Episode 4 - Do not resuscitate order DNR

#legal #emt #paramedic

In this episode, Chris and Jason discuss what a DNR order is, and what it is not. Do we still treat pain and infection in patients with DNR orders? When can we terminate resuscitation? What's the difference between a DNR and Advanced Directives? Chris and Jason answer these questions and more during episode 4 of the Back to Basics podcast!

Do Not Resuscitate. We’ve all heard the words, but our definition of their meaning varies form “don’t touch that patient because he has a terminal illness” to “We can bring him back to life so long as we don’t use a certain tube or other invasive measures”.

No doubt, there is confusion, so today Chris and I break down what a DNR is, what other end-of-life care options there are, and what it means for us as providers when we see one of these documents.

First and foremost, let’s define some terms. An advanced directive is any type of care we would render to someone when they can’t make decisions for themselves. They make these DIRECTIVES, in ADVANCED, when they ARE of sound mind, for when they may NOT be. So, let’s say I tell the doctor, I don’t want to have tubes down my throat, so I sign this document, and now if I pass out and can’t tell you those things, they won’t or will be done based on my wishes.

Advanced Directives are very general and are a similar situation to a “living medical will.” This is different than assigning a durable medical power of attorney or making someone a medical proxy. If I tell the doctor, I want my wife to make decisions for me, it doesn’t matter if my whole life I said, “No tubes down my throat” Once I’m unconscious, she makes the call. If I haven’t told the doctor anything, or put any advanced directives in place, usually the hospital will do ALL of it, and only will not if the next of kin works with the doctor and decides that’s not what I would have wanted.

The bottom line is that we try our best to do what is best for the patient, or what the patient would have wanted. DNR’s refer to something very specific though. A do not resuscitate order is only referring to when your heart stops and means to only not do CPR. You can be on hospice with a DNR in place, and still call 911 to stop you from choking, or to treat your pain, or to make you comfortable, or to heal an infection. All these nuances can be hard to navigate, so let’s jump in! As always, if you have questions, shoot them to us!

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