This protocol dictates the proper documentation, specimen acquisition and handling of legal blood alcohols.
1. A medical technologist, medical laboratory technician, nurse or physician may draw a legal blood alcohol if any one of the following criteria are met:
A. The Iowa/out-of-state law enforcement officer signs a written request for the blood alcohol AND the patient gives written consent for the blood to be drawn.
a. The officer is responsible for obtaining the written consent from the patient.
b. The technologist verifies that the consent has been obtained.
c. The officer is responsible for initiating a chain of custody.
d. Minors may give their own consent.
e. If, at the time of the venipuncture, the patient refuses, the blood sample is NOT to be taken, even if the patient previously signed a consent form.
B. The Iowa/out-of-state law enforcement officer signs a written request for the blood alcohol AND a physician certifies in writing that the patient is incapable of giving consent.
C. A court-ordered warrant for blood alcohol testing is presented.
2. If a law enforcement officer presents one of their institution’s kits complete the phlebotomy and associated paperwork as requested by the officer.
3. When a medical alcohol and a legal alcohol are ordered, two separate specimens are to be drawn.
4. Alcohol or alcohol-containing antiseptic is NOT used for preparing the skin for venipuncture. Use Betadine solution Swabaid Antiseptic pads to clean the skin. If the patient is allergic to iodine a PDI Castile Soap Towelette can be used.
Note: Do not use the iodine Sepp or ChloraPrep One Step applicators used in the Blood Culture collection procedure.
6. Legal blood alcohols can be transported to UCL Mercy-DBQ site for alcohol determination in one of the following ways in order to maintain the specimen chain of custody:
A. The requesting law enforcement officer may transport the specimen. (This is usually the preferred method.)
B. The individual who obtained the specimen may transport the specimen to UCL Mercy-DBQ site for testing. To maintain the chain of custody, the individual who obtained the specimen must keep it in his/her possession until it is transferred to an individual at UCL Mercy-DBQ site.
C. The UCL courier can transport the specimen, in the legal specimen box, if the specimen chain of custody is properly completed.
7. “Second Opinion” Legal Alcohols:
A. Iowa Code Section 321J.11 allows for a person arrested for OMVUI by a breath test to have the opportunity to have an “independent chemical test” administered at the person’s own expense.
B. This individual would be brought to the laboratory and identified by a law enforcement officer or by photo identification card.
C. The laboratory staff will do this testing without a physician’s order, handling the specimen as a “legal” blood alcohol. Initiate a chain of custody. In this case, no signed consent form is required. Complete the UCL OP requisition.
D. Refer to the “Self Ordered Test” protocol, Section II.3. in the LIS manual for registration/billing information.
E. If the client cannot pay at the time of draw, instruct them to make payment at the Cathedral Square Site Office. Testing will not be performed until payment is made.
Note: If the client cannot afford the tst the County Attorney’s Office can be billed for this testing. The office may give the OK.
F. See section II.6. for transporting the specimen to the UCL Mercy-DBQ site for testing.
G. Inform the person that the results may be picked up at the UCL-Cathedral Square site between 3:00 and 4:30 p.m. on the next day, if the specimen is drawn Sunday through Friday mornings. If the specimen is drawn Friday afternoon/evening or Saturday, results will be available the following Monday between 3:00 and 4:30 p.m.
H. The report will be given to the individual drawn, in person. Identification must be made via a photo ID.
1. Reimer, Carol R.N. (Mercy DBQ Emergency Room)
2. Conzett, William (Mercy DBQ Patient Representative)
3. Herrig, James (DBQ Co Attorney 1981)
4. Walz, Brad (Assistant DBQ Co Attorney) conversation with Dr. J. Brennan regarding the staff who may obtain a blood specimen for legal blood alcohol testing. 7/13/1998.
5. Michael Whalen (Assitant DQB Co Attorney) August 2001
i. 2/26/81 J. Dall/J. Schaefer/F.E. Cicciarelli
ii. 5/27/81 (Revised II.A.4.)
iii. 11/3/86 M. Burger (Revised: changed MSL to UCL Central)
iv. 3/8/89 B. Lucas (Revised: combined Mercy & Finley policy)
v. 5/8/98 J. Brennan, M.D. (Revised: section III. Added)
vi. 7/14/98 B. Lucas (Revised: forms; II.1.)
vii. August 2001 R. Stoffel (Revised: d’c medical and OMVUI wording)
September 2010 R. Stoffel (Revised: II.1.A.b., C., 5., 7.C.)
November 2011 R. Stoffel (Revised: II.2., 7.D-E.)