Out-of-Hospital DNR

Understanding Do Not Resuscitate (DNR) Orders

What is a DNR Order?

A Do Not Resuscitate (DNR) order is a medical directive that instructs emergency medical services (EMS) personnel not to attempt resuscitation or perform life-saving measures, including CPR, if those are the patient’s wishes. Similar to the POLST, this document should be discussed with a physician, who also signs the form.

Out-of-Hospital DNR

An out-of-hospital Do Not Resuscitate Order outlines specific measures that EMS personnel should administer, such as airway suction, oxygen, comfort positioning, pain medication, and emotional support, while directing them not to initiate CPR or other resuscitative measures.

Importance of DNR and POLST

Without a DNR and/or POLST, unwanted medical interventions, such as intubations or CPR, may occur during patient transport or between medical facilities. It’s essential for patients to have the appropriate DNR and POLST orders to ensure their end-of-life healthcare wishes are reliably safeguarded.

Legal and Ethical Considerations

In California, there are specific legal and ethical considerations related to advance directives and Do Not Resuscitate Order. Under California law, patients have the right to refuse medical treatment, including life-saving measures, and this right is strongly upheld. The state recognizes the importance of advance directives, such as Durable Power of Attorney and living wills, in enabling individuals to make healthcare decisions when they are unable to do so.

When it comes to such orders, California has clear legal requirements. A Do Not Resuscitate Order in California must include the patient’s name and the date of the order, and it must be signed by the patient (or their healthcare agent) and their physician. The order is then entered into the patient’s medical records. It’s also important to note that in California, it can be revoked at any time, verbally or in writing, and the patient can change their mind even in an emergency situation.

DNR Form California

Click to download pdf document

The California Emergency Medical Services Authority (EMSA) is also a resource for DNR and POLST forms.

Contact a Volunteer

If you have questions, would like to discuss advance care planning further, or need help preparing your advance directives, please contact us.  A volunteer will follow up with you to find out how we can assist.

Death is a challenge. It tells us not to waste time… It tells us to tell each other right now that we love each other. 

Leo Buscaglia

“Thank you very much for speaking at my Rotary Club. I feel more empowered just through knowledge!” A.L.

End of life choices California


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