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I Call Foul!

For some reason, the two states where I have chosen to reside tend to make the news a lot. Texas is always making the headlines for some reason or another — executing a prisoner or, more recently, a death row inmate who plucked his eye out and ate it. Nevada, it seems, is always in the news for some weirdness, the O.J. conviction being among them (I guess he never found the murderer of his wife). But, let me talk about my home state of Texas.

This year, the biannual Texas legislature will meet. Thus, hide your wallet and your small children — for nothing will be safe until these knuckleheads finish their business in Austin. And the bills are already being prepared for the new legislative session.

One of the most significant bills this session is House Bill 509 sponsored by State Representative Debbie Reynolds (R-Tomball). This bill will allow EMTs to draw blood from suspected drunk drivers. It will also strike language in current Texas law that allows blood to only be taken in a “sanitary place.” What the bill will allow is the taking of blood on roadside DWI traffic stops. Obviously, the vampire lobby is alive and well in Texas.

This bill was introduced because of increasing problems in finding medical personnel to draw blood from suspects. Many hospitals and even jail facilities have stopped the practice, primarily citing inadequate staffing issues. But an underlying theme is that law enforcement personnel have no interest in any sort of medical procedure. Also, it seems ethical issues can arise when physicians and nurses draw blood for non-clinical reasons. Thus, EMS seems like the answer. After all, EMS is always there and always responds; but for how long?

Using EMS personnel to draw blood is wrong on so many levels. Currently in Texas, only EMT-Intermediates and EMT-Paramedics are allowed to draw blood. Thus, will police officers and state troopers start calling out EMS crews for blood draws? Does this not ultimately impact the public trust of EMS personnel? After all, we are supposed to help. Anytime the line is blurred between EMS and law enforcement, patient trust and, occasionally, patient care will suffer.

It is not uncommon to get called to court to testify in criminal proceedings where blood has been drawn. I have drawn blood on several occasions in the emergency department and been subsequently ordered to court to testify. Generally, the testimony is brief; but as a rule, the waiting lasts forever. I have spent hours on a wooden bench outside the courtroom waiting to be called into the proceedings to testify that I did indeed draw the blood from the defendant and indeed used proper technique.

Will career EMS services pay their employees for the day they spend in court? What about volunteer services? How will volunteer EMTs and paramedics get reimbursed for the time spent away from their regular jobs? This additional responsibility could hurt the already difficult task of recruiting volunteers.

The deeper issue of this proposed bill is the shifting of government costs. An article in the Austin American Statesman details that jail personnel don’t want to collect blood from DWI suspects. This followed the declaration by two of Austin’s major hospitals that they will no longer draw blood for suspects in criminal investigations. So, what do they do? They try and shift the responsibility to an already overburdened and underpaid EMS system. It happens all the time and all we do is repeat the old Animal House line, “Thank you, sir. May I have another?” NAEMT and NAEMSP need to be all over this. I hope they do, but I won’t hold my breath.

EMS1.com columnist Bryan E. Bledsoe, DO, FACEP, EMT-P is an emergency physician, paramedic and EMS educator. Dr. Bledsoe is the principal author of the Brady paramedic textbooks and others. He has more than 20 years publishing experience and has more than 900,000 books in print and has written more than 400 articles.