03/06/1995 10:15 AM Senate HES

 SHES - 3/6/95                                                                 
                                                                               
             HB  39 AUTHORITY TO PRONOUNCE DEATH                             
                                                                               
 Number 192                                                                    
 CHAIRMAN GREEN introduced  HB 39  as the next order of business               
 before the committee.                                                         
                                                                               
 REPRESENTATIVE THERRIAULT, prime sponsor, explained that HB 39                
 would allow mobile intensive care paramedics, physicians                      
 assistants, and emergency medical technicians (EMT) to pronounce              
 death under specified circumstances.  They would pronounce death              
 after determining that a person has suffered irreversible cessation           
 of circulatory and respiratory functions when a physician is not              
 immediately available by radio or telephone.                                  
                                                                               
 Representative Therriault noted that currently when a member of an            
 emergency medical service begins CPR, they are required to continue           
 CPR until the person recovers, the EMT or physicians assistant are            
 relieved by a medical facility or a physician, the responding                 
 parties become physically exhausted, or a physician pronounces the            
 person dead.  Often in rural areas where physicians and medical               
 facilities are not immediately available, emergency medical                   
 response members are required to continue unproductive                        
 resuscitation.  Representative Therriault reviewed Sections 1 and             
 2 and the last page of HB 39 which specifies the situations in                
 which emergency medical response members could pronounce death.               
 HB 39 is practically identical to last year's legislation.                    
                                                                               
 MARK JOHNSON, Chief of the Emergency Medical Services, supported              
 HB 39.  Sometimes emergency medical responders in rural areas are             
 forced to do fruitless resuscitation.  He offered to answer any               
 questions from the committee.                                                 
                                                                               
 SENATOR SALO supported HB 39, however, is the 60 minutes of                   
 resuscitation required with hypothermia adequate.  MARK JOHNSON               
 said that few persons could last longer than 20 or 30 minutes, 60             
 minutes was chosen in order to encompass the possibility of                   
 miracles.  Those persons who have survived extended periods of                
 resuscitation have been near treatment facilities.                            
                                                                               
 Number 284                                                                    
                                                                               
 CHAIRMAN GREEN inquired as to rigor mortis and post mortem lividity           
 being used as the basis of death.  She noted that this was a                  
 question from physicians who had contacted her office.  MARK                  
 JOHNSON informed the committee that he had discussions with Dr.               
 Nakimora and Dr. Probst regarding this issue.  Mr. Johnson pointed            
 out that an amendment had been adopted on page 2, line 20 in which            
 the language "cardiac arrest, accompanied by post mortem lividity"            
 addresses the concerns of this issue.  Mr. Johnson commented that             
 in previous testimony, various emergency response members indicated           
 that lividity would not be the only determinant of death; it would            
 be a combination of circumstances.                                            
                                                                               
 CHAIRMAN GREEN stated that she intended to move this legislation.             
                                                                               
 SENATOR LEMAN moved that CS HB 39(JUD) be moved out of committee              
 with individual recommendations.  Hearing no objection, it was so             
 ordered.