Thursday, August 22, 2013

Do Not Resuscitate Orders - Part One

A week ago, I was able to participate in the annual review of Lyn's individual service plan and home inspection  with two of Lyn's team.  It was a pretty standard review except when it came to the discussion surrounding the concept of Do Not Resuscitate (DNR) orders.

A DNR is a legal document which directs medical providers to not perform CPR on an individual whose heart or breathing has stopped.  It does not prevent other forms of medical care from being administered.  It is solely focused on the methods necessary to restart a heart that has stopped.  A living will or advance medical directive are not legal documents and do not carry the same weight as the DNR even if they clearly state your wishes to not be resuscitated.  There are several types of DNR orders which can be set into place.

The standard DNR that you may be aware of which is normally a document signed by a patient or a patient's acknowledged representative when the individual is hospitalized.  These orders may only b valid for the duration of the hospital stay or may expire after a certain period of time has elapsed.

The EMS DNR directs the first responders to an emergency to not resuscitate the individual.  If the first responders are presented with such a directive, they will continue to provide medical care to the individual while comforting the bystanders witnessing the individual's death.  This DNR is one form of a Durable DNR which does not have an expiration date.  At any time, however, it may be revoked by the patient or patient's representative.

The Physician's DNR is a set of orders put in place by one or more doctors who have either had prior knowledge of the patient's wishes to not be resuscitated or who have determined that even with the application of CPR the patient has no significant hope of surviving a heart stopping event.  The Physician's DNR is sparingly used because medical advances frequently allow doctors to perform heroics to save a life which previously may not have been possible.  Thus, they are often limited to those patients in the end stages of terminal diseases.

Please note that names and availability of DNR orders varies from country to country.  In the United States, all states recognize DNR orders.  However, each state's approach may be different.  You are best advised to familiarize yourself with the laws in your location and how they impact the availability or execution of DNR orders.

Additional Information:
Deciding about CPR: Do-Not-Resuscitate (DNR) Orders A Guide for Patients and Families

No comments:

Post a Comment