Dnr

[mikie]

So you're dispatched to a parking lot where you find an elderly woman laying on the ground with bystandards doing CPR

You move her into the ambulance, apenic & pulseless, cut her shirt off and see DNR tattooed across her chest. No proof of DNR documents (in purse/wallet), no family around.

Where do you go from there?

(this may very protocol to protocol so just let us know what either your protocol is or what you would personally do)

thanks!

 

[mdtaylor]

Was it signed and notarized? Is a tatoo a legal document in your state?

Here, the protocol would be to resuscitate.

 

[JPINFV]

Work the code pending medical control contact (paramedic arrival in my case). The problem with tatoos is that they lack the ability to revoke them. Unlike, say, a medic alert bracelet (a valid DNR 'document' in California), if a patient decides not to have a DNR anymore, it's slightly harder to remove/nullify the tatoo.

 

[VentMedic]

Can you be absolutely sure DNR are not the initials of her loved one?

A DNR document contains binding legal language that must accompany the signatures.

When just the letters "DNR" is referenced in a Physician's Order in a hospital, there is usually accompanying paperwork elsewhere in the chart or a set protocol that is acknowledged.

 

[BossyCow]

Hmm so if I want a DNR tattoo it should read.. DNR... Paperwork in wallet?

 

[mdkemt]

Hmm so if I want a DNR tattoo it should read.. DNR... Paperwork in wallet?

OMG!! That is awsome...I would almost pay to see that!

 

[Ridryder911]

If you want a DNR to be valid, it better meet the State & local requirements. Each state varies, my States is only good for one year and the patient has to have a diagnosed terminal disease, and signed by a licensed medical physician as well as notarized.

First thing I check is to see how long it took to me to respond, and if how long the patient has been down. > 15 minutes without any intervention, their dead. Call the M.E. and get the next call...


R/r 911

 

[CFRBryan347768]

Work the code pending medical control contact (paramedic arrival in my case). The problem with tatoos is that they lack the ability to revoke them. Unlike, say, a medic alert bracelet (a valid DNR 'document' in California), if a patient decides not to have a DNR anymore, it's slightly harder to remove/nullify the tatoo.

What if at her midlife crisis she got it as a joke? heh. Id try and have legit papers presented, while working her up.

 

[CFRBryan347768]

Can you be absolutely sure DNR are not the initials of her loved one?

Or the head of the Department of Natural Resources? Or just a dedicated employee to them heh.

 

[JPINFV]

What if at her midlife crisis she got it as a joke? heh. Id try and have legit papers presented, while working her up.

If you're wearing a MedicAlert DNR bracelet as a joke and it gets used, then you deserve what you get because the only one laughing will be Darwin. Besides, MedicAlert requires proper documentation before they even process an order for a DNR bracelet. California actually contracts with MedicAlert to provide such a service, so technically, the bracelet ARE legit documentation.

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

http://www.emsa.ca.gov/pubs/emsa-111.asp

 

[CFRBryan347768]

If you're wearing a MedicAlert DNR bracelet as a joke and it gets used, then you deserve what you get because the only one laughing will be Darwin. Besides, MedicAlert requires proper documentation before they even process an order for a DNR bracelet. California actually contracts with MedicAlert to provide such a service, so technically, the bracelet ARE legit documentation.

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

http://www.emsa.ca.gov/pubs/emsa-111.asp

I wasn't talking about the bracelet I was talking about the tattoo.

 

[Dominion]

Here we work them. The only way we won't work a DNR is when we have seen physically the original DNR with either two valid signatures or nortarized. We can see the original and carry a copy in the transport in case of arrest enroute. But we have to see the original and it all is required to be documented. You can't provide the original, or the original doesn't have two signatures or isn't notarized, we're required to work it.

 

[JPINFV]

I wasn't talking about the bracelet I was talking about the tattoo.

So then you agreed with my first post. I was kinda of confused because it looked like you were replying about the MedicAlert medallions.

 

[traumateam1]

No paperwork, no DNR.. unless we find something on her (wallet, purse or something) that is signed and notarized then CPR will continue.. just like if you walk into someone home and there is someone laying on the ground that needs CPR, but the daughter, or son tells you there is a DNR but cannot produce it for you to see then you continue with CPR..
Well thats my two sense

 

[JPINFV]

just like if you walk into someone home and there is someone laying on the ground that needs CPR, but the daughter, or son tells you there is a DNR but cannot produce it for you to see then you continue with CPR..
Well thats my two sense

Obligatory comment that this is pursuant to local protocol/procedures for DNRs (hint, that situation is a DNR where I worked).

 

[CFRBryan347768]

So then you agreed with my first post. I was kinda of confused because it looked like you were replying about the MedicAlert medallions.

Yes I 110% agree with your first post.

 

[KEVD18]

this one isnt even a challenge.

no paper, heroic measures.

 

[mikeylikesit]

but wait....what if they had the whole document and notarization stamped on them as well?....dumbest tattoo ever. i do abide...sometimes by those stickers on peoples helmets that say "don't remove helmet unless at the ER" or something to that effect, the only time i do it anyways is when you know all the other things that can happen and will happen at an accident take place. e.g.repiratory distress. sorry buddy I'm not taking your sticker seriously enough to not render necessary care.

 

[KEVD18]

but wait....what if they had the whole document and notarization stamped on them as well?....

well then they would have an active dnr and the foolish tatoo would be irrelevant

 

[mdtaylor]

It seems to me the tatoo is merely a reminder to the medics to ASK if anyone present has a valid DNR that they would like to produce prior to resuscitation efforts beginning.