# New Ohio ems law



## FFMedic1911 (Oct 28, 2010)

http://www.firehouse.com/topic/training/ohio-board-allows-responders-draw-blood

So how do you feel about this? Personally I havn't came to a decision if am for or against. Has anyone had an experience with this before?


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## Aidey (Oct 28, 2010)

We do it, and I don't see the problem with it. The cops are the ones requesting it, it isn't like we are making the decision who to do it on or not.


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## TransportJockey (Oct 28, 2010)

I've done it a few times in CO. I am allowed to do it here in TX, I was allowed to do it in NM. I could care less why we're drawing blood. If the cop has the authority to tell us it's ok, then I'll do it.


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## reaper (Oct 28, 2010)

We did it in FL. I would only draw it on pt that agreed. Not my job to force it. It does help, but I still required the pt to consent. If not, PD could take them to ER to have it done.


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## TacoMEDIC (Oct 28, 2010)

We do it at the request of PD. No need for patient consent. Special certification is required though. I don't mind doing it at all, especially because it saves PD a 140 mile drive.


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## ffemt8978 (Oct 28, 2010)

We do it, provided we are initiating an IV.  We can't stick a patient solely to draw blood, and law enforcement provides the tubes so we don't have to keep them on hand.


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## usalsfyre (Oct 28, 2010)

Short answer here is allowed by state law, specifcally disallowed under company guidelines. 

It's really more of a law enforcement matter than a medical issue, let them handle it.


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## 46Young (Oct 28, 2010)

I'm all for it. I've seen too many accidents, quite a few fatal (for the other motorists), caused by drunk drivers. Think about the deterrent effect - when word gets out that LE has the resources to obtain blood drwas in the field, that will scare some. Consent ought to be necessary though. The thing with that is, a refusal of a blood draw ought to have the same legal consequences as refusing a brethalyzer. You can refuse, fine, but it's pretty much the same as admitting guilt.


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## Aidey (Oct 28, 2010)

Where I am refusing the blood test is the same as refusing the brethalyzer. When PD determines they want to get a blood draw the sit the person down, read them their Miranda rights and another explination of what is going on. It basically says you are being charged with DWI and you can choose to refuse the test, but if you do it means you lose your license for a year or something like that.


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## LonghornMedic (Oct 28, 2010)

I don't know where drawing blood has anything to do with *Emergency Medical Services*. The police have options other than using us. Jail nurses and ER nurses can handle the job just fine. I'm already subpoenaed more than I care for in criminal court for domestics, shootings, stabbings, etc. I'm glad we don't mess with this here.


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## CAO (Oct 28, 2010)

If you're already on the scene and working on a patient involved in such a MVA who is likely going to have an IV anyway, why not draw the blood as you're setting up the line?  As long as the police have the tubes, I don't see how it would be much different than handing any other evidence over.

As already mentioned, consent issues could raise some problems .


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## Shishkabob (Oct 29, 2010)

Aidey said:


> Where I am refusing the blood test is the same as refusing the brethalyzer. When PD determines they want to get a blood draw the sit the person down, read them their Miranda rights and another explination of what is going on. It basically says you are being charged with DWI and you can choose to refuse the test, but if you do it means you lose your license for a year or something like that.



And STILL get the blood drawn, tied down.




I'm all for it.  You drink, you drive, you crash, you bleed.


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## LonghornMedic (Oct 29, 2010)

CAO said:


> If you're already on the scene and working on a patient involved in such a MVA who is likely going to have an IV anyway, why not draw the blood as you're setting up the line?  As long as the police have the tubes, I don't see how it would be much different than handing any other evidence over.
> 
> As already mentioned, consent issues could raise some problems .



You are right, but why can't the officer have a nurse draw the blood at the ER. They have two hours in most states to draw blood. It doesn't take two hours to get to the ER. And that officer is most likely going to go to the hospital anyways to interview the patient and most likely arrest them on suspicion of DUI. As for "handing any other evidence," I don't hand over evidence. If I have the victim of a shooting or stabbing, their clothes get cut off and left on scene or get cut off enroute and left on the gurney and is moved with the patient onto the ER bed. I never, ever leave anything of evidentiary value in my ambulance. Ever seen an ambulance get taped off at a trauma center/ER as a crime scene because the crew left evidence inside while they transfered care? I have and that rig sat out of service for hours while it was processed and photographed. That isn't likely to happen too often, but I don't take the chance. Bottom line is we are not police and are not part of the law enforcement community. I don't want to be involved in the chain of custody for blood and my job is to render medical care.


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## CAO (Oct 29, 2010)

Leaving the evidence at the scene with the police is what I meant.

But if you're starting a line on scene anyway, with the police needing the blood drawn, why should they need to wait?  If you're doing it en route, then they'll have to go to the ER anyway, so the only difference would be a little higher BAC.


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## ffemt8978 (Oct 29, 2010)

LonghornMedic said:


> You are right, but why can't the officer have a nurse draw the blood at the ER. They have two hours in most states to draw blood. It doesn't take two hours to get to the ER. And that officer is most likely going to go to the hospital anyways to interview the patient and most likely arrest them on suspicion of DUI. As for "handing any other evidence," I don't hand over evidence. If I have the victim of a shooting or stabbing, their clothes get cut off and left on scene or get cut off enroute and left on the gurney and is moved with the patient onto the ER bed. I never, ever leave anything of evidentiary value in my ambulance. Ever seen an ambulance get taped off at a trauma center/ER as a crime scene because the crew left evidence inside while they transfered care? I have and that rig sat out of service for hours while it was processed and photographed. That isn't likely to happen too often, but I don't take the chance. Bottom line is we are not police and are not part of the law enforcement community. I don't want to be involved in the chain of custody for blood and my job is to render medical care.



Here's a rather common scenario from our rural area.  There's an MVC with alcohol involved.  From time of call, it takes 15-30 minutes for law to arrive on scene.  Also from the time of call, it takes from 7-45 minutes for EMS to arrive depending upon the location of the accident with an average response time of 15 minutes.  Best case scenario on scene means that we spend 10 minutes on scene before we initiate transport to the nearest hospital which is one hour away.  So one hour and 25 minutes have already lapsed, not taking into account extrication or having to deal with multiple patients.

And the investigating agency is not going to follow us to the hospital for several reasons.  First, 99% of our transports go out to out of county hospitals, and the local law enforcement agencies are not real keen on the idea of sending one of their officers out of jurisdiction (and not covering calls) for a 2.5-3 hour round trip.  Not to mention if the officer did follow us in, there would be nobody left on scene to do the accident investigation.  If they want to arrest the patient at the hospital, they will have a warrant issued and have an agency near the hospital arrest the suspect.

They also don't like to have other LEO's from different agencies meet us at the hospital because of chain of custody issues.  From a legal standpoint, it is less of a hassle because then they have to bring those LEO's to court in our jurisdiction which costs a significant amount.


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## FreezerStL (Oct 29, 2010)

I'm still on the fence with this issue...

I believe if you drink and drive you lose.
You made the decisions to endanger yourself, and more importantly others.
Deal with the repercussions.

However, we're viewed as patient advocates. We have to be careful not to skew the public's opinion of us. 

Although I know some already view us as "The Man", patients might be less inclined to share vital information over fear of getting into trouble. :sad:


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## 46Young (Oct 29, 2010)

LonghornMedic said:


> They have two hours in most states to draw blood. It doesn't take two hours to get to the ER.



How much alcohol can the accused clear in two hour's time? Maybe enough to come in under the legal limit. Even if it's a one hour incident to blood draw time, it's still too much. It could be the difference from a .09 value to a .07. Having said that, I don't know if there's a presumptive measure that adjusts for the time delay in obtaining a blood draw, but still.....

There are more than a few instances of LE giving a drunk driver the option of doing the brethalyzer back at the station instead of at the scene. This gives them an hour or two to dry out. This is to avoid jamming them up for whatever reason.


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## FrostbiteMedic (Oct 29, 2010)

We can do it here, and I see no problem with it. That being said, most every patient gets a line or INT here, so it really isn't nothing to draw a little blood when starting the line.


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## Shishkabob (Oct 29, 2010)

FreezerStL said:


> However, we're viewed as patient advocates. We have to be careful not to skew the public's opinion of us.



Drawing blood doesn't make you go against advocating for the patient.  Drawing blood, especially if you are already starting an IV, doesn't go against treating the patient in a way that harms or inhibits them getting better.



It's not like you tell the patient "I'm not going to give you any pain meds till you let me draw your blood".


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## brice (Oct 29, 2010)

pretty interesting


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## Aidey (Oct 29, 2010)

What I don't get is why people think it is ok for Nurses, techs, phlebotomists etc to do it, but not us? What is the difference?


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## CAO (Oct 29, 2010)

Because apparently we're unqualified and it's a danger to the patients, according to the critics mentioned in the article.

We're just EMTs.  We'd need phlebotomy training.

Starting a line and pushing meds is one thing.  Adding the tube would just be too much for us simple ambulance drivers


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## jjesusfreak01 (Oct 29, 2010)

46Young said:


> How much alcohol can the accused clear in two hour's time? Maybe enough to come in under the legal limit. Even if it's a one hour incident to blood draw time, it's still too much. It could be the difference from a .09 value to a .07. Having said that, I don't know if there's a presumptive measure that adjusts for the time delay in obtaining a blood draw, but still.....



People metabolize alcohol at different rates, so unless someone tests at 0.07 two hours later, (were I in a jury) I would never convict a person on that evidence.


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## Akulahawk (Oct 29, 2010)

I've never had to do it, but it's in our protocols here. The companies I worked for never carried the tubes for the LE blood draws. They expected that if LE wants a blood draw, they'd provide the tubes. If I have to draw blood for LE, it's going to be on scene. LE hands me the tubes. I draw blood. I give tubes directly back to the LE Officer that handed me the tubes. Done. No evidence left in my ambulance. LE has control/custody of the tubes the entire time unless it's in MY hands for the draw.

Of course, I worked in areas where hospitals are close by, so... it's just easier to transport and have it done at the ED. In any event, if I'm involved at a crime scene in some manner, I expect that I might be asked to testify. No difference in testifying that I was there... or having to add that I drew blood. I'd have to be there anyway.


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## FreezerStL (Oct 29, 2010)

> Drawing blood doesn't make you go against advocating for the patient. Drawing blood, especially if you are already starting an IV, doesn't go against treating the patient in a way that harms or inhibits them getting better.
> 
> 
> It's not like you tell the patient "I'm not going to give you any pain meds till you let me draw your blood"



Very true,

What concerns me about the idea is that patients who need  IV's might refuse, due to us drawing blood in the process.  


I believe DWI/DUI is a very severe offense; However, the public has many of misconceptions about EMS. Why add fuel to the fire?


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## FreezerStL (Oct 30, 2010)

> I've never had to do it, but it's in our protocols here. The companies I worked for never carried the tubes for the LE blood draws. They expected that if LE wants a blood draw, they'd provide the tubes. If I have to draw blood for LE, it's going to be on scene. LE hands me the tubes. I draw blood. I give tubes directly back to the LE Officer that handed me the tubes. Done. No evidence left in my ambulance. LE has control/custody of the tubes the entire time unless it's in MY hands for the draw.



I haven't seen/heard of protocols for LE blood draws in my areas, but those seem fair.

Keep it in LEO supervision from start to finish.


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