CSHB 478(HES) AM: "An Act relating to the authority of mobile intensive care paramedics, physician assistants, and emergency medical technicians to pronounce death under certain circumstances."
00CS FOR HOUSE BILL NO. 478(HES) am 01 "An Act relating to the authority of mobile intensive care paramedics, physician 02 assistants, and emergency medical technicians to pronounce death under certain 03 circumstances." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 09.65.120 is amended to read: 06 Sec. 09.65.120. DEFINITION OF DEATH. An individual is considered dead 07 if, in the opinion of a physician licensed or exempt from licensing under AS 08.64 or 08 a registered nurse authorized to pronounce death under AS 08.68.395, based on 09 acceptable medical standards, or in the opinion of a mobile intensive care 10 paramedic, physician assistant, or emergency medical technician authorized to 11 pronounce death based on the medical standards in AS 18.08.089, the individual 12 has sustained irreversible cessation of circulatory and respiratory functions, or 13 irreversible cessation of all functions of the entire brain, including the brain stem. 14 Death may be pronounced in this circumstance before artificial means of maintaining
01 respiratory and cardiac function are terminated. 02 * Sec. 2. AS 18.08 is amended by adding a new section to read: 03 Sec. 18.08.089. AUTHORITY TO PRONOUNCE DEATH. (a) A mobile 04 intensive care paramedic or physician assistant registered under AS 08.64.107 or an 05 emergency medical technician certified under this chapter may make a determination 06 and pronouncement of death of a person under the following circumstances: 07 (1) the paramedic or emergency medical technician is an active member 08 of an emergency medical service certified under this chapter; 09 (2) neither a physician licensed under AS 08.64 nor a physician exempt 10 from licensure under AS 08.64 is immediately available for consultation by radio or 11 telephone communications; 12 (3) the paramedic, physician assistant, or emergency medical technician 13 has determined, based on acceptable medical standards, that the person has sustained 14 irreversible cessation of circulatory and respiratory functions. 15 (b) A mobile intensive care paramedic, physician assistant, or emergency 16 medical technician who has determined and pronounced death under this section shall 17 document the clinical criteria for the determination and pronouncement on the person's 18 emergency medical service report form and notify the appropriate medical director as 19 soon as communication with the medical director can be established. The paramedic, 20 physician assistant, or emergency medical technician shall provide to the person who 21 signs the death certificate the 22 (1) name of the deceased; 23 (2) presence of a contagious disease, if known; and 24 (3) date and time of death. 25 (c) Except as otherwise provided under AS 18.50.230, a physician licensed 26 under AS 08.64 shall certify a death determined under (b) of this section within 24 27 hours after the pronouncement by the mobile intensive care paramedic, physician 28 assistant, or emergency medical technician. 29 (d) In this section, 30 (1) "acceptable medical standards" means 31 (A) the presence of injuries incompatible with life, including
01 cardiac arrest accompanied by incineration, decapitation, open head injury with 02 loss of brain matter, or detruncation; 03 (B) the presence of rigor mortis; 04 (C) the presence of post mortem lividity; or 05 (D) failure of the patient to respond to properly administered 06 resuscitation efforts; 07 (2) "failure of the patient to respond" means without restoration of 08 spontaneous pulse or respiratory effort by the patient; 09 (3) "properly administered resuscitation efforts" means 10 (A) when a person authorized to perform advanced cardiac life 11 support techniques is not available and the patient is not hypothermic, at least 12 30 minutes of cardiopulmonary resuscitation properly performed by an 13 emergency medical technician; 14 (B) when a person authorized to perform advanced cardiac life 15 support techniques is not available and the patient is hypothermic, at least 60 16 minutes of cardiopulmonary resuscitation properly performed by an emergency 17 medical technician in conjunction with rewarming techniques as described in 18 the current State of Alaska Hypothermia and Cold Water Near-Drowning 19 Guidelines published by the division of public health, Department of Health 20 and Social Services; or 21 (C) at least 30 minutes of cardiopulmonary resuscitation and 22 advanced cardiac life support techniques properly performed by a person 23 authorized to perform advanced life support services.