Forced Blood Draw? (DUI situation)

Ann RN · Feb 26, 2007

i'm in the last semester of my rn program in california and an issue came up at one of our clinical er sites regarding forced blood draws for dui (driving under the influence) and i wanted to get input from other rns regarding their state, hospital and what your laws are regarding such issues.
so, what is the protocol for your hospital regarding forced blood draws (where the person does not consent)? who initiates, who approves, who signs, who does it, under what specific conditions, is it ever allowed, can the rn refuse, etc, etc?
thanks everyone!
ken

i work in pennsylvania. pa has an implied consent law. in regards to chemical testing, you agree (consent) to take such a test, just by being licensed to drive in pa. if you are arrested for dui and refuse to take this test, in addition to court ordered penalties, you automatically lose your license for a minimum of one year. in my hospital we do not automatically do bac's on all traumas. but - our lab holds blood drawn in the er for 5 days. if law enforcement wants the test done, the blood is there from time of admission. no new blood needs to be drawn.

Trauma Columnist · Feb 26, 2007

In IL, we too have implied consent. However, if a person refuses, they automatically lose their license. If ,there is a death or serious injury, then a court order is obtained. I have seen this done several times in the middle of the night where the judge actually comes to the ER.

West_Coast_Ken, BSN, RN · Feb 26, 2007

in my hospital we do not automatically do bac's on all traumas. but - our lab holds blood drawn in the er for 5 days.

hi ann, thank you for your reply. this is an interesting situation.

in this case there was no injury. it was a "minor" hit and run and the suspect was apprehended afterward. he was brought to the er for medical clearance to go to jail (tetorifice, etc) and there was no need for other medical treatment so a blood draw was not needed (other than for the dui issue).

there were 8 police and they screamed at the rn to "draw his blood" "you can not refuse to take his blood", etc. the rn refused to do this since the patient did not consent to the procedure.

sjt9721, BSN, RN · Feb 26, 2007

Hi Ann, thank you for your reply. This is an interesting situation.
In this case there was no injury. It was a "minor" hit and run and the suspect was apprehended afterward. He was brought to the ER for medical clearance to go to jail (tetorifice, etc) and there was no need for other medical treatment so a blood draw was not needed (other than for the DUI issue).
There were 8 police and they screamed at the RN to "Draw his blood" "You can not refuse to take his blood", etc. The RN refused to do this since the patient did not consent to the procedure.

I believe the RN did the right thing.

The way I understand it, even if the RN had drawn blood for hospital tests, the police can't take one of the tubes nor have the results. They would have to go through medical records with a court order to get the results.

What we've always called a "legal blood draw" is when the cops provide the little kit...vacutainer, betadine wipe, blood tubes, chain of custody forms, etc. The patient would still have to give consent for the draw or risk losing their license. Now if someone was killed or critically injured in the MVC, I think that changes the issue...I just can't remember specifics.

The important thing to remember is that you work for the hospital, under your license from the nursing board. You are not a police department employee. Maybe checking with your Risk department is a good idea to know the specifics.

Like I told the police officer that wanted me to dig through a bedside commode (post-charcoal) for crack rocks wrapped in cellophane: "I don't work for your PD. Here are the gloves."

grammyr · Feb 26, 2007

We have to have consent from the patient. if they don't, they go to jail. I have never had anybody refuse, though. They always think the blood will get them out of the charges since they only had 2 beers.

TazziRN, RN · Feb 27, 2007

I've had people refuse. No signed consent, no draw. The only time a person cannot refuse is if the suspect is under age 18 and arrested for DUI. If the parent is not there to refuse on behalf of the minor, the draw is done.

widi96 · Feb 27, 2007

The law in MO is that if the patient refuses - we don't draw - and they automatically forfeit their license for a year. Most of the time we can draw for medical purposes, even with refusal because they are 'impaired' and could be a necessity of treatment (i.e. if they are bleeding out and we don't draw a H&H it's our butt). But when it comes to the legal draw - it is completely up to them.

Larry77, RN · Feb 27, 2007

Before reading this thread I thought that in my state (WA) they are not able to refuse the draw but maybe I just haven't seen anybody try...hmmm?

Our policy is the cops bring their kit and we call the lab the lab does the rest...us nurses have nothing to do with it.

I have not seen a blood draw for ETOH level forced...many other things but not that.

mistydave · Feb 27, 2007

I worked as a phlebotomist for several years. I haven't worked in phlebotomy now for over 8 yrs. 8 yrs. ago, when I worked in the ER 3rd shift, we had plenty of these forced draws. The police officer always signed for it. He stood there and witnessed it too. I have been in many situations that the patient asked me not to do it. Many were strapped down. Live in Ohio.

majadu · Feb 27, 2007

I traveled for 5 years and have experienced many styles of forced blood draws. In one southern California town I worked we had the clearance chairs. It was not unusual to have 4 or 5 individuals handcuffed to the chairs with a police escort. It you were assigned to that area, the police presented a warrent, opened the kit, handed you the equipment, the blood tubes and even the dressing. They then testified in court as well., I have also worked in Michigan, Florida and Arizona someplaces the officers come with a warrent, and other places phlebotomy obtains the specimens. It is very different whereever you go.

West_Coast_Ken, BSN, RN · Feb 27, 2007

I dropped by the local ED and spoke with one of the RN Supervisors there and she said hospital policy allows for a forced blood draw, but only if the person is charged with a felony.