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.

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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