Blood Draws, EMT, and your chance to help stick it to the man

[psychgeek]

I’ll preface this by admitting that it is a weird question.

Here is the background. I am a former psychologist turned law student working with an Innocence Project office. As such, I am often used to decode medical records relevant to our cases. In one of these, there are some things that just don’t seem to add up to me. The paperwork from the ED consistently states that a person of interest arrived by ambulance at 12 (I am making up the time for confidentiality reasons). All of the other records of procedures and exams fit with this time of arrival except for one. The record of the blood draw for the purposes of a toxicology screen and ascertainment of blood alcohol level states that it happened at 11:45. We have corroborating evidence that the time of arrival at the ED was recorded correctly, so the only way the time for the blood draw can be accurate is if EMTs drew blood for diagnostic testing en route to the hospital.

I suspect that this is not something that EMTs regularly do, and I almost think they would not be allowed to do so even under exceptional circumstances since there would be no doctor ordering the diagnostic procedure and it doesn't seem related to emergency medical care. I suspect the draw occurred much later (perhaps several hours after the patient arrived at the hospital) and the time was changed to cover up the delay in running the time-sensitive test. I am, of course, completely pulling this opinion out of my ass so I would like to have someone more knowledgeable than I weigh in on this before I spend the better part of tomorrow looking up the various regulations. Can anyone confirm or disconfirm that EMTs do not or cannot draw blood for procedures unrelated to emergency medical treatment?

Thanks so much.

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[joeDO2]

I’ll preface this by admitting that it is a weird question.

Here is the background. I am a former psychologist turned law student working with an Innocence Project office. As such, I am often used to decode medical records relevant to our cases. In one of these, there are some things that just don’t seem to add up to me. The paperwork from the ED consistently states that a person of interest arrived by ambulance at 12 (I am making up the time for confidentiality reasons). All of the other records of procedures and exams fit with this time of arrival except for one. The record of the blood draw for the purposes of a toxicology screen and ascertainment of blood alcohol level states that it happened at 11:45. We have corroborating evidence that the time of arrival at the ED was recorded correctly, so the only way the time for the blood draw can be accurate is if EMTs drew blood for diagnostic testing en route to the hospital.

I suspect that this is not something that EMTs regularly do, and I almost think they would not be allowed to do so even under exceptional circumstances since there would be no doctor ordering the diagnostic procedure and it doesn't seem related to emergency medical care. I suspect the draw occurred much later (perhaps several hours after the patient arrived at the hospital) and the time was changed to cover up the delay in running the time-sensitive test. I am, of course, completely pulling this opinion out of my ass so I would like to have someone more knowledgeable than I weigh in on this before I spend the better part of tomorrow looking up the various regulations. Can anyone confirm or disconfirm that EMTs do not or cannot draw blood for procedures unrelated to emergency medical treatment?

Thanks so much.

Although it is not routine for many systems to draw specifically for this purpose, it is somewhat common to have medics draw a full set of labs not knowing which tests might be run. For example, in one system I have worked in, I drew "one of every tube." In that case, when the patient arrived at the hospital, whatever tests they wanted to run they would just select the appropriate tubes and not have to stick the patient again in the ED. That being said, its also possible the labs were drawn in the ED and someone simply made an innocent mistake in recording the time in the computer.

 

[deleted6669]

when I worked as a medic we also drew a few tubes and taped them to the iv bag so the lab could start working on them as soon as the pt arrived at the hospital.

 

[McPoyle]

We would fairly routinely draw blood for alcohol related things such as DUIs in the area I worked.

 

[Dwindlin]

I also routinely drew blood on patients prior to arriving at the ED.

 

[FiremedicMike]

By protocol we are to draw all tubes in all STEMI and CVA cases. I don't know what tests are run off each tube, I only know that we have 5 tubes to fill somewhere during our 4 minute transport..