Out-of-Hospital DNR
Do Not Resuscitate Order
Your DNR order is meant to alert any emergency medical services (EMS) personnel to not attempt resuscitation or perform heroic life-saving measures including CPR, if those are your wishes. Like the POLST, this document should be discussed with your physician, who also signs the form. It is usually requested by a person already seriously ill who wishes to avoid unwanted medical interventions according to his or her specific end-of-life health care wishes.
An out-of-hospital DNR outlines your specific wishes and typically directs paramedics to ONLY to administer the following measures: suction the airway; administer oxygen; position for comfort; splint; control bleeding; provide pain medication; provide emotional support; and contact health care professionals. Without a DNR, EMS personnel will likely initiate CPR or continue if already started; administer chest compressions; intubate (EndoTracheal or Esophageal Obturator Airway); initiate cardiac monitoring; administer cardiac resuscitation drugs; defibrillate; or provide ventilator assistance.
DNR Form California
Click to download pdf document
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.
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.
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