Re: 911:: communicable disease / airing of

[Guest guest]

In my EMT class we were told not to ever mention a patients illness like

that. Not even to members of our own crew members. It is a legal issue. I am

in the state of Va. The instructor was pretty clear on it. Even if a patient

tells us they are HIV possitive we can't pass that information on except to

the hospital staff and then only the staff that will be treating that patient

and not on the radio only in person and only when not around others.

Tammy

[Guest guest]

Michigan does not have any EMD laws, currently. However it is illegal

to provide that information over the radio.. as well as the patients

name. The reason being... its in our EMS laws as well as the basic

infrastructure of most medical ethics. The patient has a right to

confidentially. There was a case that I remember involving a Police

officer who informed a neighbor about a person's HIV status. This

police officer was sued successfully. I would have to look for this

information to give you more of the specifics.

However its just not limited to HIV/AIDS status... It includes all

communicable diseases such as Hepatitis or TB. Their reasoning behind

not informing responders of this information is that your EMS crews

should already be prepared for such cases and do not need to be given

this information... otherwise the EMS crews could also be held liable

for not following OSHA's bloodborne pathogen guidelines.

The place to look for this information is in your EMS laws. I am

surprised APCO does not have this information available. A good

resourse would be the NAEMD. If you have any questions or if i was

clear on anything... just let me know.

>In the APCO Basic Emergency Medical Dispatch Course

>it states " It is illegal for you to relay knowledge that a

>patient is HIV positive to responding units in any way,

>including radio and telephone " .

>

>(page 28 of the Apco Institute EMD course book)

>

>Does anyone have the statute for this -- I am in Minnesota.

>Not sure if all states are the same.

>

>I have contacted APCO and they are unable to come up with the

> " legal " on this.

>

>Thanks,Lorraine

--

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Danny s Jr. franks@...

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ICQ: 10176273 http://home.earthlink.net/~studfrog

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http://www.dvaems.com

[Guest guest]

lorraine wrote: <<< In the APCO Basic Emergency Medical Dispatch Course it

states " It is illegal for you to relay knowledge that a patient is HIV

positive to responding units in any way,

including radio and telephone " . >>>

our center's lawyer confirmed that to release private, medical information

without the patient's consent is a violation of federal and state privacy

laws. we've taken " patient's consent " to mean written consent. this mans

that even if the caller is the patient/victim and tells the dispatcher s/he

has xyz medical condition we will not transmit that information to

responding units either over voice radio, telephone or mdt.

we routinely flag addresses in our CAD system with certain types of

precautionary information. the standard we have adopted for flagging

addresses with medical information is this: if the medical condition is

apparent to a casual observer then privacy is not compromised and the

information can be relayed. otherwise we require a written waiver of

liability from the patient or patient's legal guardian.

the example we use to illustrate this standard is this: joe brown is

confined to a wheelchair and may need assistance evacuating his home in case

of a fire. the fact that mr. brown is wheelchair bound is apparent to a

casual observer and thus his privacy is not compromised. however, we could

not legally have or disseminate the reason that put mr. brown in the

wheelchair without his written consent. this standard applies to all

medical situations, not just communicable diseases.

rich

[Guest guest]

In a message dated 12/19/01 8:43:46 PM Eastern Standard Time,

heimdalcmo@... writes:

> In my EMT class we were told not to ever mention a patients illness like

> that. Not even to members of our own crew members. It is a legal issue. I

> am

> in the state of Va.

I believe that in the state of NJ there are also guidelines prohibiting

passing on this information over the radio. We have pretty much solved the

problem by using one of our regular codes as a tip off for officers and

responding volunteer squad members. Signal 8 for us means " Use Caution " .

S08 on a squad call alerts the responders that this is not an average call

and they should use ALL cautions prescribed by the health dept for

communicable diseases. They don't know what the actual disease is, but they

do know there is something amiss.

I'm sure there is some ambulance chasing lawyer out there that could make an

issue of this, but up to this point we have found that it is the only thing

we can do to protect our guys.

Patty

BTPD NJ

[Guest guest]

Lorraine,

This is mostly a guess, but, I am thinking the statute would be the Privacy Act.

Freida

LaVergne,TN

> >Does anyone have the statute for this -- I am in Minnesota.Not sure if all

states are the same.

[Guest guest]

In a message dated 12/20/01 8:14:41 PM Eastern Standard Time,

Logan.paul@... writes:

>

> So, while dispatchers might think this is good information to pass onto

> providers, the way see it is you are allowing them to be lazy and not do a

> proper patient assessment.

>

>

An EXCELLENT observation.

Patty

BTPD NJ

[Guest guest]

>This is mostly a guess, but, I am thinking the statute would be the Privacy

Act.

The Privacy Act, possibly the ADA, and other state/federal laws may

come into effect with the airing of this information.

If your agency needs specific statutes that cover this, inquire with

your City/County/State attorney.

Anyone who puts this type of information over the air is open

for liability.

The answer is Universal Precautions...

Weintraut

[Guest guest]

>We still have a code for that to advise responding units that a household has

a communicable disease in it, I refuse to use it

You are wise in refusing to use the code.

It will not shield you from liability.

Weintraut

[Guest guest]

I have to totally disagree with you on this... NO way does this

information protect EMS personnel of contracting any bloodborne

pathogen. What you are doing is violating this patients rights. It

does not matter how you look at it, its a violation. I have treated

many individuals with a communicable disease and they only protection

provided to me is Personal Protection Equipment as described by OSHA.

Every time an EMS crew is comes in contact with ANY patient, it is

required to used universal precautions. As an EMT I can be fined by

OSHA for not utitlizing universal precautions. What you and your

agency are doing is illegal. It does not matter if your caller

volunteers this information... what matters is that at some point

this information could be later used in some other way. Something

else to think about... how many people think that the questions asked

of them by a calltaker/disaptcher is required and they must answer.

If people do not know the profession... they may think this and so

they will answer. Your question does not provide them with an

alternative. It simply states... " Does anyone in the household have

anything contageous.... " Which says to me " answer this question

along with all the others I have asked. " The question provides no out

for people who may not want to answer it or state they are not

required to.

>Well, that was a legal issue we stressed over for a long time, and the end

>result is that we DO put the information out digitally over our MDT/MCT

>system. In the event that we need to alert a responding unit of a

>communicable disease, we simply re-affirm their need to take universal

>precautions. As far as I know, we have not yet been challenged legally on

>this issue and have been using it for a few years now. The problem is what's

>more important, patient privacy or the safety of public safety employees. We

>are to ask the question of every caller (EMS calls) if it's likely the

>caller knows the answer. We ask the question vaguely ( " Does anyone in the

>household have anything contageous, such as hepatitis, TB, HIV, etc.?) Very

>seldom does anyone become upset that we ask the question, and those that

>answer it " YES " are usually more than willing to volunteer what it is that

>they have. The bottom line is, it provides an extra measure of safety for

>the EMS workers, both in the field and in the hospital. I, for one, like it,

>but I can certainly see both sides of the coin.

>

> Ed

>

[Guest guest]

I completely agree with Danny. I have been working as an EMT (at all levels)

for more than 15 years and have treated all kinds of " icky " stuff without

any prior knowledge and have yet to " come down " with anything.

My training and years of experience have taught me to treat everyone as if

they are contagious in order to protect not only myself, but my family as

well.

So, while dispatchers might think this is good information to pass onto

providers, the way see it is you are allowing them to be lazy and not do a

proper patient assessment.

I hope everyone has a Happy and Safe Christmas and a Great New Year.

M. Logan, EMT-P

Communications Training Officer

Dane County Public Safety Communications

210 Luther King Jr. Blvd. Room 109

Madison, Wisconsin 53709

logan.paul@...

pnb@... (home)

http://www.co.dane.wi.us/communicationscenter/index.html

Statements made reflect personal opinion and are not necessarily the

view of Dane County Public Safety Communications or any other employee

-----Original Message-----

From: Danny s Jr

I have to totally disagree with you on this... NO way does this

information protect EMS personnel of contracting any bloodborne

pathogen. What you are doing is violating this patients rights. It

does not matter how you look at it, its a violation. I have treated

[Guest guest]

We use " EMD " , but one that we designed for our own use. We've been using it

now since about 1997/98. I'm not saying I agree with what we're doing, but

it works and it's not being challenged. We dispatch for 20 different Fire

Departments and each one questioned this, and they have all agreed to play

along. Believe me, it's been to the attorneys for review, you can count on

it.

Re: 911:: communicable disease / airing of

> I'm assuming you don't use EMD since your asking a question that isn't

supported by EMD? And aren't the responding units supposed to be using

universal precautions without having to be told?

>

> Jim J

> Mr 911

> TriCom

>

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[Guest guest]

Then your " EMD " and your Attorneys are doing you a disservice. Also

your own EMD program is another pitfall... its not nationally

recognized nor is there any medical basis for it... I would hope

whoever came up with it has some medical background and researched

it. With the NAEMD, they have 25 years of medical research.

PowerPhone has also but forth a standard and many years of research.

I would hate to be apart of your agency with your current practices.

I think its pretty clear from our discussions here, that there will

always be someone out there to challenge your polices and

procedures/guidelines... I know I would.

>We use " EMD " , but one that we designed for our own use. We've been using it

>now since about 1997/98. I'm not saying I agree with what we're doing, but

>it works and it's not being challenged. We dispatch for 20 different Fire

>Departments and each one questioned this, and they have all agreed to play

>along. Believe me, it's been to the attorneys for review, you can count on

>it.

[Guest guest]

When I was in Oregon, if a communicable disease or safety issue rose

up, we would dispatch the call and then inform the responding units

to use " universial precautions " Where I work at now in Nevada, we

arent allowed to tell them ANYTHING. the thinkin down here is that

they should ALWAYS respond using universal precautions and be

prepared for it, that is how we save ourselves from Liability issues

I guess!

Chris

[Guest guest]

>if a communicable disease or safety issue rose

up, we would dispatch the call and then inform the responding units

to use " universial precautions " Where I work at now in Nevada, we

arent allowed to tell them ANYTHING.<

If you only say " use universal precautions " on calls where you have

information of a communicable disease... you are in effect using

a code to indicate some of this persons medical history....

A lawyer would tear you up...

If you said it on EVERY call, you're ok.. but that's total stupid...

A dispatcher should never have to say it....

Weintraut

[Guest guest]

I would like to thank everyone for the info on airing communicable disease info

Is there any legal statute that can be sited for NOT airing the info?

Thanks again,

Lorraine

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