DNR (Do Not Resuscitate)
In 2015, the Institute of Medicine (22 Sep 2017 Journal of the American Heart Association. 2017;6) noted:
- survival of less than 6% when cardiac arrest occurs outside the hospital, and
- only 24% when cardiac arrest occurs inside the hospital.
California does use the DNR (Do Not Resuscitate) that tells emergency medical services (EMS) personnel not to attempt resuscitation or perform heroic measures on a particular patient who has reached a point of medical futility. Like the POLST, these documents are signed by the patient’s physician. The intent is to prevent medical staff or EMS personnel from performing unwanted medical interventions on a seriously ill patient. DNR Form California
Unless a patient has a DNR and/or POLST (best to have both), unwanted intubations or CPR may occur during transport to or between medical facilities. Having a living will, health care power of attorney, and a DNR order in a hospital chart will not prevent this from occurring. The patient must have the appropriate POLST or out-of-hospital DNR orders to safeguard their wishes reliably.
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.