EMS Evidentiary Blood Draws

1. EMS Evidentiary Blood Draws Joe Kovacs, Paramedic, EMSIC, BHSA Operations Systems Manager Medstar Ambulance

2. Need For Evidentiary Blood Draws • Partnership with communities served • Safety concerns • Hospital Issues • Budgetary/Financial issues • Types of delivery system

3. Partnership • Strengthen relationships with community • Other services offered

4. Safety • Officer Safety • Transporting • Suspect remains in Lock-up • Procedure is Video and/or audio taped

5. Safety • Hospital Issues • Waiting Times • Triage as a low priority • Bed Usage • Tying up bed that could be utilized for others • Defense • Who performed the blood draw • Confusion with other samples • Court time • Tying up numerous staff for court

6. Quote from an Police Officer: “Having the draw done by a Medic trained for this, will ensure the safety of the prisoner and the citizens that are at the hospital. I can tell you from past experiences, drunks that need the draws, are the type that I call "hot & cold."  They go from passive to instant "A@#$*&^" in a blink of an eye.  There have been many a time that the drunk will have to be physically restrained by myself and or others to do this. We all know hospitals are filled with items that can be used as weapons causing serious injuries to the officer and others, if one of these individuals go "hot".”

7. Financial • Decreases in number of officers • Budgetary issues • Contractual issues • Keeping officers “on the street” • Cost recovery • Court costs • Fines

8. History • Numerous States utilize EMS for blood draws • Texas • California • Utah • Ohio • Michigan • North Carolina

9. History • No consistency within the country • Use of hospitals • Clinics • Nurses • Phlebotomy • Physicians • Areas using police officers trained to draw blood • Specialized vehicle • Prosecutor, Nurse, Magistrate/Judge

10. Maricopa, Arizona DUI-Van

11. History • Oakland County • Police Departments • 6 area departments • February 2009 thru February 2010 • 142 blood draws by EMS • No Cases lost due to evidentiary reasons • Berkley Public Safety Department • Deputy Director Robert North • EMS Blood draws

12. Advantages and Risks • Establishment of contracts with communities served • No protection within EMS legislation • Liability protection • General practice liability insurance • Must prove negligence • Statue provides protection • Local Court jurisdiction approval • Use of warrant

13. Process • Training • Chain of Custody • Protocols • Documentation • Maintaining records • Billing

14. History • Advantages • Tied into the communities served • Addition of services besides EMS • Non-traditional revenue source • Another avenue for Medic’s • Alternative type of care • Response times • Within 60 minutes

15. Risks • Liability • Gross negligence • Injuries • Needle stick • Violent encounters • Poor Documentation • Response time • Failure to follow proper protocols • Lost cases

16. Model Programs • Determine service area • Market • Public Safety, Police, Sheriff • Demand • How many requests/transports • Based on previous years • Budget

17. Types of Programs • On – Call System • Dedicated Team • Well versed in protocols • Consistency with paperwork • Experience with draws • Departments deal with same individuals • Not tying up EMS Units • Utilizing On-duty Units • Response time • Numerous units available • Ability to respond for numerous requests • Short task times • Potential need for transport Advantages Advantages

18. Types of Programs • On – Call System • Limited number of providers • On – Call pay • Minimum number of hours • Vehicle usage • Private or company • Response time issues • Utilizing On-duty Units • Taking units away from primary response • Delays due to high EMS call volume • Not primary duty • Paperwork issues • Not well versed with blood draws Disadvantages Disadvantages

19. Questions