Forced Blood Draw? (DUI situation)

Specialties Emergency

Published

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

if the court accepts it , and the defense doesnt get it thrown out, it is a piss poor defense attorney...where is the chain of evidence? where is the security of the specimen documented? who has had it in their constant presence?

Piss poor attorney times two! A regular blood draw would usually involve an alcohol wipe, which would contaminate the sample. DUI draws specify betadine wipes, or possibly soap and water, NO ALCOHOL! :madface:

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Piss poor attorney times two! A regular blood draw would usually involve an alcohol wipe, which would contaminate the sample. DUI draws specify betadine wipes, or possibly soap and water, NO ALCOHOL! :madface:

And that makes no sense. There is not enough alcohol in the wipe to alter the result, but somebody obviously used that successfully as a defense in the past.

And we use zephirin chloride

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Specializes in ICU/CCU, CVICU, Trauma.
if the court accepts it , and the defense doesnt get it thrown out, it is a piss poor defense attorney...where is the chain of evidence? where is the security of the specimen documented? who has had it in their constant presence?

Phlebotomist draws the blood

Phlebotomist labels the blood

Phlebotomist takes the blood to the lab

Phlebotomist locks the blood in the lab

It gives a more accurate BAC, since it is from blood drawn on admission, not later when the BAC has dropped.

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Specializes in ICU/CCU, CVICU, Trauma.
Piss poor attorney times two! A regular blood draw would usually involve an alcohol wipe, which would contaminate the sample. DUI draws specify betadine wipes, or possibly soap and water, NO ALCOHOL! :madface:

As Tazzi has said, an alcohol wipe would not contaminate the sample. It's a different alcohol, is much too small an amount and should be allowed to air dry first anyway. We do not use alcohol wipes for blood draws, either.

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We had an ER doc who was popped for DUI, and he fought it. His defense was that alcohol was used prior to the draw. One night we had two soldiers brought in who had overturned a Humvee, and per military protocol they asked us to draw BA levels. I drew one with zeph chloride, my partner drew one and used an alcohol wipe. Her pt's result came back at 6-8, and the doc freaked him out by saying it was positive. Then he found out about the wipe and told the pt that it was the nurse's fault, etc. I tried to tell him that a) the result was negative [the way our lab gives results, negative is any number between 0-10]. He insisted I was wrong. We ordered another draw and this time I did it. Result was the same. Doc insisted that it meant the soldier had been drinking. Poor kid was almost in tears. I called the lab. Lab tech called the dept manager, who lived across the street. He came storming into the ER, demanding to know "Who's the idiot who keeps insisting the BA is positive????" I pointed to Doc. The manager told him very loudly and very clearly and in front of everyone including the soldiers that everyone has a small amount in their system that is naturally occuring, and that anything under 10 is negative.

No apology to me or the soldier from the doc. Nothing.

Oh......he lost his case. He didn't do any jail time but had to pay a huge fine on top of the very expensive attorney's fee.

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Phlebotomist draws the blood

Phlebotomist labels the blood

Phlebotomist takes the blood to the lab

Phlebotomist locks the blood in the lab

It gives a more accurate BAC, since it is from blood drawn on admission, not later when the BAC has dropped.

is it really locked up, and who is going to court to say that for ____days it was continuosly under lock and key....no other access to that container? NONE! no other person, no one. and BAC doesnt always go DOWN, you can have a person who is NOT over at time of accident/incident, and because they "had one for the road" (and lived two miles down the street) is now, an hour later OVER....assumption=not good practice

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Specializes in Trauma, Teaching.
And that makes no sense. There is not enough alcohol in the wipe to alter the result, but somebody obviously used that successfully as a defense in the past.

Nevertheless, courts insist no alcohol be used, at least around here.

We do legal draws with the officers' kit, our BACs don't count. If they refuse, we only do a forced draw with a warrent.

If the only thing they need is a legal draw, they bypass the ER altogether, just go straight to lab. NM also has an implied consent law.

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Specializes in Emergency.

I asked a cop here about this yesterday, and he said that if someone refuses a breathalyzer test when they are pulled over, it is treated the same as if they had tested postive. He said they are charged then for refusal, which is the same as being proven over the limit, therefore no blood test needed. Co-operate or guilty....

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Specializes in ER, Med-surg, ICU.

I agree with your questioning. In our ED, The police bring in the driver and sometimes it has taken four to five police officers to hold the patient down to draw blood. It seems like it would not be allowed. however, I asked our neighbor who is a state patrol, and he replied that it is legal to collect it forcibly because it is evidence that will be lost if it is not taken right away. i would still think that the patient would be able to say no, however, if you are arrrested do you lose your rights?

b eyes

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this is second hand information so i am going to offer it in that context

i think that refusal is allowed if you get stopped at a check point [you lose license]

if there are injuries, even minor ones, i believe that a forced draw is done with a court order...judge can fax order...all injuries are done because complications can arise and they may need a lot of evidence when they go to court

however i would hate to be the nurse in that position which way tdo you jump..remove a tool that could keep a drunk on the streets or do a draw on a patient who is refusing which goes against all yo learn in school

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RURAL TEXAS

ER RN x 14yrs...(Level I trauma ctr to now RURAL) My understanding,

Patient must concent to Blood Legal Alcohol draw--- UNLESS (1) Death @ scene, (2) Court Ordered). Pt. brought in by EMS accompanied by Trooper... Pt. not under arrest, Pt. refused to allow blood draw. Trooper became upset..I suggested Tropper to supeona ER lab, ord'd by MD. Long story short... I was told that the TROOPER wanted my arrest for refusal to draw. What about me being personally sued for ASSAULT/Battery??? by patient. Hospital P&P stated (at that time) If pt. refuse, no Blood will be drawn. Does the hospital support you in court for Assault/Battery charges???The trooper wanted to arrest me but NOT the patient??? WHAT's the LEGAL aspect and where does the RN stand, and who supports the RN, WHAT's THE BNE TAKE ON THIS???? PLEASE LET ME KNOW!!!

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RURAL TEXAS

ER RN x 14yrs...(Level I trauma ctr to now RURAL) My understanding,

Patient must concent to Blood Legal Alcohol draw--- UNLESS (1) Death @ scene, (2) Court Ordered). Pt. brought in by EMS accompanied by Trooper... Pt. not under arrest, Pt. refused to allow blood draw. Trooper became upset..I suggested Tropper to supeona ER lab, ord'd by MD. Long story short... I was told that the TROOPER wanted my arrest for refusal to draw. What about me being personally sued for ASSAULT/Battery??? by patient. Hospital P&P stated (at that time) If pt. refuse, no Blood will be drawn. Does the hospital support you in court for Assault/Battery charges???The trooper wanted to arrest me but NOT the patient??? WHAT's the LEGAL aspect and where does the RN stand, and who supports the RN, WHAT's THE BNE TAKE ON THIS???? PLEASE LET ME KNOW!!!

Ultimately you would have to talk with a lawyer for the legal aspects. You could also contact your BON however they are great at being vague and not giving an exact or direct answer. It is just a bad situation. The above example is a failure of the legal system and because of this failure we get pulled in. Your hospital legal team should be able to help you out quite a bit.

This is not a life or death emergency which the ER is meant for, I think I have posted the same thing on this thread. I would love to work in a true emergency room, you know that actually were able to handle emergencies promptly and take care of sick people. I understand the serious consequence about drunk driving but I am not in the legal system. I work taking care of people (or rather did) and not only that, I am a member of the most trusted profession out there--I cannot "physically force treatment or diagnostic testing on someone who is competent" it is not ethical.

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