04/29/1995 02:30 PM Senate JUD

              HB 39 AUTHORITY TO PRONOUNCE DEATH                              
                                                                              
 REPRESENTATIVE GENE THERRIAULT, sponsor of HB 39, gave the                    
 following testimony.  HB 39 is the reintroduction of legislation              
 that died in the Senate Rules committee last year due to lack of              
 time.  The measure grants the authority to intensive care                     
 paramedics, physicians assistants, and EMTs to pronounce death in             
 certain circumstances.  Due to the rural nature of Alaska, many               
 volunteer care providers respond to emergency situations where                
 death may occur but are out of contact with a consulting physician.           
 Once CPR is started, the provider cannot stop until the victim is             
 in a location where a physician can pronounce death.  Situations              
 occur in which the provider knows the victim cannot be                        
 resuscitated, yet must continue futile CPR, which can be traumatic            
 to the victim's relatives, and to the provider.  He has worked                
 extensively with state agencies that oversee EMT services to draft            
 concise language.  Section 2 adds a new section to the statute to             
 specify when the authority is granted and the procedure and                   
 information necessary to pronounce death.                                     
                                                                               
 Number 209                                                                    
                                                                               
 SENATOR TAYLOR questioned the definition of "properly administered            
 resuscitation" on page 4, and wondered whether the 30 minute CPR              
 requirement could create provider liability when the victim is not            
 hypothermic.                                                                  
                                                                               
 REP. THERRIAULT repeated under current law, once a provider begins            
 to administer CPR, CPR cannot be stopped until a physician                    
 pronounces death.  The 30 minute limit was arbitrarily chosen, but            
 grants the authority to pronounce death after 30 minutes.                     
                                                                               
 Number 230                                                                    
                                                                               
 SENATOR TAYLOR clarified the 30 minute limit should be considered             
 to be a reasonable standard; not an absolute standard. He expressed           
 concern that by specifying a 30 minute time limit, the risk of                
 someone enforcing it in an illogical situation increases.  He                 
 discussed a situation in Wrangell in which a car accident victim              
 was killed instantly, and fortunately the paramedics were able to             
 contact a physician shortly after arriving on the scene.  However,            
 if the physician was unable to be contacted, it would have been               
 useless to administer CPR for 30 minutes.  He also expressed                  
 concern about the ability to pronounce death.  He recounted a                 
 second situation in which a pilot was pronounced brain dead by the            
 Ketchikan General Hospital but after receiving treatment at                   
 Harborview Medical Center in Seattle, is almost fully recovered.              
                                                                               
 Number 270                                                                    
                                                                               
 SENATOR GREEN asked whether any individual administering CPR is               
 still unable to stop administering CPR until a replacement is                 
 available.  REP. THERRIAULT was unsure how current law applies to             
 private individuals.                                                          
                                                                               
 Number 284                                                                    
                                                                               
 MATT ANDERSON, Training Coordinator for the Emergency Medical                 
 Services Section of the DHSS, testified in support of HB 39.  The             
 bill is medically appropriate, was crafted considering current                
 medical techniques and standards, and will be easy to implement.              
 Many of the issues raised by committee members can be adequately              
 addressed by the training program.  He noted the conditions                   
 required for a person to be pronounced dead on page 3 are listed as           
 "or."  He explained the 30 minute time limit for patients who fail            
 to respond to proper resuscitation efforts follows standard medical           
 procedure.  Currently, lay rescuers trained in CPR are advised to             
 do so until: the situation becomes too hazardous; they are                    
 physically exhausted; or until new rescuers relieve them.                     
                                                                               
 Number 315                                                                    
                                                                               
 SENATOR GREEN moved CSHB 39(JUD) from committee with individual               
 recommendations.  There being no objection, the motion carried.