"Less Than Perfect" DNRs

[Akulahawk]

Normally I would expect that in situation 1 I'd get an order to terminate efforts and in situation 2 I'd get an order to go full-tilt boogie on resus efforts and terminate efforts according to protocol. Where I live, EMS isn't allowed to "trust" the family in situation 2 unless someone can prove they're the designated HC decision-maker with paperwork to back it up. Because of that, situation 1 gets OLMC involved. Situation 2 goes very quickly to full-tilt boogie ALS. If there's a DPAHC, then everything pretty much gets cleaned up instantly and neither situation happens...

 

[TheLocalMedic]

Here we actually have (in writing) a stipulation that we should consider a family's wishes to terminate resuscitation if there isn't a DNR present. We also don't have to contact OLMC when we decide to terminate, regardless of circumstance. Even BLS can stop working a code if there's a prolonged period of "no shock advised" from the AED, which is really helpful for the extremely rural departments.

 

[cjclrkk]

OK, murder by DNR is one thing, but would you resuscitate a 35 y/o that you found hanging by the neck from the rope, still warm and viable with a hand written DNR pinned to his shirt?

you would have to immediatley begin working the pt there is no legal backing for you to follow the request of a DNR that someone else could have easily written and pinned to their shirt

 

[WildlandEMT89]

Recently was given a DNR DNI form that also stated the pt was a full code. When in doubt and we defer to family if available or they get a full code work up usually.