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.