3-21-94)

Weintraut

[Guest guest]

>just to use " UP " because you were

given info during a phone call.

The only way you could safely do this is to use the

statement on EVERY call.

Otherwise, it could be considered a " code " that the

patient has a infectious disease.

If you're using a code... you might as well say it over the air..

Same difference, you are violating the patients rights.

Weintraut

[Guest guest]

Andi

Opinion says " Heck yes, tell the officer anything you can. "

Our legal opinions however have told us that ANY communication via ANY means is

a violation of that person's right to privacy. So, in that case..yes, having the

conversation over the cell phone, via pager or any other way would be as much a

violation as airing the information over the airwaves.

Freida

La Vergne, TN

> My question is does anybody else think this was a violation of his

confidentiality? We didn't air it to Q Public, just our officer. Good thing

too because the officer wasn't aware of the danger. Any opinion on that

situation?

[Guest guest]

>The officer is responsible for putting on the gloves, you shouldn't

have to remind him.

Amen.

Weintraut

[Guest guest]

Hate to throw a curve on this subject, but calling a responding unit on the

wireless telephone which is/can also be monitored by the public or

scannable by anyone, is the same as broadcasting the information on the

radio. We also do not broadcast any information as described in past

emails. It is in all protocols for all responding units to use precautions

for every patient.

Hodges

Professional Standards & Training Coordinator

http://www.seminolepublicsafety.org

Choose your attitude!

[Guest guest]

I think it would still be a violation. All the

officers/rescue/EMS personnel should be trained to treat every

situation as if it were the real thing. Those who are trained

that way and don't choose to follow the regs, well, how stupid

can one be? As always, it is just my opinion.

@ Burlington, VT, Police/Fire Departments

[Guest guest]

The officer should ALWAYS go in prepared, and ALWAYS assume there is

'danger'. IMO its akin to not wearing a vest if you work in a retirement

community. Elderly people don't have guns, right ? To presume there is " no

danger " unless told otherwise is the absolute bass-ackwards position. I've

fought this one in dispatch and police forums the same. The cops usually

swear its their given right to be advised of dangers that we are aware of.

Weapons - yes. Biohazards - no way . And that if someone tells us about

hepatitis or HIV or anything and we DON'T tell them, they will get 'even'

with us. I still stand by the training that I've received and will not

advise anyone of medical type biohazard information if it is given to me.

Period.

One other thing - I have had people tell me on the phone " tell the officers

or the EMT's I have HIV or Hepatitis. " I've programmed a response in my

brain to this: " I'm sorry but I can't tell them that. IF you think it is

important that they know that when they arrive, you need to tell them that. "

Diane G.

UVM PD / Burlington VT

> us by cell before he went in. We did advise him of the hep-c. No

information was aired and the officer went in prepared.

> My question is does anybody else think this was a violation of his

confidentiality? We didn't air it to Q Public, just

> our officer. Good thing too because the officer wasn't aware of the

danger. Any opinion on that situation?

[Guest guest]

Not only should/do officers carry gloves, when I go out on ride alongs, I

grab a pair and put in my pocket. One officer laughed at me and I told her

" then don't expect me to help you if you get a bad accident call! " All

employees (including dispatchers) have yearly blood borne-air borne pathogen

training so I'd have no excuse to not be prepared. It's like taking a

couple bucks for coffee, a pen & paper to take notes on, and if chilly, a

jacket.

Kathy

[Guest guest]

There is actual case law on three cases where the words

" universal percautions " were used over the air.

One case in particular was an AIDS patient whose family

sued the communications center and won somewhere around

seven million dollars. Another case was dispatched via

cell phone and picked up by the public.

Our agency has stuck by the fact that scene responders

should already be utilizing these precautions. We give no

forwarning over the air or phone. Hope this helps!

B

Blair County PA

[Guest guest]

In a message dated 6/3/02 8:03:45 PM Pacific Daylight Time,

jtkjones@... writes:

> ? If a caller calls and says he/she is having a heart attack that's medical

> history in the making. Am I now not allowed to give that out over the

> radio? From now on should I just say Medics go to 123 Main Street. You'll

> find out what you have when you get there?

>

> I think telling a EMS unit the patients chief complaint would not count as

> medical breech like a infectious disese is. Chief complaints also alerts

> the units responding as what level of care they need. Like a Cardiac tech

> or can an EMT handle it.

[Guest guest]

Not actually. Verbal consent does not release a person from

liability. As far as the other statement about what if the patient

becomes unconscious before arrival of an EMS unit. Please understand

that EMT/Paramedics are always faced with unconscious patients who

may or may not have an infectious disease. I dispatch and work in the

field as an EMT and at no time does any information regarding a

patient's infectious disease status change my course of treatment.

You treat the patients current medical condition, not their disease.

>If the caller tells or asks you to advise responding units of their

>condition then they have released you from any confidentiality there

>might have been.

>

>Jim (not a lawyer)

>Mr 911

>TriCom

[Guest guest]

Please keep in mind that just because a patient tells you does not

mean they have to tell the responding EMS personnel. Patients have

the right to refuse disclosure of infectious diseases. When the

patient tells you they have an infectious disease, they might not

understand the fact you can put that information over the air so that

their neighbors can listen (if they have a scanner or such). And in

that case, they might change their minds.

Not to mention by releasing that information and not advising the

person that this information can be heard by people other than the

EMS personnel, where is your legal standing there? You could be held

liable for not advising the patient of their rights.

>In a message dated 6/3/02 5:23:40 PM Mountain Daylight Time,

>KESPICH@... writes:

>

><< does anything change if the person who is the

> patient ASKS you to relay the information to responding units? >>

>We've been told by our city attorney that if the PATIENT tells us anything,

>we can relay it. But if it comes from any other source, we can not air/mdt

>the info. Best thing we can do is tell the caller to be sure to tell the

>paramedics. I've even asked to speak to the first responder when they

>arrived on scene and told them what the caller said and to verify it with the

>caller/patient.

>

>Kathy

[Guest guest]

<<<But if a person voluntarily tells you to tell the medics about a medical

problem, I will tell them.>>>

I was always told. If they tell you to tell the medics, or who ever, then

you tell the caller. Please inform them when they get there, I can not tell

them

Jim

Columbus Police

Columbus Ohio

[Guest guest]

jim wrote: <<< It is also common knowledge that 911 calls are recorded and

people should know that just about anyone can get a copy of a tape through

the freedom of information act...All the second party has to do is request a

copy of the phone call and voila, info on the complainant is all there.

These requests can be refused under certain circumstances but also must be

granted in many cases. >>>

in illinois there are certain conditions under which information requested

under FOIA should be refused. they include the release of complainant name,

address and telephone number data if the caller has made a complaint to the

police as opposed to a report. a complaint could be anything from a barking

dog to criminal activity. a report might be an auto accident. this

precludes someone from requesting a tape of a 9-1-1 call to find out who

called the cops about his loud party. this same exclusion to FOIA includes

copies of the CAD ticket, etc. of course the information could always be

subpoenaed but i hope that most agencies would at least challenge the

legality of a subpoena seeking information that was denied under FOIA in

front of a judge.

rich

[Guest guest]

And when you air that information, where does it go? It goes to

everyone with a scanner/radio etc... in that case you just violated

that person rights to confidentiality, because you not only told EMS,

but to everyone else who was listening.

>I didn't say liability. Anyone can sue you at any time. But if a

>person voluntarily tells you to tell the medics about a medical

>problem, I will tell them.

>

>Jim

>Mr 911

>TriCom

[Guest guest]

Cardiac history is not covered as a disability under the ADA like

HIV/AIDS and there is not a Federal Law requiring confidentiality

like there is of HIV/AIDS patients. Should have taken the time to

read over the article that was provided by from the NAED.

>It is also common knowledge that 911 calls are recorded and people

>should know that just about anyone can get a copy of a tape through

>the freedom of information act. One they verbally state to having

>something it's available for many to hear if the tape access is

>granted. Same when a caller wants to be anonymous but makes that

>decision after leaving his/her name and number and address. I can

>take that out of the CAD ticket but it's still on tape. All the

>second party has to do is request a copy of the phone call and

>voila, info on the complainant is all there. These requests can be

>refused under certain circumstances but also must be granted in many

>cases.

>

>This leads me to ask: Under certain EMD cards there are medical

>history questions such as " Does the patient have a history of heart

>problems " . Is that also covered as being confidential? If a caller

>calls and says he/she is having a heart attack that's medical

>history in the making. Am I now not allowed to give that out over

>the radio? From now on should I just say Medics go to 123 Main

>Street. You'll find out what you have when you get there?

>

>Jim (still not a lawyer)

>Mr 911

>TriCom

[Guest guest]

I know this has probably already been covered, but as many places as I have

been, it is common practice that Medics, Police offers and hospital

emergency room personel WEAR GLOVES no matter what if there is a possibility

of contamination either by blood or whatever. We shouldnt, as dispatchers,

have to tell them there is a possibility of an infection disease present.

If they wear their gloves, and treat EVERY scene as an infection enviroment

like they are supposed to, we wouldnt have this problem

Just my opinion

Chris

Lake Tahoe

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[Guest guest]

The chances are that what you are referring to is a HERN or Med

Channel. These are both radio freq and can be picked up by a scanner.

Advising a patient's infectious disease status over these channels is

also considered a breach of their confidentially. Yeah you are

advising the hospital of what you have, but you are also providing

that information to everyone else. The rule of thumb with patient

confidentially is that you can only provide patient information to a

healthcare professional who is directly taking over care. That only

occurs when you transfer a patient (in person) from EMS's care to

hospital care and a verbal report is made to the RN or Physician.

>if I am not mistaken, I believe here the ambulances are equipped

>with some sort

>of direct phone line to the emergency rooms. I know that (for the

>agencies that

>I worked for) we cannot hear what is said btwn the two (ambulance & er

>doctors)...

>

>of course, every agency/jurisdiction has different technology & protocol.

[Guest guest]

>not fire and not medical, admittedly mostly before

aids and the Act, but everyone seems to focus on the dispatched

situation,

where gloves would be the norm.

And that's what we're mostly talking about, the dispatch situation,

and whether or not to transmit infectious disease information.

Due to the Act, and good common sense, transmitting infectious

disease information is liable, and unnecessary... Universal Precautions

is the only answer.

As for the " instant action " situations, you're right, the officer/s

can be put in immediate danger... nothing dispatch can do

about that. Officers need to be trained, and regularly brought

to attention about those dangers.

Weintraut

[Guest guest]

Hey stranger :-)

1) No we don't air it.

2) No don't " type it " .

3) No we don't " store it " .

Steve son

Manager - Communications & Technical Services

Lenexa Ks Police Dept (a Kansas City suburb)

sdavidson@...

911:: universal precautions

Hello all!

I am back on the list after a lengthy time away! I am very glad to be back!

Question for the group - what is your agency's SOP in regards to airing

communicable disease information? Can you type it to responders on their

MDT/Laptop? Are you allowed to enter premise histories with such information?

Crissy

Poudre Emergency Communications

Fort CO

[Guest guest]

>Privileged is Privileged! Using a special code, signal,

phrase or even saying " use universal precautions " is

violating the law, unless of course you are saying these

phrases each and every time you send units to a call.So sue me.

Someone may very well do just that. And if they do,

and you have disclosed privileged information, they

will more than likely win.

Weintraut

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[Guest guest]

I agree with Bob. Also keep in mind that each and every person has a

right to privacy. Even if the person volunteers that information, it

can not be legally relayed to a third party. And frankly the

responders are dumb asses if they need to be told to use Universal

Precautions. And not to mention you have OSHA guidelines regarding

universal precautions and bloodborne pathogens. As an EMT I dont need

to be told when I need to wear universal precautions, every patient

should be consider to be a carrier of a bloodborne pathogen.

And before anyone is thinking they are doing a service for their

responders, think about the disservice you just gave to that person

who's rights you just violated.

There are other solutions to airing this information over any format

of media...

>

>Remember, voice recordings, pager records and MDT's are public record and

>can be viewed by anyone. It is a consistence thing! I know there are some

>out there that do not agree with any applicable laws concerning this, and

>some that are even thinking that what are the odds of being caught?

>

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