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