By John Q. Hosedrinker 
Two Kentucky paramedics are facing potential license revocation after administering antivenom to a man bitten by a venomous snake. The incident occurred when a Jameson’s mamba bit Jim Harrison, co-director of the Kentucky Reptile Zoo, who was in critical condition. Despite receiving authorization from an ER doctor, the paramedics administered the antivenom without the required “wilderness paramedic” certification, which is now under investigation by the Kentucky Board of Emergency Medical Services (KBEMS). A hearing has been scheduled to determine their professional fate, but officials suggest the outcome often results in dismissal or additional training.
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The story here is that a couple of Kentucky paramedics are facing the potential loss of their licenses, all because they made a life-saving decision. They administered antivenom to a person who had been bitten by a snake. Sounds like a classic case of “no good deed goes unpunished,” doesn’t it?
The crux of the issue appears to be a technicality. According to the rules, only “wilderness paramedics” are authorized to administer antivenom. The paramedics in this case weren’t “wilderness certified”. But here’s the kicker: they were dispatched to a snake bite case, and they had access to the antivenom, likely because they were at a zoo. Moreover, and critically, they got permission from an ER doctor to administer the life-saving dose. As many people have said, with a doctor’s permission, it’s essentially a prescription, and the immediate threat to life was real.
The situation raises a lot of questions. Why were regular paramedics dispatched to a snake bite case in the first place if only wilderness paramedics are supposed to handle this situation? And how did these regular paramedics even have access to the antivenom? Sounds like there was a breakdown somewhere, perhaps at the hospital they worked for, rather than a failure on the paramedics’ part.
It’s not hard to see why a hearing has been triggered. It’s a necessary process, given the rules. But, as several people have pointed out, revoking these paramedics’ licenses would be a massive overreaction. These guys were faced with a life-or-death situation. The victim, the zoo keeper, was in dire straits. As the injured man himself said, he was likely to die, and he specifically asked the paramedics to save his life, and they acted. They did their duty.
Consider the implications of not acting. The paramedics could have faced a different legal battle: a lawsuit for failing to provide care. The choice seems obvious. With the victim facing paralysis, respiratory arrest, and cardiac arrest, the only option was to administer the antivenom, and that’s what they did. They followed the doctor’s orders. The fact that the doctor gave them permission underscores the rightness of their actions.
The good news is that there seems to be a consensus that the paramedics will likely not be punished. The Kentucky Board of Emergency Medical Services has a process, and it seems this is just a matter of procedure, a routine investigation, but that doesn’t mean it isn’t frustrating. One source cited the executive director of the KBEMS stating that these investigations usually result in dismissal or additional training, rather than serious penalties. This outcome makes sense. It’s hard to see how anyone could argue that these paramedics did anything wrong. They sought guidance, followed a doctor’s orders, and saved a life.
It’s especially important to note that the injured person, the man who received the antivenom, is standing by these paramedics. That speaks volumes. He understands that they acted swiftly and decisively, and it saved his life. It sounds like he was the expert in this situation. He had the antivenom, knew the snake, and directed the paramedics on what to do. These kinds of hearings are often required to verify facts and make sure that all steps were properly taken, but common sense dictates that in this case there’s not much to assess.
Furthermore, some people are saying, the circumstances are highly unusual. This wasn’t a typical snake bite with time for transport. This was a rare situation where swift action was critical. The snake was not a native species and the bite could have been fatal. Every second mattered.
It’s a good reminder of the inherent tension in medicine and in life. Rules and regulations are important, but sometimes, the best course of action is to use common sense, especially when dealing with the difference between life and death. Sometimes, you have to break the rules to save a life, and it’s hard to imagine a scenario where that decision should result in punishment. It is also important to note that this may be a result of the medical system and insurance, and not a failing of the paramedics themselves. They did everything in their power. It is also possible that the paramedics were not allowed to administer the antivenom to help lower the cost of it, since it can be expensive.