DNR Standard Flashcards
What interventions count as CPR/”life saving measures” according to the DNR Standard?
- Chest compression
- Defibrillation
- Artificial ventilation
- Insertion of an OPA, NPA, or SGA
- Endotracheal intubation
- Transcutaneous pacing
- Advanced resus drugs such as, but not limited to, vasopressors, antiarrythmic agents, and opioid antagonists.
What must a complete DNR form include?
- Full name of patient
- Check box checked to indicate one of the following is met: - current plan of tx exists that reflects pt’s expressed wish when capable, or consent of SDM if incapable, that CPR not be included in the pt’s tx plan. - the physician’s current opinion is that CPR won’t or probably won’t help, and this was discussed with the pt or the SDM.
- Check box checked to ID the professional designation of who signed the form.
- Printed name of the MD, RPN, RN, or RN(EC) signing the form.
- Signature from the appropriate medical professional.
- The date the form was signed, which needs to make sense (not in the future).
Can a DNR be a copy?
Yes, a valid DNR may be a fully completed original or a copy of a fully completed original.
What should a paramedic do when they receive a DNR?
Not initiate CPR if the pt arrests. Note time of arrest, pulses and resps absent for at least 3 minutes from the time that resp or cardiac arrest was noted = death.
If we receive a valid DNR, when can we start CPR?
If pt is capable and clearly expresses a wish to be resuscitated, or a capable pt who expresses a vague, incomplete, or ambiguous request that makes it unclear what the wishes of the pt are.
What can we do for a DNR pt?
Provide management necessary to provide comfort or alleviate pain as required by pt’s clinical condition.
What do we do once it has been determined that death has occurred?
Advise CACC/ACS, follow the deceased pt standard. Note and document the time it is confirmed the pt is deceased (3 min post arrest).
