SENATE BILL REPORT
SB 5768
As Reported By Senate Committee On:
Health & Long-Term Care, March 1, 1999
Title: An act relating to emergency medical services.
Brief Description: Allowing emergency medical technicians to administer epinephrine.
Sponsors: Senators Finkbeiner and Oke.
Brief History:
Committee Activity: Health & Long‑Term Care: 2/18/99, 3/1/99 [DPS-WM].
SENATE COMMITTEE ON HEALTH
& LONG-TERM CARE
Majority Report: That Substitute Senate Bill No. 5768 be substituted therefor, and the substitute bill do pass and be referred to Committee on Ways & Means.
Signed by Senators Thibaudeau, Chair; Wojahn, Vice Chair; Costa, Franklin and Winsley.
Staff: Christopher Blake (786-7446)
Background: Anaphylaxis is an allergic hypersensitivity reaction of the body to a foreign protein or drug. Anaphylaxis can be caused by drugs, insect stings, foods, and inhalants. A reaction may cause increased irritability, dyspnea, or cyanosis. In some cases it can result in convulsions, unconsciousness, and even death. Last November a girl on Mercer Island died after having a severe allergic reaction to nuts in a cookie.
Epinephrine is used to treat anaphylactic reactions. Those with severe allergies that could result in an anaphylactic reaction may receive a prescription to administer a dose of epinephrine through the use of an autoinjector device. Presently, paramedics and intermediate life support technicians may administer epinephrine. Emergency medical technicians, however, may only administer epinephrine to patients who have a prescription for epinephrine for allergic reactions.
Summary of Substitute Bill: All emergency medical services medical program directors are required to design a training curriculum and protocols to allow emergency medical technicians to carry and administer epinephrine to patients under 26 years old who have a prescription for epinephrine. Emergency medical technicians are to be trained in the use of epinephrine and then authorized to carry and administer the drug. The Secretary of Health must develop criteria for evaluating and approving these programs. Emergency medical technicians are permitted to carry and administer epinephrine to patients reasonably believed to be under 26 years of age or with evidence of a prescription for epinephrine upon successful completion of an approved training program.
Substitute Bill Compared to Original Bill: The substitute bill changes "anaphylactic shock" to "anaphylaxis" and "epinephrine autoinjector devices" to "epinephrine." Training and protocols are limited to patients under 26 years of age or with evidence of a prescription for epinephrine. An emergency medical technician's authority to administer epinephrine is limited to those reasonably believed to be under 26 years of age or with evidence of a prescription for epinephrine.
Appropriation: None.
Fiscal Note: Requested on February 10, 1999.
Effective Date: Ninety days after adjournment of session in which bill is passed.
Testimony For: The risk of misdiagnosis of anaphylaxis is small because it is usually very clear when an individual is experiencing this condition. There are no contraindications related to the use of epinephrine in life-threatening cases of anaphylaxis. If emergency medical technicians are not allowed to administer epinephrine, local governments will be exposed to lawsuits.
Testimony Against: Emergency medical technicians do not have the diagnostic abilities to recognize when it is appropriate to use epinephrine. Emergency medical technicians already have 110 hours of training and this bill will add another 20 hours of training in addition to more time in continuing education requirements. Emergency medical technicians are already authorized to use a patient's prescribed epinephrine pen.
Testified: Senator Finkbeiner, prime sponsor (pro); Nancy Kastner-Klinck (pro); Craig Kastner-Klinck (pro); Janet Griffith, Department of Health (informational); Kristin LeClair, Food Education Allergy Support Team (pro); Dr. Ronald Case (pro); Dr. Lothar Pinkers (con).