DNR Identification

E

Eileen Brady

Forum Ride Along
Messages
7
Reaction score
0
Points
0
Hello to all of EMTLIFE. Please visit the website www.dnrrevolution.com

The DNR Revolution is a voting/survey website for all medical professionals.
The goal is one DNR Bracelet for all hospitals, nursing homes and
911 EMS personnel.

The survey questions were written by Pasco County Florida Firefighter's.

The DNR Revolution has begun. Please Vote for one DNR Bracelet.
Please answer the survey questions.

Every Vote will be counted and Every Voice will Be Heard.
 
My state doesn't recognize DNR. It uses a legal document, called a P.O.L.S.T or Physician's Orders for Life Sustaining Treatment. Unlike a bracelet, it is a multi page legal document signed by both the patient or pt's designee, and the physician who went over the details with the pt.

It is not a do or do not resuscitate, it covers all facets of life sustaining treatment and determines what level of treatment is desired by the pt.
 
Many states already have their own standard DNR/DNI paperwork and wrist bracelet programs, I know MA certainly does. It's called Comfort Care/DNR. This should be more of an educational movement for families then an effort to commercialize DNR orders.
 
DNR Revolution

Hello Bossy Cow. We are aware of the POLST, but no matter what Form each
state uses EMS wants a Bracelet for instant identification. The problem is
that when EMS arrives either the nursing home nurses are unable to "Find" the form, hospitals do not discharge patients with the forms and/or private residence patients families become hysterical and cannot find the paperwork
and without the DNR EMS has to resuscitate. The DNR Revolution intent is to "ADD" a bracelet for easy identification. Thre Revolution's goal is not to replace any existing form each state is using. We just want to make it
mandatory that a bracelet can be used for quick identification.
Please check out the website at www.dnrrevolution.com and spread the word.

Also, to Betty who emailed me. I'm not sure I responded correctly I'm new to the forums. We are presenting to the Federal Government, because we have had enough. We want and need one DNR Bracelet for all hospitals,
nursing homes and EMS personnel for quick identification.

Bossy Cow and Betty thank you so much for responding to me and please
spread the word. The DNR Revolution has begun. And the goal is One
DNR Bracelet for all HealthCare facilities and EMS personnel.
Please tell everyone to get on and Vote. Every Vote will be counted and every voice will be heard. Eileen Brady
 
I believe the idea behind this is to get a nationwide standardization and recognition for DNR orders.

If you look at some of the questions, these are issues that come up everyday in almost every hospital across the country.

A patient may have been in the hospital with a DNR written in the chart for hospital use but doesn't realize it is not valid outside of hospital walls.

Crossing state lines is also an issue for some.

A lot of this has to do with education of the patient and the providers as well. There are also many variations in each state for each DNR order.

From a recent thread on another forum, it is clear in EMS also do not understand the many types of orders or the differences between a Living Will and DNR, DNI or a comfort care order.

I do agree there should be something standard and easily recognizeable. However, there are some issues since the DNR can contain a few specifics that could easily be overlooked and often are even with the paperwork in hand.

I hope Eileen will jump in and correct any of my comments to what I am getting from this campaign.

If anything, I hope it will get some to review their protocols and the various forms of DNR, DNI, comfort care and hospice orders that are in their area. This is an areas that is often overlooked until you come across a situation with a gray area.
 
Reposted from the other forum in the same topic:


I think you really need to look outside of your area.
Quiz questions:
"Do you agree that most Americans do not know EMS requires a Nonhospital DNR Order?"

Well, when I was working in So Cal patients did not need a prehospital DNR order.

"Have you ever arrived at a private residence and was told the patient was a DNI/DNR, but because the family could not “Find” the Nonhospital DNR Order, you had to start CPR? "

There are places where, either via standing orders or online medical control, that would be a DNR despite the lack of physical paperwork.

There are also established companies that provide a DNR bracelet service, such as the Medic Alert company. Again, in So Cal one of these was recognized as a valid DNR and the prehospital DNR paperwork (note: There is a prehospital DNR form available in California, it's just not required to be used) included instructions on how to receive one. I currently work and go to school in Massachusetts where they include the stupid "We will only recognize our DNR form (Comfort Care/DNR verification form)" rule. That said, there is a paper DNR bracelet that can be printed out and worn for quick identification.


http://www.medicalert.org/Main/AdvanceDirectives.aspx#dnr

Link to Orange County, CA EMS DNR protocol which takes a more liberal approach to DNRs than most areas. http://ochealthinfo.com/docs/medical/ems/P&P/330.51.pdf
 
Hello Emt.Dan

We know Massachusetts has a great system, but most of the states
do not. Our goal is for every state to have a DNR system that works for
our patients and all healthcare facilities. Dan, this is in no way an attempt to
commercialize the DNR.

Betty is right. The DNR Revolution's goal is to obtain national standarization for the identification of DNR Patients.

In my slideshow I provide proof that DNR Patients are being resuscitated and connected to Mechanical Ventilators nationwide. The goal of the DNR Revolution is to bring national attention to the bedside DNR Identification problems that we as a medical professional have. 78 million baby boomers
are headed our way and we are not ready. We need one DNR Bracelet per
state. Maybe I should be clear on that. We are not trying to change any state that has a system they like and works we are asking everyone
to help all the states that do not have a DNR Bracelet Comfort Care System.
We are asking for everyone's help.

To JPINFV : Hello. We did look outside our area. There are many areas across the country that do not allow EMS not to resuscitate without the DNR order in their hand.

I thank you all for your replies. I will try and keep up with replying
 
I know this is horribly off topic... but rereading and rereading I'm trying to figure out..

Who is Betty?
 
Apology for using real name

Hello. I apologize I had no idea that I'm not suppose to use real names.

Eileen
 
Eileen Brady said:
Hello. I apologize I had no idea that I'm not suppose to use real names.
Click to expand...
Internet much? ;)

I'm afraid that a bracelet isn't going to cut it. Not specific enough. And your timeline numbers are off too. You don't have to invent something that can be presented within three seconds. Whoever calls EMS in the first place then has several minutes to find the DNR and have it waiting on our arrival.

The answer here is not a gadget. The answer -- as is the case in every EMS issue -- is education. Whoever is handing out the DNR forms needs to be educating the recipient about what to do with it, which includes keeping it at the patient's side at all times. If they are bedridden, tacking it to the wall above the bed, not stuffing it in a drawer somewhere. If they are ambulatory, sticking it on the refrigerator door or tacked to the wall next to the telephone, not in a pile of papers on the desk. They need to be told that, if it is not IMMEDIATELY available for medical personnel, it might as well not exist.

Problem solved.
 
Eileen Brady said:
Hello. I apologize I had no idea that I'm not suppose to use real names.
Eileen
Click to expand...


There's no law or rule about using names on the Internet, Eileen. Purely optional if a poster uses a name or not. As you can see with my signature, I have no problem using my name.

I think you have a plausible idea here that looks to of benefit for patients and medics. I'm interested to see if it comes to fruition.

Good luck!

Ray
 
DNR Revolution

Hello Forum Captain.

A Bracelet is the best form for DNR identification. A bracelet meets all the time "constraints" deadline required for DNR Identification before CPR must begin. Brain death occurs shortly after respiratory arrest occurs. Given that precious time is lost before EMS even arrives. EMS has very little time to identify the patient is a DNR before CPR must begin.

Why tack something on a wall when you can have quick identification in the form of a bracelet?

What happens if the patient is in the nursing home dining room across the building?

What happens when the patient is ambulatory and the family takes them
for a car ride and forgets the Nonhospital DNR Order?

What happens when the patient is ambulatory and goes on a day outing
and doesn't take their Nonhospital DNR Order?

In one CMS survey I found 75% of patients did go out on a day outing
without their Nonhospital DNR?

As far as telling the patient's and their families that if it is not immediately available for medical personnel, it might as well not exist, we as compassionate medical professionals must always remeber that when 911 is called, something has happened to the patient, and that patient's and
their families "panic" when they see their loved ones gasping for breath.

The DNR Revolution stands for the identification, education and distribution
and the standardization for the DNR Order. I urge all of EMTLIfe to
go to the DNR Revolution website and review the slideshow I am presenting to the nation.
Eileen Brady
 
AJ Hidell said:
The answer here is not a gadget. The answer -- as is the case in every EMS issue -- is education. Whoever is handing out the DNR forms needs to be educating the recipient about what to do with it, which includes keeping it at the patient's side at all times. If they are bedridden, tacking it to the wall above the bed, not stuffing it in a drawer somewhere. If they are ambulatory, sticking it on the refrigerator door or tacked to the wall next to the telephone, not in a pile of papers on the desk. They need to be told that, if it is not IMMEDIATELY available for medical personnel, it might as well not exist.

Problem solved.
Click to expand...

That's what I'm saying! Lets not push for legislation for standardized wristbands, but increased education for families. Maybe create standardized pamphlets for Discharge planners, or PCPs to give to their patients about the purpose of DNR/DNIs. Do as some communities have done, and set a standardized location for the DNR to be found (on the refrigerator). Provide Grant funding for ambulance companies to visit the homes of patients who have DNRs, make sure that they have their documents accessible, even possibly, get a copy to keep on record.
 
Sasha said:
I know this is horribly off topic... but rereading and rereading I'm trying to figure out..

Who is Betty?
Click to expand...

I am shocked you did not know that.
 
Another concern would be I don't like you so I place a DNR bracelet on you and they let you die. The perfect murder. Are there any checks and balances to prevent that.
 
Eileen Brady said:
The DNR Revolution stands for the identification, education and distribution and the standardization for the DNR Order.
Click to expand...
I think we can all agree to support that worthy cause. I just don't think that a bracelet is the way to go. Medic417 gives an example of the type of problem found in such an approach. I need more information than can be put on a bracelet, if I am to make an educated and intelligent medico-legal decision about my patient.

Personally, I would be more inclined to push for ID cards, which can more specifically identify the person it is issued to, as well as the specifics of the medical condition and terms of the DNR order. A small laminated ID card with a neck chain would suit the purpose well. And, being as it would be around the neck, it is much less likely to be overlooked than a bracelet on the wrist.
 
You must log in or register to reply here.
Back
Top