Legislature(1995 - 1996)
04/29/1995 02:30 PM Senate JUD
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
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.