HOUSE BILL REPORT
ESB 5835
As Reported by House Committee On:
Health Care
Title: An act relating to the emergency administration of epinephrine.
Brief Description: Regarding administration of epinephrine.
Sponsors: By Senators Finkbeiner, Thibaudeau, Winsley, McAuliffe, Costa, Honeyford, McCaslin, Kohl‑Welles, Prentice, Kline, Benton and Oke.
Brief History:
Committee Activity:
Health Care: 3/29/01 [DPA].
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Brief Summary of Engrossed Bill (As Amended by House Committee)
$Emergency Medical Technicians are allowed to carry and administer epinephrine indefinitely.
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HOUSE COMMITTEE ON HEALTH CARE
Majority Report: Do pass as amended. Signed by 14 members: Representatives Campbell, Republican Co‑Chair; Cody, Democratic Co‑Chair; Schual‑Berke, Democratic Vice Chair; Skinner, Republican Vice Chair; Alexander, Ballasiotes, Conway, Darneille, Edmonds, Edwards, Marine, McMorris, Pennington and Ruderman.
Staff: Antonio Sanchez (786‑7383).
Background:
Anaphylaxis (severe allergic reactions) 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. In some cases it can result in convulsions, unconsciousness, and even death. 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 called the "Epi-Pen".
In 1999 the Washington State Legislature passed the "Kristine Kastner Act" requiring that all ambulance and aid services make epinephrine available to Emergency Medical Technicians (EMTs) in their supplies. The EMTs are now authorized to administer epinephrine to patients of any age with evidence of a prescription. They are also authorized to administer epinephrine to patients under the age of 18 upon the request of a parent or guardian or upon the request of a person who presents written authorization from the patient, parent, or guardian. The Department of Health was required to develop and distribute protocols and guidelines for medical training, establish the procurement process for the Epi-Pens, notify the over 500 licensed emergency medical services providers of the new requirements, and report to the Legislature on the statewide incidence of anaphylaxis and the training and care necessary to allow EMTs to carry and administer epinephrine.
The report by the Department of Health indicated that in 13 different counties across the state there were 26 different cases involving the use of Epi Pens by EMTs. Of those cases, 50 percent showed improvement of their allergic condition, 42 percent showed a reversal of the allergic reaction, and one patient was in cardiac arrest when the emergency medical services personnel arrived and the condition was considered irreversible. Their recommendation was to authorize that EMTs continue to be allowed to carry and administer epinephrine.
The legislative authorization for allowing EMTs to continue to carry and administer epinephrine is scheduled to end on December 31, 2001.
Summary of Amended Bill:
The scheduled expiration date for the legislative authorization allowing Emergency Medical Technicians (EMTs) to continue to carry and administer epinephrine is removed. The EMTs will be allowed to carry and administer epinephrine indefinitely.
Amended Bill Compared to Engrossed Bill:
The requirement that the state Nursing Care Quality Assurance Commission adopt rules and policies allowing public school districts to provide for the administration of epinephrine to students by school employees under certain circumstances is eliminated.
Appropriation: None.
Fiscal Note: Available.
Effective Date of Amended Bill: Ninety days after adjournment of session in which bill is passed.
Testimony For: The EPI program has been very effective and should continue. More time is needed to see if a program should be developed for schools statewide.
Testimony Against: None.
Testified: Tom Saelid; Doug Nelson, Mary Ann Pintler and Karen McCall, Public School Employees; Ann Simons, School Nurse Organization of Washington; Judy Maire, Office of the Superintendent of Public Instruction; and Stacia Hollar.