Bill Text: CA AB1882 | 2009-2010 | Regular Session | Amended

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Bill Title: Health facilities: chilling or therapeutic hypothermia.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2010-04-20 - In committee: Set, second hearing. Held without recommendation. [AB1882 Detail]

Download: California-2009-AB1882-Amended.html

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BILL NUMBER: AB 1882	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MARCH 10, 2010

INTRODUCED BY   Assembly Member  Arambula  
Portantino 
    (   Coauthor:  
Assembly Member  Portantino   )


                        FEBRUARY 16, 2010

   An act to add Section 1255.4 to the Health and Safety Code,
relating to health facilities.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1882, as amended,  Arambula   Portantino
 . Health facilities: chilling or therapeutic hypothermia.
   Existing law provides for the licensure of health facilities,
including general acute care hospitals, by the State Department of
Public Health. The violation of these provisions is a misdemeanor.
   This bill would require each general acute care hospital with an
emergency department to adopt a protocol or policy establishing a
procedure for assessing patients in the emergency room who are
comatose after experiencing cardiac arrest  ,  to
determine  if they are candidates for   whether
to treat these patients with chilling or therapeutic
hypothermia.  The bill would require the protocol or policy
to establish procedures for implementing the chilling, or inducing of
hypothermia, of patients who are comatose after a cardiac arrest.
  The bill would also impose additional requirements
upon the hospital if it undertakes this treatment. 
   By creating a new crime, this bill would impose a state-mandated
local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.   The Legislature hereby finds and declares all of the
following:
   (a) Scientific and medical journals have reported on the
usefulness of therapeutic hypothermia or chilling of patients who
have suffered heart attack, cardiac arrest, or stroke. Procedures
such as induced hypothermia are designed to protect endangered cells,
prevent tissue death and preserve organ function following acute
events associated with severe oxygen deprivation such as stroke or
cardiac arrest.
   (b) Therapeutic hypothermia is believed to work by protecting
critical tissues and organs, including the brain, heart, and kidneys,
following ischemic or inflammatory events, by lowering metabolism
and preserving cellular energy stores, thereby potentially
stabilizing cellular structure and preventing or reducing injuries at
the cellular, tissue, and organ level.
   (c) Two international clinical trials on hypothermia after cardiac
arrest published in the New England Journal of Medicine demonstrated
that induced hypothermia reduced mortality and improved long-term
neurological function. Based on these and other results, the American
Heart Association (AHA) and the International Liaison Committee on
Resuscitation (ILCOR) have issued guidelines recommending that
cardiac arrest victims be treated with induced hypothermia.
   (d) In the United States and other developed countries, an
estimated 1.4 million people experience cardiac arrest each year, of
which an increasing number, currently about 350,000, survive to
receive advanced care. The AHA guidelines now recommend the use of
therapeutic cooling as part of the critical care procedures for
patients with an out-of-hospital cardiac arrest following ventricular
fibrillation.
   (e) Therapeutic hypothermia is used to cool a patient's body in
order to reduce cell death and damage caused by acute ischemic events
in which blood flow to critical organs, such as the heart or brain
is restricted, and to prevent or reduce associated injuries such as
adverse neurological outcomes. Methods have been developed that cool
external or surface-based temperatures. There are additional
procedures that can be used to cool body temperatures internally.
   (f) Therapeutic hypothermia has been used to safely and
effectively cool patients and represents an important new tool for
protecting the brain from ischemia, especially in postcardiac arrest
patients who are at higher risk of brain tissue damage due to the
prolonged lack of blood flow.
   (g) With the increase in survival of cardiac arrest victims
resulting from the advent of automated external defibrillators,
cooling patients is the next logical therapeutic approach, especially
in light of the large body of supporting scientific literature.
Guidelines issued by the AHA and ILCOR make recommendations for
cardiac arrest victims to be treated with induced hypothermia.
   (h) It is the intent of the Legislature that patients that have
suffered cardiac arrest be assessed for the benefits of therapeutic
hypothermia.
  SEC. 2.  Section 1255.4 is added to the Health and Safety Code, to
read:
   1255.4.  (a) Each general acute care hospital with an emergency
center shall adopt a protocol or policy that establishes a procedure
for assessing a patient in the emergency center who is comatose after
experiencing cardiac arrest, to determine if the patient is an
eligible candidate for chilling or hypothermia therapy by weighing
the benefits of the therapy for the patient and the subsequent effect
upon the patient's recovery against the risks. This protocol or
policy shall establish procedures for implementing the chilling, or
inducing of hypothermia, of a patient who becomes comatose after a
cardiac arrest. 
   (b) Whenever a patient is treated with chilling or hypothermia
therapy pursuant to subdivision (a), the hospital shall note this
treatment in the patient's record.  
   (b) 
    (c)  The hospital shall adopt procedures that require
communication between the hospital emergency center and the hospital
intensive care unit or other units to where the patient may be
transferred during treatment by chilling or therapeutic hypothermia
pursuant to the protocol or policy described in subdivision (a). The
information communicated shall include the length of time the patient
has been in chilling or hypothermia therapy, the emergency
department assessment for the need for this treatment, and
instructions or recommendations on how long the patient should
continue to be treated with chilling or hypothermia therapy. 

   (c) 
    (d)  When a comatose, cardiac arrest patient is being
treated by chilling or hypothermia therapy or has been assessed by a
general acute care hospital to be an eligible candidate for this
therapy, and is subsequently transferred to the emergency room or
intensive care unit of any other general acute care hospital, the
transferring hospital shall inform that destination hospital of the
 patient   patient's  assessment for and
treatment with therapeutic hypothermia.
  SEC. 3.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.