Section 15 CPGs

Question 1

End of life - DNAR

Answer 1

End of life terminal stage
-patient becomes acutely unwell
-Is there respiratory distress
-If there is respiratory distress, preform basic airway maintenance and provide oxygen therapy, and continue to recent and reliable written instruction from patient’s doctor stating that the patient is not for resuscitation
-If there is no respiratory distress, continue to recent and reliable written instruction from patient’s doctor stating that the patient is not for resuscitation
-If there is no recent and reliable written instruction from the patient’s doctor stating that the patient is not for resuscitation, proceed to primary survey CPG
-If recent and reliable written instruction from patient’s doctor stating that the patient is not for resuscitation is found, is there an agreement between caregivers present and practitioners not to resuscitate
-If yes, it is inappropriate to commence CPR, continue to inform ambulance control
-If no, go to primary survey CPG
-Is a pulse present
-If yes, provide supportive care until handover to appropriate practitioner and continue to consult with ambulance control re, location to transport patient/deceased
-If no pulse present, continue to consult with ambulance control re, location to transport patient/deceased
-Complete all appropriate documentation
-keep next of kin informed, if present
-Emotional support for relatives should be considered before leaving the scene

-FOLLOW LOCAL PROTOCOL FOR CARE OF DECEASED
-CONFIRM AND AGREE PROCEDURE WITH CLINICAL STAFF IN THE EVENT OF A DEATH IN TRANSIT
-APPROPRIATE PRACTITIONER; MEDICAL PRACTITIONER, NURSE, ADVANCED PARAMEDIC, PARAMEDIC, EMT
-THE DYING PATIENT, ALONG WITH THEIR FAMILY, IS VIEWED AS A SINGLE UNIT OF CARE