EMS A to Z: The DNR Order

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

What is a DNR?

A Do Not Resuscitate order is exactly that – a prehospital medical order directing EMS providers to withhold resuscitative measures, like CPR and intubation, if the patient is in cardiac arrest.

To be valid a DNR must be:

Signed by the patient, a physician, and a witness (or notarized).

Have a photo or description of the patient.

It is typically on orange paper, but photocopies are accepted if otherwise valid.

What other forms might we see?

POLST and MOLST forms are more detailed and communicate the patient’s wishes as far as resuscitation as well as long-term care (dialysis, medical nutrition, etc.).

While these are not necessarily specifically intended for prehospital providers; they do communicate the patient’s wishes and we strive to respect those.

Advanced Directives or a Living Will are legal documents prepared, often far in advance of an illness, that detail the patient’s wishes for end-of-life care (among other things).

They can be lengthy but are valid if present and available.

If in doubt (for example: no paperwork present, but family says “they’re DNR!”); begin BLS resuscitation and call medical direction for assistance!