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As a pre-hospital EMS provider, how do you have time to determine the presence and validity of a DNR before making your choice?

by gohrt 13y ago

JshWright 13y ago
It's pretty simple... is there a DNR in my hand that hasn't expired and has been signed by both the patient and a doctor and hasn't expired? If yes, then don't initiate resuscitation. Obviously a DNR could be forged, but baring obvious cases of forgery (which I've never seen), we're not liable for honoring a DNR that we reasonably believe is valid.
- jlgaddis 13y ago
  What about a "verbal DNR"? I was recently involved in a pretty bad motorcycle accident and was asked multiple times (by EMS on the scene, medical staff in the ER, medical staff right before going into the OR, etc.) if I had a DNR and/or if I would want them to attempt to save me if something happened. I remember thinking that was kinda weird since my assumption was that such requests would need to be in writing. Perhaps it was because I was incapable of writing or signing my name, though (two broken wrists)? Instead of me signing any documents, they just asked me verbally after making sure they had two other employees present as witnesses.
  - JshWright 13y ago
    That's actually _better_ than a written document as far as I'm concerned. A DNR basically says "If I'm unable to speak for myself, here's how I would like to be treated." If you _are_ able to tell me how you want to be treated, then there's no question (assuming I'm confident in your ability to make informed decisions... not drunk off your ass... etc...)
FireBeyond 13y ago
In addition to what Josh says, in ambiguous situations, we will begin CPR or other life-saving measures whilst efforts are made to obtain/ascertain. We can always discontinue these efforts - on the other hand, delayed starts of such measures are more likely (if they result in survival at all) to end up with exactly the kinds of situations described here, brain damage, serious side effects, and the like.

As a pre-hospital EMS provider, how do you have time to determine the presence and validity of a DNR before making your choice?

by gohrt 13y ago

As a pre-hospital EMS provider, how do you have time to determine the presence and validity of a DNR before making your choice?

JshWright 13y ago

It's pretty simple... is there a DNR in my hand that hasn't expired and has been signed by both the patient and a doctor and hasn't expired? If yes, then don't initiate resuscitation. Obviously a DNR could be forged, but baring obvious cases of forgery (which I've never seen), we're not liable for honoring a DNR that we reasonably believe is valid.

jlgaddis 13y ago
What about a "verbal DNR"? I was recently involved in a pretty bad motorcycle accident and was asked multiple times (by EMS on the scene, medical staff in the ER, medical staff right before going into the OR, etc.) if I had a DNR and/or if I would want them to attempt to save me if something happened. I remember thinking that was kinda weird since my assumption was that such requests would need to be in writing. Perhaps it was because I was incapable of writing or signing my name, though (two broken wrists)? Instead of me signing any documents, they just asked me verbally after making sure they had two other employees present as witnesses.
- JshWright 13y ago
  That's actually _better_ than a written document as far as I'm concerned. A DNR basically says "If I'm unable to speak for myself, here's how I would like to be treated." If you _are_ able to tell me how you want to be treated, then there's no question (assuming I'm confident in your ability to make informed decisions... not drunk off your ass... etc...)

FireBeyond 13y ago

In addition to what Josh says, in ambiguous situations, we will begin CPR or other life-saving measures whilst efforts are made to obtain/ascertain. We can always discontinue these efforts - on the other hand, delayed starts of such measures are more likely (if they result in survival at all) to end up with exactly the kinds of situations described here, brain damage, serious side effects, and the like.