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Correct me if I am wrong, but doesn't the current law allow for the

mandatory blood draw only if there is a death or serious bodily injury as a

result of the crash? If that is the case, then I don't see a circumstance

where a paramedic will be called to the scene when there are no other

injuries. You'll be out there taking care of the serious injuries anyway.

If you don't have time to draw blood from an uninjured suspect, then that's

the way it goes. Maybe there are some cops out there with an ego that would

try to pull you away from patient care in order to obtain blood, but if so,

I'm lucky to have never met one. And if one can't testify to a blood draw

under " recognized medical procedure " , how would one be able to testify to

any veinipuncture if called into court to do so? Either you can describe

the process of putting a needle into a vein or you can't. One other thing

that may be a consideration is that it is possible that some jail facilities

have a paramedic or EMT-I on site for medical response. It seems to me that

this bill would allow those folks the draw blood from a suspect at the jail,

whereas before they were not specifically allowed to do so. I guess for me

it isn't a big deal...it's just part of the profession.

Ed Strout, RN, CEN, LP

Clinical Practice Coordinator

Austin- County EMS

517 S. Pleasant Valley Rd.

Austin, Tx. 78741

Office

Pager

Fax

e-mail: ed.strout@...

HEADS UP!!

Folks,

HB 1141 by Riddle adds EMT-I and Paramedics to those who can be ORDERED by a

police officer to draw blood whenever they think they need it. It makes no

provision for us to decide when we have time to do this nor to refuse when

patient care of that patient or others should come first. It provides for

no

compensation for doing it, and they could call us to the scene of any DWI

stop or to the jail to draw blood anytime they wanted us. No provisions for

who will pay for the calls, pay for the supplies, pay the overtime we'll

spend sitting in the courthouse waiting to testify, nothing about the

medical directors who every decent defense attorney will call to cross

examine on the training and so forth. The bill provides protection from

liability only if the blood is drawn using " recognized medical procedures. "

Want to try testifying on that subject? Want to try documenting blood

draws? Folks, this is a BAD bill for EMS. We all want to stop DWIs but

this is not the way to do it.

We have until approximately 1500 tomorrow to get letters off to the members

of the House CalendarCommittee opposing this. If it is set on the calendar

for hearing it will probably pass without opposition since the members won't

know about any opposition.

Here's a sample letter to send to the members. Names of committee members

and their FAX numbers will follow.

Dear _____________

As an __________________ working for _______________________ I am very

concerned about HB 1141 by Debbie Riddle, which would add EMT-Is and

paramedics to the list of people who could draw blood when police believe a

person is driving under the influence. Please don't set that bill for

consideration on the House floor.

While the bill looks innocent, it will have unintended consequences for EMS

providers and EMS personnel. Even if EMTs are on the scene of a traffic

accident helping patients, taking blood from a person under arrest in a

chaotic situation is difficult. If the alleged drunk driver is not injured,

then very likely that person is in handcuffs with his or her hands behind

the

back. This makes it very difficult, if not dangerous for an EMT to take

blood. Who will stand behind the paramedic who gets an accidental blood

stick

from a person who turns out to have AIDS or hepatitis? What if the person

resists the procedure and the EMT breaks a needle in the arm?

What if the police call an ambulance out to have EMTs and Paramedics take

blood when there are no other injuries? Many times ambulances are called out

when there is no emergency. Calls of this nature could tie up an ambulance

when someone else has an emergency and needs us.

HB 1141 is just a bill that should not pass. Please support Emergency

Medical

Services in your area. Don't set this bill.

Sincerely,

(Your Name)

Members to fax:

> All numbers are AC 512.

>

> Beverly Woolley, 463-9333

>

> Arlene Wohlgemuth, 463-6551

>

> Wayne Christian, 463-3102

>

> Suzanna Gratia Hupp, 463-8284 [a strong supporter of this bill]

>

> Velma Luna, 463-8090

>

> Jerry Madden, 463-9974

>

> Menendez, 463-0634

>

> Gene Seaman, 4633509

>

> Barry Telford, 463-8155

>

> Vicki Truitt, 477-5770

>

> Sylvester , 463-8380

>

Gene Gandy, JD, LP

EMS Consultant

HillGandy Associates

POB 1651

Albany, TX 76430

wegandy@...

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I strongly agree Gene and have faxed all the folks I can. Arlene

Wohlgemuth's fax reports out of service and of course Suzanna Gratia Hupp's

fax does not answer. All others went through.

Would love to see others do the same if they concur.

Larry Mc

Coordinator

Paris Junior College EMSP

HEADS UP!!

Folks,

HB 1141 by Riddle adds EMT-I and Paramedics to those who can be ORDERED by a

police officer to draw blood whenever they think they need it. It makes no

provision for us to decide when we have time to do this nor to refuse when

patient care of that patient or others should come first. It provides for no

compensation for doing it, and they could call us to the scene of any DWI

stop or to the jail to draw blood anytime they wanted us. No provisions for

who will pay for the calls, pay for the supplies, pay the overtime we'll

spend sitting in the courthouse waiting to testify, nothing about the

medical directors who every decent defense attorney will call to cross

examine on the training and so forth. The bill provides protection from

liability only if the blood is drawn using " recognized medical procedures. "

Want to try testifying on that subject? Want to try documenting blood

draws? Folks, this is a BAD bill for EMS. We all want to stop DWIs but

this is not the way to do it.

We have until approximately 1500 tomorrow to get letters off to the members

of the House CalendarCommittee opposing this. If it is set on the calendar

for hearing it will probably pass without opposition since the members won't

know about any opposition.

Here's a sample letter to send to the members. Names of committee members

and their FAX numbers will follow.

Dear _____________

As an __________________ working for _______________________ I am very

concerned about HB 1141 by Debbie Riddle, which would add EMT-Is and

paramedics to the list of people who could draw blood when police believe a

person is driving under the influence. Please don’t set that bill for

consideration on the House floor.

While the bill looks innocent, it will have unintended consequences for EMS

providers and EMS personnel. Even if EMTs are on the scene of a traffic

accident helping patients, taking blood from a person under arrest in a

chaotic situation is difficult. If the alleged drunk driver is not injured,

then very likely that person is in handcuffs with his or her hands behind

the

back. This makes it very difficult, if not dangerous for an EMT to take

blood. Who will stand behind the paramedic who gets an accidental blood

stick

from a person who turns out to have AIDS or hepatitis? What if the person

resists the procedure and the EMT breaks a needle in the arm?

What if the police call an ambulance out to have EMTs and Paramedics take

blood when there are no other injuries? Many times ambulances are called out

when there is no emergency. Calls of this nature could tie up an ambulance

when someone else has an emergency and needs us.

HB 1141 is just a bill that should not pass. Please support Emergency

Medical

Services in your area. Don’t set this bill.

Sincerely,

(Your Name)

Members to fax:

> All numbers are AC 512.

>

> Beverly Woolley, 463-9333

>

> Arlene Wohlgemuth, 463-6551

>

> Wayne Christian, 463-3102

>

> Suzanna Gratia Hupp, 463-8284 [a strong supporter of this bill]

>

> Velma Luna, 463-8090

>

> Jerry Madden, 463-9974

>

> Menendez, 463-0634

>

> Gene Seaman, 4633509

>

> Barry Telford, 463-8155

>

> Vicki Truitt, 477-5770

>

> Sylvester , 463-8380

>

Gene Gandy, JD, LP

EMS Consultant

HillGandy Associates

POB 1651

Albany, TX 76430

wegandy@...

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Representative Hupp is a Law and Order legislator. Nothing wrong with that

and she has sponsored many bills that have been of help to law enforcement

and the millitary. She was a good bit of help to me back during the EMS

" education wars " . I suspect she is unaware of the potentials this bill is

creating. I also suspect she would be very interested in hearing our side of

the story.

As someone else mentioned her fax machine is not answering tonight. It is

too late today but tomorrow I will phone her office. Anybody else that

wishes should do so as well. Especially those living in Lampasas or Burnet

counties as that is her district.

Capitol office

Austin

Fax

District Office

Lampasas

Mailing address

Room EXT E1.414

P.O. Box 2910

Austin, TX 78768

Regards,

Donn

HEADS UP!!

>

>

>

> Folks,

>

> HB 1141 by Riddle adds EMT-I and Paramedics to those who can be ORDERED by

a

> police officer to draw blood whenever they think they need it. It makes no

> provision for us to decide when we have time to do this nor to refuse when

> patient care of that patient or others should come first. It provides for

no

> compensation for doing it, and they could call us to the scene of any DWI

> stop or to the jail to draw blood anytime they wanted us. No provisions

for

> who will pay for the calls, pay for the supplies, pay the overtime we'll

> spend sitting in the courthouse waiting to testify, nothing about the

> medical directors who every decent defense attorney will call to cross

> examine on the training and so forth. The bill provides protection from

> liability only if the blood is drawn using " recognized medical

procedures. "

> Want to try testifying on that subject? Want to try documenting blood

> draws? Folks, this is a BAD bill for EMS. We all want to stop DWIs but

> this is not the way to do it.

>

> We have until approximately 1500 tomorrow to get letters off to the

members

> of the House CalendarCommittee opposing this. If it is set on the calendar

> for hearing it will probably pass without opposition since the members

won't

> know about any opposition.

>

> Here's a sample letter to send to the members. Names of committee members

> and their FAX numbers will follow.

>

> Dear _____________

>

> As an __________________ working for _______________________ I am very

> concerned about HB 1141 by Debbie Riddle, which would add EMT-Is and

> paramedics to the list of people who could draw blood when police believe

a

> person is driving under the influence. Please don’t set that bill for

> consideration on the House floor.

>

> While the bill looks innocent, it will have unintended consequences for

EMS

> providers and EMS personnel. Even if EMTs are on the scene of a traffic

> accident helping patients, taking blood from a person under arrest in a

> chaotic situation is difficult. If the alleged drunk driver is not

injured,

> then very likely that person is in handcuffs with his or her hands behind

the

> back. This makes it very difficult, if not dangerous for an EMT to take

> blood. Who will stand behind the paramedic who gets an accidental blood

stick

> from a person who turns out to have AIDS or hepatitis? What if the person

> resists the procedure and the EMT breaks a needle in the arm?

>

> What if the police call an ambulance out to have EMTs and Paramedics take

> blood when there are no other injuries? Many times ambulances are called

out

> when there is no emergency. Calls of this nature could tie up an ambulance

> when someone else has an emergency and needs us.

>

> HB 1141 is just a bill that should not pass. Please support Emergency

Medical

> Services in your area. Don’t set this bill.

>

> Sincerely,

>

> (Your Name)

>

> Members to fax:

> > All numbers are AC 512.

> >

> > Beverly Woolley, 463-9333

> >

> > Arlene Wohlgemuth, 463-6551

> >

> > Wayne Christian, 463-3102

> >

> > Suzanna Gratia Hupp, 463-8284 [a strong supporter of this bill]

> >

> > Velma Luna, 463-8090

> >

> > Jerry Madden, 463-9974

> >

> > Menendez, 463-0634

> >

> > Gene Seaman, 4633509

> >

> > Barry Telford, 463-8155

> >

> > Vicki Truitt, 477-5770

> >

> > Sylvester , 463-8380

> >

>

>

>

>

> Gene Gandy, JD, LP

> EMS Consultant

> HillGandy Associates

> POB 1651

> Albany, TX 76430

>

> wegandy@...

>

>

>

>

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I faxed as many of them as their machines would respond.

Jane Hill

HEADS UP!!

Folks,

HB 1141 by Riddle adds EMT-I and Paramedics to those who can be ORDERED by a

police officer to draw blood whenever they think they need it. It makes no

provision for us to decide when we have time to do this nor to refuse when

patient care of that patient or others should come first. It provides for no

compensation for doing it, and they could call us to the scene of any DWI

stop or to the jail to draw blood anytime they wanted us. No provisions for

who will pay for the calls, pay for the supplies, pay the overtime we'll

spend sitting in the courthouse waiting to testify, nothing about the

medical directors who every decent defense attorney will call to cross

examine on the training and so forth. The bill provides protection from

liability only if the blood is drawn using " recognized medical procedures. "

Want to try testifying on that subject? Want to try documenting blood

draws? Folks, this is a BAD bill for EMS. We all want to stop DWIs but

this is not the way to do it.

We have until approximately 1500 tomorrow to get letters off to the members

of the House CalendarCommittee opposing this. If it is set on the calendar

for hearing it will probably pass without opposition since the members won't

know about any opposition.

Here's a sample letter to send to the members. Names of committee members

and their FAX numbers will follow.

Dear _____________

As an __________________ working for _______________________ I am very

concerned about HB 1141 by Debbie Riddle, which would add EMT-Is and

paramedics to the list of people who could draw blood when police believe a

person is driving under the influence. Please don’t set that bill for

consideration on the House floor.

While the bill looks innocent, it will have unintended consequences for EMS

providers and EMS personnel. Even if EMTs are on the scene of a traffic

accident helping patients, taking blood from a person under arrest in a

chaotic situation is difficult. If the alleged drunk driver is not injured,

then very likely that person is in handcuffs with his or her hands behind

the

back. This makes it very difficult, if not dangerous for an EMT to take

blood. Who will stand behind the paramedic who gets an accidental blood

stick

from a person who turns out to have AIDS or hepatitis? What if the person

resists the procedure and the EMT breaks a needle in the arm?

What if the police call an ambulance out to have EMTs and Paramedics take

blood when there are no other injuries? Many times ambulances are called out

when there is no emergency. Calls of this nature could tie up an ambulance

when someone else has an emergency and needs us.

HB 1141 is just a bill that should not pass. Please support Emergency

Medical

Services in your area. Don’t set this bill.

Sincerely,

(Your Name)

Members to fax:

> All numbers are AC 512.

>

> Beverly Woolley, 463-9333

>

> Arlene Wohlgemuth, 463-6551

>

> Wayne Christian, 463-3102

>

> Suzanna Gratia Hupp, 463-8284 [a strong supporter of this bill]

>

> Velma Luna, 463-8090

>

> Jerry Madden, 463-9974

>

> Menendez, 463-0634

>

> Gene Seaman, 4633509

>

> Barry Telford, 463-8155

>

> Vicki Truitt, 477-5770

>

> Sylvester , 463-8380

>

Gene Gandy, JD, LP

EMS Consultant

HillGandy Associates

POB 1651

Albany, TX 76430

wegandy@...

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Actually Jane this is a change to an existing law, not a new law. I had an

opportunity to look up the existing law and it is very specific. The only

circumstance where a police officer can obtain blood without voluntary

consent is if the suspect was the operator of a vehicle and was involved in

a collision, and the officer believes that someone has dies or will likely

die as a result of the collision. They cannot order a blood draw for a

minor injury collision or a DWI stop. (Transportation Code Section 724.012

If a collision as described above occurs, then most likely an ambulance will

be sent to the scene anyway, so it's not really an additional call for the

system. Since the suspect has to be involved in the collision, then the

suspect will most likely also have to be considered a patient while at the

scene, which means that an EMS provider will have to do an assessment. That

makes the provider a witness, which means that the possibility of sitting in

court already exists.

They way I read this change in the law (and I'm the first to admit that I

have no legal background, so my interpretation is simply my humble opinion),

it simply adds paramedics to the list of medical professionals qualified to

draw blood in this circumstance. The law as it currently stands

specifically excludes EMS as qualified individuals. (Transportation Code

Section 724.017...this is the part that is up for change).

There has been discussion in the past about the fact that EMS providers are

not looked at or treated as medical professionals in the same way that

nurses are. While this may not be exactly how we had hoped to start that

process, it does seem that we will inevitably have to accept some of the

not-so-good aspects of that goal, and this is one of those unpleasant side

effects.

Gene has raised legitimate concerns about liability and infection control.

I can't say how the liability issues may bear out, but the infection control

issues are covered by law. The agency that employs you (or that you

volunteer for) is required by law to pay for treatment and testing in the

event of an exposure to a communicable disease. (Government Code Chapter

607).

It's time for me to get back to work, so I'll close this note by saying that

this is one of the better discussion threads I've seen come through in a

while. It is discussion that needs to happen, and I thank you all for

keeping it professional and interesting. This isn't to say that I'm done

with it...just saying keep up the good work on this and any other topics

that concern us.

Re: HEADS UP!!

First off, this is concerning a NEW potential law that would allow law

enforcement to use us for this purpose in many situations. It IS a big deal

for services with few resources. There WOULD be situations where EMS

agencies would be called out to do this if this passes, you can count on it.

And the service responsible for the area - volunteer or not - can be called

out for this. There could be issues arising where the officer wants the

blood drawn, but you ARE caring for other serious injuries and patients and

don't have time but are now being pressured to do this too.

Then there is the inevitable situation involving being subpoenad for court

for these blood draws. Austin may can afford to pay for their medics to sit

in court and pay for someone else to cover their shifts while they are

there. But smaller services could find this as another unnecessary burden

for another unfunded mandate. Something like this that you have identified

as " just part of the profession " that is not entirely necessary and that

could actually negatively impact any segment of the EMS service population

(rural, municipal, etc.) is not something that we need to add to our already

overwhelmed systems.

Just my opinions.

Jane Hill

HEADS UP!!

Folks,

HB 1141 by Riddle adds EMT-I and Paramedics to those who can be ORDERED by

a

police officer to draw blood whenever they think they need it. It makes

no

provision for us to decide when we have time to do this nor to refuse when

patient care of that patient or others should come first. It provides for

no

compensation for doing it, and they could call us to the scene of any DWI

stop or to the jail to draw blood anytime they wanted us. No provisions

for

who will pay for the calls, pay for the supplies, pay the overtime we'll

spend sitting in the courthouse waiting to testify, nothing about the

medical directors who every decent defense attorney will call to cross

examine on the training and so forth. The bill provides protection from

liability only if the blood is drawn using " recognized medical

procedures. "

Want to try testifying on that subject? Want to try documenting blood

draws? Folks, this is a BAD bill for EMS. We all want to stop DWIs but

this is not the way to do it.

We have until approximately 1500 tomorrow to get letters off to the

members

of the House CalendarCommittee opposing this. If it is set on the

calendar

for hearing it will probably pass without opposition since the members

won't

know about any opposition.

Here's a sample letter to send to the members. Names of committee members

and their FAX numbers will follow.

Dear _____________

As an __________________ working for _______________________ I am very

concerned about HB 1141 by Debbie Riddle, which would add EMT-Is and

paramedics to the list of people who could draw blood when police believe

a

person is driving under the influence. Please don't set that bill for

consideration on the House floor.

While the bill looks innocent, it will have unintended consequences for

EMS

providers and EMS personnel. Even if EMTs are on the scene of a traffic

accident helping patients, taking blood from a person under arrest in a

chaotic situation is difficult. If the alleged drunk driver is not

injured,

then very likely that person is in handcuffs with his or her hands behind

the

back. This makes it very difficult, if not dangerous for an EMT to take

blood. Who will stand behind the paramedic who gets an accidental blood

stick

from a person who turns out to have AIDS or hepatitis? What if the person

resists the procedure and the EMT breaks a needle in the arm?

What if the police call an ambulance out to have EMTs and Paramedics take

blood when there are no other injuries? Many times ambulances are called

out

when there is no emergency. Calls of this nature could tie up an ambulance

when someone else has an emergency and needs us.

HB 1141 is just a bill that should not pass. Please support Emergency

Medical

Services in your area. Don't set this bill.

Sincerely,

(Your Name)

Members to fax:

> All numbers are AC 512.

>

> Beverly Woolley, 463-9333

>

> Arlene Wohlgemuth, 463-6551

>

> Wayne Christian, 463-3102

>

> Suzanna Gratia Hupp, 463-8284 [a strong supporter of this bill]

>

> Velma Luna, 463-8090

>

> Jerry Madden, 463-9974

>

> Menendez, 463-0634

>

> Gene Seaman, 4633509

>

> Barry Telford, 463-8155

>

> Vicki Truitt, 477-5770

>

> Sylvester , 463-8380

>

Gene Gandy, JD, LP

EMS Consultant

HillGandy Associates

POB 1651

Albany, TX 76430

wegandy@...

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However Ed, by way of inclusion, these changes expand the location of such

actions from the

hospital setting into the uncontrolled prehospital setting, along with the

inherent risks

found therein. The amendments seem to promote greater convenience for law

enforcement

personnel, and far less convenience (and risk) for EMS personnel.

On DUI scenes where the victim has or is likely to die, the responding crew will

most

likely be preoccupied with treating the injured. If they are the only responding

and

transporting EMS unit, is it then incumbent on the EMS provider to send another

EMS unit to

stick the DUI suspect who might not have been injured or transported? Consider

rural and

wilderness providers in this scenario.

Bob Kellow

ed.strout@... wrote:

> Actually Jane this is a change to an existing law, not a new law. I had an

> opportunity to look up the existing law and it is very specific. The only

> circumstance where a police officer can obtain blood without voluntary

> consent is if the suspect was the operator of a vehicle and was involved in

> a collision, and the officer believes that someone has dies or will likely

> die as a result of the collision. They cannot order a blood draw for a

> minor injury collision or a DWI stop. (Transportation Code Section 724.012

>

> If a collision as described above occurs, then most likely an ambulance will

> be sent to the scene anyway, so it's not really an additional call for the

> system. Since the suspect has to be involved in the collision, then the

> suspect will most likely also have to be considered a patient while at the

> scene, which means that an EMS provider will have to do an assessment. That

> makes the provider a witness, which means that the possibility of sitting in

> court already exists.

>

> They way I read this change in the law (and I'm the first to admit that I

> have no legal background, so my interpretation is simply my humble opinion),

> it simply adds paramedics to the list of medical professionals qualified to

> draw blood in this circumstance. The law as it currently stands

> specifically excludes EMS as qualified individuals. (Transportation Code

> Section 724.017...this is the part that is up for change).

>

> There has been discussion in the past about the fact that EMS providers are

> not looked at or treated as medical professionals in the same way that

> nurses are. While this may not be exactly how we had hoped to start that

> process, it does seem that we will inevitably have to accept some of the

> not-so-good aspects of that goal, and this is one of those unpleasant side

> effects.

>

> Gene has raised legitimate concerns about liability and infection control.

> I can't say how the liability issues may bear out, but the infection control

> issues are covered by law. The agency that employs you (or that you

> volunteer for) is required by law to pay for treatment and testing in the

> event of an exposure to a communicable disease. (Government Code Chapter

> 607).

>

> It's time for me to get back to work, so I'll close this note by saying that

> this is one of the better discussion threads I've seen come through in a

> while. It is discussion that needs to happen, and I thank you all for

> keeping it professional and interesting. This isn't to say that I'm done

> with it...just saying keep up the good work on this and any other topics

> that concern us.

>

> Re: HEADS UP!!

>

> First off, this is concerning a NEW potential law that would allow law

> enforcement to use us for this purpose in many situations. It IS a big deal

> for services with few resources. There WOULD be situations where EMS

> agencies would be called out to do this if this passes, you can count on it.

> And the service responsible for the area - volunteer or not - can be called

> out for this. There could be issues arising where the officer wants the

> blood drawn, but you ARE caring for other serious injuries and patients and

> don't have time but are now being pressured to do this too.

>

> Then there is the inevitable situation involving being subpoenad for court

> for these blood draws. Austin may can afford to pay for their medics to sit

> in court and pay for someone else to cover their shifts while they are

> there. But smaller services could find this as another unnecessary burden

> for another unfunded mandate. Something like this that you have identified

> as " just part of the profession " that is not entirely necessary and that

> could actually negatively impact any segment of the EMS service population

> (rural, municipal, etc.) is not something that we need to add to our already

> overwhelmed systems.

>

> Just my opinions.

>

> Jane Hill

> HEADS UP!!

>

> Folks,

>

> HB 1141 by Riddle adds EMT-I and Paramedics to those who can be ORDERED by

> a

> police officer to draw blood whenever they think they need it. It makes

> no

> provision for us to decide when we have time to do this nor to refuse when

> patient care of that patient or others should come first. It provides for

> no

> compensation for doing it, and they could call us to the scene of any DWI

> stop or to the jail to draw blood anytime they wanted us. No provisions

> for

> who will pay for the calls, pay for the supplies, pay the overtime we'll

> spend sitting in the courthouse waiting to testify, nothing about the

> medical directors who every decent defense attorney will call to cross

> examine on the training and so forth. The bill provides protection from

> liability only if the blood is drawn using " recognized medical

> procedures. "

> Want to try testifying on that subject? Want to try documenting blood

> draws? Folks, this is a BAD bill for EMS. We all want to stop DWIs but

> this is not the way to do it.

>

> We have until approximately 1500 tomorrow to get letters off to the

> members

> of the House CalendarCommittee opposing this. If it is set on the

> calendar

> for hearing it will probably pass without opposition since the members

> won't

> know about any opposition.

>

> Here's a sample letter to send to the members. Names of committee members

> and their FAX numbers will follow.

>

> Dear _____________

>

> As an __________________ working for _______________________ I am very

> concerned about HB 1141 by Debbie Riddle, which would add EMT-Is and

> paramedics to the list of people who could draw blood when police believe

> a

> person is driving under the influence. Please don't set that bill for

> consideration on the House floor.

>

> While the bill looks innocent, it will have unintended consequences for

> EMS

> providers and EMS personnel. Even if EMTs are on the scene of a traffic

> accident helping patients, taking blood from a person under arrest in a

> chaotic situation is difficult. If the alleged drunk driver is not

> injured,

> then very likely that person is in handcuffs with his or her hands behind

> the

> back. This makes it very difficult, if not dangerous for an EMT to take

> blood. Who will stand behind the paramedic who gets an accidental blood

> stick

> from a person who turns out to have AIDS or hepatitis? What if the person

> resists the procedure and the EMT breaks a needle in the arm?

>

> What if the police call an ambulance out to have EMTs and Paramedics take

> blood when there are no other injuries? Many times ambulances are called

> out

> when there is no emergency. Calls of this nature could tie up an ambulance

> when someone else has an emergency and needs us.

>

> HB 1141 is just a bill that should not pass. Please support Emergency

> Medical

> Services in your area. Don't set this bill.

>

> Sincerely,

>

> (Your Name)

>

> Members to fax:

> > All numbers are AC 512.

> >

> > Beverly Woolley, 463-9333

> >

> > Arlene Wohlgemuth, 463-6551

> >

> > Wayne Christian, 463-3102

> >

> > Suzanna Gratia Hupp, 463-8284 [a strong supporter of this bill]

> >

> > Velma Luna, 463-8090

> >

> > Jerry Madden, 463-9974

> >

> > Menendez, 463-0634

> >

> > Gene Seaman, 4633509

> >

> > Barry Telford, 463-8155

> >

> > Vicki Truitt, 477-5770

> >

> > Sylvester , 463-8380

> >

>

> Gene Gandy, JD, LP

> EMS Consultant

> HillGandy Associates

> POB 1651

> Albany, TX 76430

>

> wegandy@...

>

>

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Guest guest

I guess this is what I was trying to say in my first post...I have never met

a cop who would try to interrupt patient care in order to get blood drawn.

Perhaps it is my own naivete based on my experiences here in Central Texas.

Our agency (including STAR Flight) have a very good working relationship

with the dozens of LE agencies we work with, so even if this change in the

law does occur we will be able to work through potential conflicts in

advance. I hope that this is the case in rural areas as well. I can see

benefits if a LE agency has a paramedic cop (like Mosely), and in cases

where a jail uses paramedics as responders. I can also see the potential

problems. By the way....I'm not faxing letters of support for this

change... I'm just enjoying a cerebral discussion with my colleagues.

Ed Strout, RN, CEN, LP

Clinical Practice Coordinator

Austin- County EMS

517 S. Pleasant Valley Rd.

Austin, Tx. 78741

Office

Pager

Fax

e-mail: ed.strout@...

Re: HEADS UP!!

>

> First off, this is concerning a NEW potential law that would allow law

> enforcement to use us for this purpose in many situations. It IS a big

deal

> for services with few resources. There WOULD be situations where EMS

> agencies would be called out to do this if this passes, you can count on

it.

> And the service responsible for the area - volunteer or not - can be

called

> out for this. There could be issues arising where the officer wants the

> blood drawn, but you ARE caring for other serious injuries and patients

and

> don't have time but are now being pressured to do this too.

>

> Then there is the inevitable situation involving being subpoenad for court

> for these blood draws. Austin may can afford to pay for their medics to

sit

> in court and pay for someone else to cover their shifts while they are

> there. But smaller services could find this as another unnecessary burden

> for another unfunded mandate. Something like this that you have

identified

> as " just part of the profession " that is not entirely necessary and that

> could actually negatively impact any segment of the EMS service population

> (rural, municipal, etc.) is not something that we need to add to our

already

> overwhelmed systems.

>

> Just my opinions.

>

> Jane Hill

> HEADS UP!!

>

> Folks,

>

> HB 1141 by Riddle adds EMT-I and Paramedics to those who can be ORDERED

by

> a

> police officer to draw blood whenever they think they need it. It makes

> no

> provision for us to decide when we have time to do this nor to refuse

when

> patient care of that patient or others should come first. It provides

for

> no

> compensation for doing it, and they could call us to the scene of any

DWI

> stop or to the jail to draw blood anytime they wanted us. No provisions

> for

> who will pay for the calls, pay for the supplies, pay the overtime

we'll

> spend sitting in the courthouse waiting to testify, nothing about the

> medical directors who every decent defense attorney will call to cross

> examine on the training and so forth. The bill provides protection from

> liability only if the blood is drawn using " recognized medical

> procedures. "

> Want to try testifying on that subject? Want to try documenting blood

> draws? Folks, this is a BAD bill for EMS. We all want to stop DWIs

but

> this is not the way to do it.

>

> We have until approximately 1500 tomorrow to get letters off to the

> members

> of the House CalendarCommittee opposing this. If it is set on the

> calendar

> for hearing it will probably pass without opposition since the members

> won't

> know about any opposition.

>

> Here's a sample letter to send to the members. Names of committee

members

> and their FAX numbers will follow.

>

> Dear _____________

>

> As an __________________ working for _______________________ I am very

> concerned about HB 1141 by Debbie Riddle, which would add EMT-Is and

> paramedics to the list of people who could draw blood when police

believe

> a

> person is driving under the influence. Please don't set that bill for

> consideration on the House floor.

>

> While the bill looks innocent, it will have unintended consequences for

> EMS

> providers and EMS personnel. Even if EMTs are on the scene of a traffic

> accident helping patients, taking blood from a person under arrest in a

> chaotic situation is difficult. If the alleged drunk driver is not

> injured,

> then very likely that person is in handcuffs with his or her hands

behind

> the

> back. This makes it very difficult, if not dangerous for an EMT to take

> blood. Who will stand behind the paramedic who gets an accidental blood

> stick

> from a person who turns out to have AIDS or hepatitis? What if the

person

> resists the procedure and the EMT breaks a needle in the arm?

>

> What if the police call an ambulance out to have EMTs and Paramedics

take

> blood when there are no other injuries? Many times ambulances are called

> out

> when there is no emergency. Calls of this nature could tie up an

ambulance

> when someone else has an emergency and needs us.

>

> HB 1141 is just a bill that should not pass. Please support Emergency

> Medical

> Services in your area. Don't set this bill.

>

> Sincerely,

>

> (Your Name)

>

> Members to fax:

> > All numbers are AC 512.

> >

> > Beverly Woolley, 463-9333

> >

> > Arlene Wohlgemuth, 463-6551

> >

> > Wayne Christian, 463-3102

> >

> > Suzanna Gratia Hupp, 463-8284 [a strong supporter of this bill]

> >

> > Velma Luna, 463-8090

> >

> > Jerry Madden, 463-9974

> >

> > Menendez, 463-0634

> >

> > Gene Seaman, 4633509

> >

> > Barry Telford, 463-8155

> >

> > Vicki Truitt, 477-5770

> >

> > Sylvester , 463-8380

> >

>

> Gene Gandy, JD, LP

> EMS Consultant

> HillGandy Associates

> POB 1651

> Albany, TX 76430

>

> wegandy@...

>

>

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> I guess this is what I was trying to say in my first post...I have never

met

> a cop who would try to interrupt patient care in order to get blood drawn.

To date, neither have I, unfortunately, there will be one somewhere along

the line. We have also enjoyed an outstanding relationship with our LE here,

many are EMT's, and many others are FF's, so we all work together in more

ways than one. A bill like this needs to be written in " idiot proof "

fashion. A drawback to that, is each time we make something 'idiot proof';

they come up with a better idiot.

Remember that drawing of the blood is only a part of the problem, overtime

is another part of the equation, as is the question of compensation, neither

of which is addressed in the bill.

Just my 0.02 worth.

Hatfield EMT-P

" Women and cats do as they please. Men and dogs might as well relax and get

used to it. "

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> The court would pass this along as fees upon conviction.

> Maybe assessing it to the DA's office, or the police department. Would

> certainly cause them to consider who they draw blood on.

Or assess it to the defendant upon conviction, we would then see our money,

but it could take years.

Hatfield EMT-P

" Women and cats do as they please. Men and dogs might as well relax and get

used to it. "

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On Fri, 18 Apr 2003 08:36:49 -0700 (PDT) " Mike , LP "

writes:

> ... let all the emt's and paramedics carry guns...

> that'll solve the problem.

Interesting concept, plug and patch all at once ... great for response

times! :-)

A lot of deputies in Utah and some of the counties in AZ have dual LEO -

paramedics.

With the Maricopa Co. SO (Phoenix area) there are three full time Deputy

/ paramedics, a bunch of EMTs and the Medical Rescue Posse has 10

paramedics and 20 EMTs. Some of the posse members are Qualified Armed

Possemen, and can carry weapons on duty. Most are unarmed and just do

Medical Rescue / First Response in the Lake Area.

" There are countless ways of attaining greatness, but any road to

reaching one's maximum potential must be built on a bedrock of respect

for the individual, a commitment to excellence, and a rejection of

mediocrity. "

- Buck Rodgers

Larry RN NREMTP

Nurse, Teacher, Medic

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> let all the emt's and paramedics carry guns... that'll solve the problem.

Job security?!?!?!....:)

Mike

Hatfield EMT-P

" Women and cats do as they please. Men and dogs might as well relax and get

used to it. "

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Dr. Bledsoe raises questions and brings up points that cannot be ignored. HB

1141 has ramifications that go far beyond merely drawing blood for a trooper.

I wish to insert some comments into the body of his post, so please read

below.

Gene Gandy

In a message dated 4/18/2003 11:40:59 AM Central Daylight Time,

bbledsoe@... writes:

> I have been following this thread and see problems:

>

> 1. Where is the input from Texas medical directors? We need a state

> EMS medical director who is an advocate for the profession. Dr. Racht is

> serving in a de facto role--but with no authority.

I believe Dr. Racht is aware of this and is working on it. However, to my

knowledge all the other physicians besides are asleep at the wheel.

The idea of a state medical director is one that needs to be considered

seriously.

> 2. If paramedics and EMT-Is function under the delegated authority of

> the Medical Practice Act as described by their medical director, does this

> proposed law not undermine the authority of the medical director?

Yes. Suppose the legislature passed laws requiring that EMTs and Paramedics

administer a certain drug to all patients regardless of the medical

director's wishes. It's the same thing. This act allows a police officer to

" order " the drawing of blood by an EMT or Paramedic. Read the Act. It

reads:

Only the

following [a physician, qualified technician, chemist, registered

professional nurse, or licensed vocational nurse] may take a blood

specimen at the request or order of a peace officer under this

chapter:

(1) a physician;

(2) a qualified technician;

(3) a registered professional nurse;

(4) a licensed vocational nurse; or

(5) a licensed or certified emergency medical

technician-intermediate or emergency medical

technician-paramedic.

BTW, all you physicians. Get ready to be called out to draw blood. The

trouble with this is not with 99% of the law enforcement officers. The

trouble is with the 1% that are bullheaded and stubborn and can't stand to

have their authority challenged. They're the ones that will threaten us with

arrest and so forth if we don't want to draw the blood. They will not

understand that we operate under the delegated practice of our physicians.

> 3. If this law is enacted, will it give legislative authority to EMS

> providers to perform an act that their medical director may not want the

> system to be involved in for various reasons?

See above. The legislature is stepping into the practice of medicine here.

Suppose the legislature decides that we should draw blood for an HIV test on

every patient. The principle is the same.

> 4. Is the legislature, it it's wisdom, or lack thereof, creating a

> hodge podge of legislative statutes that affect EMS care in a piece meal

> fashion?

Yes. One only has to look to California to see what havoc the legislature

can wreak when it gets into regulating EMS through legislation.

> 5. Should we not have a statewide EMS ordinance/law that defines and

> guides EMS practice with an EMS governing agency, state medical director,

> and similar responsibilities?

Careful, . We don't want state mandated scope of practice do we? I

don't think that's what you're saying, but please clarify. Remember when

Paramedics in CA couldn't do endotracheal intubation because

Wedworth-Townsend, the EMS law, only permitted medics to " insert esophageal

airway, " the classic order given again and again on EMERGENCY? It took years

to overcome that.

> 6. Are EMS people not advocates for the patient? Is drawing blood for

> legal prosecution not a failure to maintain such advocacy?

Yes. This is bad public policy. Bad. We are patient advocates, and we are

NOT law enforcement. When we blur those distinctions we create a situation

of potential distrust between ourselves and our patients. We rely on the

patient to give us truthful medical histories in order to do our jobs. If

the patient thinks they may be compromised by being honest with us, they

will stop talking to us. Medical people have always had to be careful about

letting their personal views about social policy enter into their practices.

Same for lawyers. I am often asked how I could defend someone I knew was

guilty of some crime. The answer is that I have no choice. The constitution

requires it, and my oath as a lawyer requires it. We treat those of whom we

disapprove as well as those that we approve of. That's what our ethical and

legal standards require us to do.

> 7. Might such an action violate HIPAA as the EMS people are functioning

> under HIPAA constraints while the police are not?

>

HIPAA and the confidentiality requirements of Chapters 181 and 773, Texas

Health and Safety Code wouldn't prohibit us from drawing blood because that's

not a " disclosure, " but there is a good question as to whether we would be

able to testify about it. Chapter 773's confidentiality rules are, in fact,

more stringent than HIPAAs in terms of what we can disclose from a patient's

records in court. Enter TDH which has the power to enforce the HIPAA

standards and the 773 standards against each individual certificant and

licensee.

> This issue has grave consequences that go beyond the topical discussion here

> and should be opposed at all junctures.

Correct. If you agree and you haven't yet faxed, written or called the

members of the Calendar Committee, time is running out. We need help in the

form of urgent communications with those people. If this bill gets to the

house floor there's no stopping it because MADD is behind it. MADD means

well, and I support them with my donations, but they haven't thought this

one through.

Gene Gandy

>

> E. Bledsoe, DO, FACEP, EMT-P

> Midlothian, Texas

>

>

>

>

>

>

>

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>

>New Mexico tried a simular program in the early 80s. This state sponcored

>program was called BAT (Blood Alcohol Testing). The idea behind the

>program was to get the patrol officers back on the street as fast as

>possible. A police officer and a paramedic were sent out in a BAT Mobile

>(coverted ambulance) to the scenes of DUI stops and suspected DUI

>MVCs. The BAT Mobile was operated only on weekend nights and

>holidays. All I had to do was draw the blood, package and label it. We

>were paid $60.00 per 8 hour shift which worked out to $7.50 per hour. BIG

>bucks for a paramedic in the 80s. Then we started getting called into

>court. Many times we would be there all day and sometimes for two days

>waiting to testify. We were not paid for this time. I was ordered to

>appear in court for a case at 0830. I was working the night before and

>ten minutes prior to shift change 's Law struck. I was sent way out

>in the county on a MVC and didn't get back to the station until 9:30. I

>was charged with contempt of court. I had to appear in court for the

>original case and then again for the contempt. The contempt was

>dismissed, but I lost a day of work. After one year the service made a

>policy that we could not work for the BAT service due to the amount of

>time we were tied up in court. The entire program was suspended due to a

>lack of paramedics/nurses/LVNs willing to work for them.

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>

>New Mexico tried a simular program in the early 80s. This state sponcored

>program was called BAT (Blood Alcohol Testing). The idea behind the

>program was to get the patrol officers back on the street as fast as

>possible. A police officer and a paramedic were sent out in a BAT Mobile

>(coverted ambulance) to the scenes of DUI stops and suspected DUI

>MVCs. The BAT Mobile was operated only on weekend nights and

>holidays. All I had to do was draw the blood, package and label it. We

>were paid $60.00 per 8 hour shift which worked out to $7.50 per hour. BIG

>bucks for a paramedic in the 80s. Then we started getting called into

>court. Many times we would be there all day and sometimes for two days

>waiting to testify. We were not paid for this time. I was ordered to

>appear in court for a case at 0830. I was working the night before and

>ten minutes prior to shift change 's Law struck. I was sent way out

>in the county on a MVC and didn't get back to the station until 9:30. I

>was charged with contempt of court. I had to appear in court for the

>original case and then again for the contempt. The contempt was

>dismissed, but I lost a day of work. After one year the service made a

>policy that we could not work for the BAT service due to the amount of

>time we were tied up in court. The entire program was suspended due to a

>lack of paramedics/nurses/LVNs willing to work for them.

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I don't know that I'd want to work a special traffic unit just for the

purpose of DWI enforcement. I suppose if a change in the law was to occur,

then a special enforcement unit could be created. But that's a whole

'nuther topic.

Ed Strout, RN, CEN, LP

Clinical Practice Coordinator

Austin- County EMS

517 S. Pleasant Valley Rd.

Austin, Tx. 78741

Office

Pager

Fax

e-mail: ed.strout@...

Re: HEADS UP!!

>

>New Mexico tried a simular program in the early 80s. This state sponcored

>program was called BAT (Blood Alcohol Testing). The idea behind the

>program was to get the patrol officers back on the street as fast as

>possible. A police officer and a paramedic were sent out in a BAT Mobile

>(coverted ambulance) to the scenes of DUI stops and suspected DUI

>MVCs. The BAT Mobile was operated only on weekend nights and

>holidays. All I had to do was draw the blood, package and label it. We

>were paid $60.00 per 8 hour shift which worked out to $7.50 per hour. BIG

>bucks for a paramedic in the 80s. Then we started getting called into

>court. Many times we would be there all day and sometimes for two days

>waiting to testify. We were not paid for this time. I was ordered to

>appear in court for a case at 0830. I was working the night before and

>ten minutes prior to shift change 's Law struck. I was sent way out

>in the county on a MVC and didn't get back to the station until 9:30. I

>was charged with contempt of court. I had to appear in court for the

>original case and then again for the contempt. The contempt was

>dismissed, but I lost a day of work. After one year the service made a

>policy that we could not work for the BAT service due to the amount of

>time we were tied up in court. The entire program was suspended due to a

>lack of paramedics/nurses/LVNs willing to work for them.

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I have been following this thread and see problems:

1. Where is the input from Texas medical directors? We need a state

EMS medical director who is an advocate for the profession. Dr. Racht is

serving in a de facto role--but with no authority.

2. If paramedics and EMT-Is function under the delegated authority of

the Medical Practice Act as described by their medical director, does this

proposed law not undermine the authority of the medical director?

3. If this law is enacted, will it give legislative authority to EMS

providers to perform an act that their medical director may not want the

system to be involved in for various reasons?

4. Is the legislature, it it's wisdom, or lack thereof, creating a

hodge podge of legislative statutes that affect EMS care in a piece meal

fashion?

5. Should we not have a statewide EMS ordinance/law that defines and

guides EMS practice with an EMS governing agency, state medical director,

and similar responsibilities?

6. Are EMS people not advocates for the patient? Is drawing blood for

legal prosecution not a failure to maintain such advocacy?

7. Might such an action violate HIPAA as the EMS people are functioning

under HIPAA constraints while the police are not?

This issue has grave consequences that go beyond the topical discussion here

and should be opposed at all junctures.

E. Bledsoe, DO, FACEP, EMT-P

Midlothian, Texas

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Good questions. I don't see anywhere in the proposed changes that gives EMS

providers any kind of legislative authority. All I see it that it adds

paramedics to the list of persons who are qualified to draw blood. There

are other laws in place that regulate when and where a paramedic is

authorized to perform invasive procedures, and this law doesn't give a

police officer the power to supercede those laws. I would imagine that a

system's medical director could choose not to authorize this under his/her

delegated authority and that would be the end of it for that particular

locality.

Ed Strout, RN, CEN, LP

Clinical Practice Coordinator

Austin- County EMS

517 S. Pleasant Valley Rd.

Austin, Tx. 78741

Office

Pager

Fax

e-mail: ed.strout@...

HEADS UP!!

I have been following this thread and see problems:

1. Where is the input from Texas medical directors? We need a state

EMS medical director who is an advocate for the profession. Dr. Racht is

serving in a de facto role--but with no authority.

2. If paramedics and EMT-Is function under the delegated authority of

the Medical Practice Act as described by their medical director, does this

proposed law not undermine the authority of the medical director?

3. If this law is enacted, will it give legislative authority to EMS

providers to perform an act that their medical director may not want the

system to be involved in for various reasons?

4. Is the legislature, it it's wisdom, or lack thereof, creating a

hodge podge of legislative statutes that affect EMS care in a piece meal

fashion?

5. Should we not have a statewide EMS ordinance/law that defines and

guides EMS practice with an EMS governing agency, state medical director,

and similar responsibilities?

6. Are EMS people not advocates for the patient? Is drawing blood for

legal prosecution not a failure to maintain such advocacy?

7. Might such an action violate HIPAA as the EMS people are functioning

under HIPAA constraints while the police are not?

This issue has grave consequences that go beyond the topical discussion here

and should be opposed at all junctures.

E. Bledsoe, DO, FACEP, EMT-P

Midlothian, Texas

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Good points, :

1. Because GETAC is an advisory body to the TDH, it is not empowered to

officially interact (directly) with the legislature. Has the TDH been asked, " Is

this O.K. with you? " , thus allowing input from GETAC? It's the " mother may I "

syndrome again. Texas needs a State EMS Medical Director, but that would also

provide ample evidence of the need for a Texas State EMS Commission.

2. Permitting a non physician to order paramedics and EMT-I's to perform

medical procedures seems to violate the intent of delegated medical practice.

But, in all likelihood, no one has bothered to ask.

3. These changes appear to exclude the system medical director from the

process, since they are not mentioned on the body of House Bill 1141.

4. Yes. But should I be surprised?

5. Yes. See: #1

6. Yes. But, in many examples the suspect might not be a " patient " .

7. Ask Gene.

As an extension of this logic, shouldn't animal control officers be authorized

to order paramedics and EMT-I's to tranquilize or euthanize dangerous or rabid

animals on the scene, thus sparing them the time hassle of transporting them to

the appropriate facilities? After all - it's kinda medical you know.

Bob Kellow

" Bledsoe (Notebook) " wrote:

> I have been following this thread and see problems:

>

> 1. Where is the input from Texas medical directors? We need a state

> EMS medical director who is an advocate for the profession. Dr. Racht is

> serving in a de facto role--but with no authority.

> 2. If paramedics and EMT-Is function under the delegated authority of

> the Medical Practice Act as described by their medical director, does this

> proposed law not undermine the authority of the medical director?

> 3. If this law is enacted, will it give legislative authority to EMS

> providers to perform an act that their medical director may not want the

> system to be involved in for various reasons?

> 4. Is the legislature, it it's wisdom, or lack thereof, creating a

> hodge podge of legislative statutes that affect EMS care in a piece meal

> fashion?

> 5. Should we not have a statewide EMS ordinance/law that defines and

> guides EMS practice with an EMS governing agency, state medical director,

> and similar responsibilities?

> 6. Are EMS people not advocates for the patient? Is drawing blood for

> legal prosecution not a failure to maintain such advocacy?

> 7. Might such an action violate HIPAA as the EMS people are functioning

> under HIPAA constraints while the police are not?

>

> This issue has grave consequences that go beyond the topical discussion here

> and should be opposed at all junctures.

>

> E. Bledsoe, DO, FACEP, EMT-P

> Midlothian, Texas

>

>

>

>

>

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I took a little time to try and read the existing law (at Gene's

suggestion). It outlines all of the circumstances where an individual may

be asked to provide a blood, breath, or urine sample. Again, I can find

only one circumstance where the officer can get the sample without the

suspect's consent. The proposed change in the law doesn't appear to address

only that circumstance, but rather appears to add Paramedics and EMT-I

providers to the list of folks who are authorized to draw blood in any of

the circumstances. We've gotten stuck (pardon the pun) on the one

circumstance that would be the most difficult (involuntary collection).

This law has been in effect since the mid 80's (although it appears that the

most recent revision was in 1997). Doctors, nurses, chemists, and

" qualified technicians " have been on the list for at least 8 years. I don't

know that any doctor has been called out to draw blood since it was first

enacted, and doubt that any chemist has either. Dr. Racht regularly

responds to calls in our area, and he's been on the list for years, yet I

don't know of any time that he was asked, let alone forced to draw blood

despite the fact that he was readily available. Our flight nurses have been

on the list since at least 1997, and they go to rural areas all the time,

and again, I don't know that they have ever been asked. Cops aren't dumb.

They know what we are there to do. If the 1% is out there, then let him

arrest a medic on the scene for refusing his " order " . I can't imagine that

he'll do it more than once, at least if the publicity is handled correctly.

Ed Strout, RN, CEN, LP

Clinical Practice Coordinator

Austin- County EMS

517 S. Pleasant Valley Rd.

Austin, Tx. 78741

Office

Pager

Fax

e-mail: ed.strout@...

Re: HEADS UP!!

Dr. Bledsoe raises questions and brings up points that cannot be ignored.

HB

1141 has ramifications that go far beyond merely drawing blood for a

trooper.

I wish to insert some comments into the body of his post, so please read

below.

Gene Gandy

In a message dated 4/18/2003 11:40:59 AM Central Daylight Time,

bbledsoe@... writes:

> I have been following this thread and see problems:

>

> 1. Where is the input from Texas medical directors? We need a state

> EMS medical director who is an advocate for the profession. Dr. Racht is

> serving in a de facto role--but with no authority.

I believe Dr. Racht is aware of this and is working on it. However, to my

knowledge all the other physicians besides are asleep at the wheel.

The idea of a state medical director is one that needs to be considered

seriously.

> 2. If paramedics and EMT-Is function under the delegated authority of

> the Medical Practice Act as described by their medical director, does this

> proposed law not undermine the authority of the medical director?

Yes. Suppose the legislature passed laws requiring that EMTs and Paramedics

administer a certain drug to all patients regardless of the medical

director's wishes. It's the same thing. This act allows a police officer

to

" order " the drawing of blood by an EMT or Paramedic. Read the Act. It

reads:

Only the

following [a physician, qualified technician, chemist, registered

professional nurse, or licensed vocational nurse] may take a blood

specimen at the request or order of a peace officer under this

chapter:

(1) a physician;

(2) a qualified technician;

(3) a registered professional nurse;

(4) a licensed vocational nurse; or

(5) a licensed or certified emergency medical

technician-intermediate or emergency medical

technician-paramedic.

BTW, all you physicians. Get ready to be called out to draw blood. The

trouble with this is not with 99% of the law enforcement officers. The

trouble is with the 1% that are bullheaded and stubborn and can't stand to

have their authority challenged. They're the ones that will threaten us

with

arrest and so forth if we don't want to draw the blood. They will not

understand that we operate under the delegated practice of our physicians.

> 3. If this law is enacted, will it give legislative authority to EMS

> providers to perform an act that their medical director may not want the

> system to be involved in for various reasons?

See above. The legislature is stepping into the practice of medicine here.

Suppose the legislature decides that we should draw blood for an HIV test on

every patient. The principle is the same.

> 4. Is the legislature, it it's wisdom, or lack thereof, creating a

> hodge podge of legislative statutes that affect EMS care in a piece meal

> fashion?

Yes. One only has to look to California to see what havoc the legislature

can wreak when it gets into regulating EMS through legislation.

> 5. Should we not have a statewide EMS ordinance/law that defines and

> guides EMS practice with an EMS governing agency, state medical director,

> and similar responsibilities?

Careful, . We don't want state mandated scope of practice do we? I

don't think that's what you're saying, but please clarify. Remember when

Paramedics in CA couldn't do endotracheal intubation because

Wedworth-Townsend, the EMS law, only permitted medics to " insert esophageal

airway, " the classic order given again and again on EMERGENCY? It took

years

to overcome that.

> 6. Are EMS people not advocates for the patient? Is drawing blood for

> legal prosecution not a failure to maintain such advocacy?

Yes. This is bad public policy. Bad. We are patient advocates, and we are

NOT law enforcement. When we blur those distinctions we create a situation

of potential distrust between ourselves and our patients. We rely on the

patient to give us truthful medical histories in order to do our jobs. If

the patient thinks they may be compromised by being honest with us, they

will stop talking to us. Medical people have always had to be careful about

letting their personal views about social policy enter into their practices.

Same for lawyers. I am often asked how I could defend someone I knew was

guilty of some crime. The answer is that I have no choice. The

constitution

requires it, and my oath as a lawyer requires it. We treat those of whom we

disapprove as well as those that we approve of. That's what our ethical and

legal standards require us to do.

> 7. Might such an action violate HIPAA as the EMS people are functioning

> under HIPAA constraints while the police are not?

>

HIPAA and the confidentiality requirements of Chapters 181 and 773, Texas

Health and Safety Code wouldn't prohibit us from drawing blood because

that's

not a " disclosure, " but there is a good question as to whether we would be

able to testify about it. Chapter 773's confidentiality rules are, in fact,

more stringent than HIPAAs in terms of what we can disclose from a patient's

records in court. Enter TDH which has the power to enforce the HIPAA

standards and the 773 standards against each individual certificant and

licensee.

> This issue has grave consequences that go beyond the topical discussion

here

> and should be opposed at all junctures.

Correct. If you agree and you haven't yet faxed, written or called the

members of the Calendar Committee, time is running out. We need help in

the

form of urgent communications with those people. If this bill gets to the

house floor there's no stopping it because MADD is behind it. MADD means

well, and I support them with my donations, but they haven't thought this

one through.

Gene Gandy

>

> E. Bledsoe, DO, FACEP, EMT-P

> Midlothian, Texas

>

>

>

>

>

>

>

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I don't believe this law has anything to do with recognizing us as

professionals. We have been already recognized by the things we do now.

12-lead EKGs, RSI, and a host of other things. Paramedics doing certain

skills in the field and showing the medical community that they work in the

streets has lead to nurses being allowed to do more in the ER. Taking blood

out of a drunks arm is not what I call being " finally " recognized as one of

the team.

I see this as a convenience for law enforcement. This way they can just call

an ambulance to " just check someone out " and " while your here get this guys

blood for me. " As I understand it you will have to do it if " ordered " to do

so. Does this mean that if you refuse there is a penalty involved? Jail

time? Assessing a fine? Getting your certification revoked or being placed

under probation?

I guess you will feel real professional spending a lot of time in court

defending what you did, why you did it, how you did it, and you will know all

of the technical and medical facts you need as the defendants lawyer rips you

a new one. I don't think the medical community is going to think any higher

or lower of you or your professional status while your sitting in that chair.

I think they will just be happy it's not them.

Ed

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> It's already law. Why are we fighting over being INCLUDED in something

> where we were EXCLUDED before? This is a GOOD thing - paramedics

> recognized as MEDICAL PROFESSIONALS.

I fail to see where drawing blood for law enforcement improves our standing

as medical professionals. If it is simply doing something we were not

allowed to do before, could we not try to be approved to perform triage when

working in ER's across the state? Are we instantly recognized as medical

professionals because now 'we can do what the nurses do'? Where does this

increase our level of professionalism?

I really don't see where being able to draw blood is a benefit at all, I do

see where it could lead to issues. No matter what the reason, the bill

introduced in it's present form is not a good thing.

" TJ " Hatfield EMT-P

" Women and cats do as they please. Men and dogs might as well relax and get

used to it. "

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Mike,

If I remember right, you're an Austin cop too, aren't you? For this

debate I think you really ought to focus on the medical end of

things, and not law enforcement.

> There is NO provision in the law that allows ANYONE to be " ordered "

to do

> so by law enforcement. It simply allows paramedics to count

Sorry fella, but the bill really does use the term " ordered " . Word

for word here is what it says:

" Only the following may take a blood specimen at the request or order

of a peace officer under this chapter: "

While a cop would probably be disinclined to " order " a physician to

do anything, I don't think they would hesitate with field EMS

personnel. You may be one of the lucky ones who has never had a

unpleasant situation occur on scene involving an overzealous or big-

headed LEO. It has happened to me and I know that allowing cops to

have authority over EMS is simply a bad idea.

The wording of this bill is simply bad. It leaves us with few

options, scant protection, and copious liabilities. While stating

that the person drawing the sample is not liable for damages so long

as we use " recognized medical procedure " , it also says " this

subsection does not relieve a person from liability for negligence in

the taking of a blood specimen. "

Do you know how many different ways a plaintiff's attorney can

convince a jury that the bad ol paramedic was negligent? Could not an

attorney argue that the very act of drawing blood from a suspect who

had refused was negligence or malpractice? Who is going to pay our

wages and legal expenses while we fight the charge? And if the jury

finds in favor of the suspect, who will pay the damages when our

malpractice insurance won't? Who will give me a job when my medical

director says I can't work here anymore because I did what a cop told

me to even though it wasn't in my protocols?

Try to put you alliances and allegiances aside Mike, and look at it

practically, from an EMS perspective.

..... Max:)

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I want to reiterate that the cops can order a blood draw in only one

circumstance. The suspect must be the driver of a vehicle that was

involved in a crash where someone has died or probably will die.

Also..a paramedic cannot do anything that their medical director will

not authorize. So if your medical director says no to this, then a

cop cannot order you to do so. If he does, he is in effect ordering

you to break the law. The worst that can happen is that you will be

arrested. Since this must be a traffic fatality, the news will be

there to cover the story of the zealous LE officer arresting you for

not breaking the law.

This has happened in Austin. A cop arrested a medic for not stopping

his assessment so that the cop could interview the patient as a

witness. The end result? Unemployed cop, no charge filed against

the medic.

Ed

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Doc, How come we don't have a state level medical director or for that matter

state level protocals since we are all allegedly trained to the same standards.

Tom Fuller EMT-I

HEADS UP!!

I have been following this thread and see problems:

1. Where is the input from Texas medical directors? We need a state

EMS medical director who is an advocate for the profession. Dr. Racht is

serving in a de facto role--but with no authority.

2. If paramedics and EMT-Is function under the delegated authority of

the Medical Practice Act as described by their medical director, does this

proposed law not undermine the authority of the medical director?

3. If this law is enacted, will it give legislative authority to EMS

providers to perform an act that their medical director may not want the

system to be involved in for various reasons?

4. Is the legislature, it it's wisdom, or lack thereof, creating a

hodge podge of legislative statutes that affect EMS care in a piece meal

fashion?

5. Should we not have a statewide EMS ordinance/law that defines and

guides EMS practice with an EMS governing agency, state medical director,

and similar responsibilities?

6. Are EMS people not advocates for the patient? Is drawing blood for

legal prosecution not a failure to maintain such advocacy?

7. Might such an action violate HIPAA as the EMS people are functioning

under HIPAA constraints while the police are not?

This issue has grave consequences that go beyond the topical discussion here

and should be opposed at all junctures.

E. Bledsoe, DO, FACEP, EMT-P

Midlothian, Texas

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