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Location of a DNR
I responded to a cardiac arrest at 3:40 am i get there the 89 year old patient is DOA so i immediatly start doing compressions. I succesfully resuscitate him. We get him loaded and get him to the ER about 20 min later his son comes in with the DNR and they unplugg the guy imediatly. 1. if you have a DNR keep it close to you so the EMT's know. 2. as the EMT never get your hopes up when you recusitate a patient. Needless to say i learn that leason the hard way.
Replies to This Discussion
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Permalink Reply by Dwight Anthony Price II on
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Casue to a bystandard witch was his wife she didnt know what was wrong. and paramedics can offer drugs and other comforts to make his go a lil easier.
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Permalink Reply by Brian Dumser on
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That sucks. However, sometimes family members do not agree with a DNR. We had one where the daughter didn't agree so she called us when her mother went down. We arrive, start doing our thing and the brother arrives as were getting her packaged into the ambulance and starts yelling about a DNR. The daughter denied any DNR even existed so we (per SMO's) got ready to transport. At the last minute the brother comes out of the house with the valid DNR! Needless to say the daughter got upset and demanded we do everything possible to save her mother. We had to get the P.D. involved. Not a good call.
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Permalink Reply by Matthew Madairy on
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I disagree with your post. If the pt is DOA (Priority 4), then working them is not an option. We don't work DOA's, at least in my jusrisdiction. I believe that you had an 89 y/o pt in cardiac arrest. If the pt was resuscitated, it probably wouldnt have been just from compressions. Further, I highly doubt that the ER staff would have pulled the plug immediatly without some sort of meeting. At the time that the resuscutation took place, there was no DNR produced. It is an advanced directive that dictates to what level of car we provide, either DNR-A or DNR-B. NOT A LIVING WILL. The pt. was cared for as if there was no DNR because at the time of care, there wasn't one.
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Permalink Reply by Mike Schlags (Captain Busy) Retd on
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Sounds like you did things by the numbers.
1. If there is no obvious DNR, you need to do you job... you did so, no problem.
2. If someone like the son shows up at the ER, and produces the ever popular DNR, then folks get to unplug the guy, you go home, and hopefully, your system has the contract for EMS so you can collect the $5000.00 ambulance bill for working the guy up and transporting him to the ER.
3. Don't worry about DNR's... this is not your problem or worry, it's the families.
4. Always err on the side of life and safety, just like you did, which in my opinion was very professional.
Keep doing what you are doing. Your right on tract here brother.
TCSS,
CBz
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Well it was toned as a 89 year old pr in cardiac arrest but the guy was flat lined when we got there. upon arriving i started compresions and compresions only and the guy regaind a heart beat. i continued to give compressions till the paramedics arrived. and they might not have unplugd him immediatly but thats not realy the point of the story.
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Thanks man. im on a voulenteer EMS so no 5000 for us lol
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Permalink Reply by Davin Eshelman on
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Usually 911 dispatchers don't always know if the guy has a DNR or not. The local hosp. tells their DNR pts. to keep their forms on the fridge so it is easier for EMS crews to find.
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Local protocol is if we get called to a possible DOA and the pt. is warm, then we start doing CPR and what not. But if the pt. is cold, then we call the ME and wait for his arrival.
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If the pt is COLD, you should still do CPR unless other obvious signs of the pt being long dead are present, like rigor mortis, etc.
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I've actually never been on a call where the pt had a DNR and was concious and alert and able to speak to me.
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Wow, pooling and lividity, and the MD still ordered CPR?
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Permalink Reply by Richard Armstrong on
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here our guys automatically start CPR until the piece of paper is produced.Can't take the word of somebody cause who knows maybe the wife or son or daughter hates them and they will get a bunch of money when they pass so tell you there is a DNR when there isn't so they can cash in.
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