EMTs are now authorized to obtain blood samples on DWI stops

[akflightmedic]

You are obviously confusing the issue and insist on drawing irrelevant comparisons that have no bearing on the crux of the issue.

The teenager calling thinks there may be a problem, so you have been called to evaluate a possible patient.

The PD on a DUI stop are not calling you to evaluate in a medical capacity, they are calling for a blood draw. What part of this do you not understand?

[CTXMEDIC]

You are obviously confusing the issue and insist on drawing irrelevant comparisons that have no bearing on the crux of the issue.

The teenager calling thinks there may be a problem, so you have been called to evaluate a possible patient.

The PD on a DUI stop are not calling you to evaluate in a medical capacity, they are calling for a blood draw. What part of this do you not understand?

youre so right. drawing blood isnt a 'medical capacity'. silly me. lemee guess. youre one of those guys that wants to sit on the couch until a full code or a good trauma call drops. god forbid you get a call beneath your superior skill level.

i see this is a pointless converation. its always hard to motivate the lazy.

[ccmedoc]

WOW, This thread turned seriously foul..

I think that an ethical discussion could be argued any way you want, depending on your conventions. What this boils down to is do you have an ethical and/or moral duty to protect the public from this offender. The Draw must be authorized by the detainee by signature, or is court ordered and a warrant is present. At least around here. It is up to you, and your companies policies whether you can ethically do the job. No one can force you to do it, but it feels like that sometimes.

As for sterile, this is a nonissue. How many ED, Jail infirmary, or lab rooms are sterile. The kit has provodine and assorted other goodies to use, and any materials used from your own stash needs to be logged and charted. Paper work is paramount. A good aseptic technique should be observed, as in any venipuncture. If this is an issue, than bigger problems exist..IMHO!

Chain of evidence is short. The kit is opened, the draw is done, wherever it is done, the specimens are bagged, tagged, and signed at that point. The Medic can chart the time, date, tag, officer, badge#, and any other extraneous thoughts that may enter their head. At that point the time to lab is most likely no different that from a jail to the lab. I am not sure that this is even an issue. Due care can be taken with transport of the specimen, the outlabs do this all the time..

To touch on whether it is the Medics job or not, it depends on what you signed on for. I think it would be prudent to train and educate a few designated personnel to perform these draws, as the legal ramifications may be lessened if consistency can be shown. Consistent procedures and controls would be key. Officers and medics alike, can do this service. I would not be opposed to basics doing blood draws if properly educated. Phlebotomists are not extremely highly trained in their wiles, after all. I may be wrong, as it happens all the time...

To start a program and offer sign on for perspective candidates for the job would weed out the morally and ethically challenged.

There are companies around here that obtain the urine samples for companies that have truck drivers in accidents. Granted, it is not the blood draw we all fear, but important just the same. It could go to court, it could be contested, and it is NOT OUR JOB!!..I detest the last phrase more than I could possibly elaborate on this forum. It is a cop out, suffice it to say.

With the crowding in the EDs in the nation, the space constraints, and the complaints from posters here about waiting for a room for 30 minutes or longer. Does it not seem a bit logical to perform these draws in the police station, in the back of an ambulance, in the jail, as opposed for tying up a nurse, and the room to provide this service? I think so, but logic doesn't always dictate..

As to the posters who repeatedly say that they can't fathom how nurses and docs can ethically or morally deal with this phenomenon known as the legal blood draw. Your perspective is a bit short sighted. If you have the tunnel vision you were supposedly trained not to have, then the patient is the person in front of you and you can touch. It is your ethical responsibility to help this person and, sometimes, it is necessary to incarcerate this person to help them. Whether it is detox or prison.

Can you also, depending on the perspective, see the community as your patient. How could you, ethically or morally, let this person into your community if they are intoxicated, or are prone to driving intoxicated? I pray the one you couldn't perform the legal BAC draw on doesn't go out and hurt you or yours.

I am not advocating to substitute for lab techs, nurses, or docs. I do, however, think that this is 'Your Job' if you are to do your part for upholding the law and maintaining a sense of community well-being. Being a healthcare professional is a bit more than dealing with AMIs, strokes, MVCs, and the occasional asthma attack. If you want more, you have to do more.

Did we ever conclude that Paramedics, on the whole, were a profession.? I used to believe so.. 8)

-Just another opinion..Nothing fancy..

[CTXMEDIC]

well said. BTW, in texas we have an 'implied consent' law. if you operate a vehicle on texas roads, by virtue of your operation you are giving consent to a breath or blood sample. no warrant is needed and the bad guy doesnt have to agree to it.

[ccmedoc]

well said. BTW, in texas we have an 'implied consent' law. if you operate a vehicle on texas roads, by virtue of your operation you are giving consent to a breath or blood sample. no warrant is needed and the bad guy doesnt have to agree to it.

I think I would get a warrant. Implied consent for something not medically necessary for survival is a bit out of bounds.

Someone driving erratically and appears altered needs to be evaluated for hypoglycemia, among other things. Alcohol on the breath does not constitute anything, especially if the officer mis-construes a fruity odor of DKA with the "alcohol smell".. Extending this to a blood draw for BAC is a court decision. There are boundaries to every practice, This is one IMHO..In or out of hospital; Nurse, Medic, or Doc.

[CTXMEDIC]

again, no warrant is needed in texas. and the hypoglycemia argument is even more reason for us to respond to these requests.

[ERDoc]

again, no warrant is needed in texas. and the hypoglycemia argument is even more reason for us to respond to these requests.

DKA is seen with hyperglycemia.

[ccmedoc]

again, no warrant is needed in texas. and the hypoglycemia argument is even more reason for us to respond to these requests.

Absolutely. These patients should be evaluated every time.

[DwayneEMTP]

Yeah, but not many that are lazy choose to work in Afghanistan. I like many of your posts CTX, but you're talking out your ass here. You need to make your point, as you've proven most capable of, without taking the easy way out by drawing silly conclusions or calling names. And I'm hoping that if you reread your post the thought came to you, "Holy shit! I'm calling him lazy, yet I can't be bothered to hit my shift key! Ooops." (Meant in fun, I figured you could take it...).

Besides, for what my word is worth to you, as I work with him I can tell you that though he's not much to look at, no one that works with him would consider him lazy.

The more I've thought of it, the more I've come to believe that, for me, this isn't directly a "do no harm" ethics issue, but it is so indirectly. If we harm the publics trust by convincing them that EMS is a medical care as well as a policing entity, then we retard our ability to care for them. If they can't trust that their well being is our ONLY concern, then we've betrayed them, and I find that immoral as well as unethical.

Dwayne

[ccmedoc]

The more I've thought of it, the more I've come to believe that, for me, this isn't directly a "do no harm" ethics issue, but it is so indirectly. If we harm the publics trust by convincing them that EMS is a medical care as well as a policing entity, then we retard our ability to care for them. If they can't trust that their well being is our ONLY concern, then we've betrayed them, and I find that immoral as well as unethical.

Dwayne

I find this interesting. By the public trust, do you mean the public one person at a time, or the community as a whole. Where does the public trust begin and end? where does our responsibility to the community end and the responsibility to the single person begin? This is, indeed, a medical issue at this point for the well being of the person, and the community in general. As long as the BAC is being performed asd part of a police investigation, it is not a betrayal of trust or breach of ethics.

This does not in any way allow for EMS policing the community. It should not retard the ability to care for them. The major point to this is that we, the EMS personnel, are not initiating the investigation into the patients BAC. The Police are. We are a tool at this point and it is unethical not to participate in an investigation towards a possible felony.

If you are providing care and it becomes evident that the patient is intoxicated, it does not need to be divulged to the police. The medical control will need to know for treatment and that is all. It would then be unethical or immoral to alert the PD to the fact that the patient was intoxicated. This, I feel, is the difference. There is no betrayal.

It is a tough place to be in a medical profession where you have moral and ethical responsibilities to the community, law enforcement, and the individuals you care for. By the definition of your comment, I take it that it would also be immoral or unethical to report a person, whether intoxicated, deranged, or simply agitated, that tells you they will kill themselves at the earliest convenience or kill a certain party by name. This is your legal responsibility, but would you forgo your responsibility to your community in lieu of the patient in front of you? Who is being betrayed.. Different, but similar situations.

Welcome to the medical field, and community service. The public you serve trust and rely on you to make the correct decision, both for the majority and the individual. If you choose to hide behind protocols, then so be it. You still have to take a moral and ethical stand. I, for one, will not hold that against you. I may not agree with you, but......

-Just my opinion..I have a few..