DNR Guidelines

My 2nd assignment was very interesting. Because my EMT program has students enrolled from all over the US and in other countries, they asked that we research and write a basic summary on the  the Do Not Resuscitate protocol for our home state.

Here is what I found for Idaho:
The Do Not Resuscitate (DNR) guidelines for Idaho are as follows:
In order for the DNR protocol to take place, patients must have indications of a respiratory or cardiac arrest AND either have a valid and intact Idaho POST/DNR or bracelet; a signed DNR order from another state; or be wearing DNR identification jewelry.

Contraindications of this protocol include when the maker of the form or physician has revoked the DNR order; the DNR order is not physically present or has been defaced or destroyed; or there are verbal or physical threats from bystanders.

While attempting to determine the patient's DNR status, perform routine patient assessment, resuscitation, or other medical interventions.  If a valid DNR order or DNR identification jewelry is found, obtain reasonable assurance that the patient is the person for whom the order was written.

If resuscitative efforts have been started before learning of a valid DNR order, stop the resuscitative efforts immediately.  If it is determined that the patient does NOT have a valid DNR order, proceed with all resuscitative efforts within scope of practice, and do not discontinue efforts before receiving permission from medical control.

The DNR order may be disregarded only if there is a good faith belief that the order has been revoked, to avoid confrontation, or is ordered to do so by the attending physician (an attending physician is a physician licensed in Idaho who is selected by, or assigned to, the patient and who has primary responsibility for the treatment and care of the patient.  The attending physician can also be an EMS online medical control physician.).

If the patient has severe trauma, is involved in a mass casualty incident, or there is evidence of homicide or suicide, the EMS provider is not required to attempt to locate a POST form or jewelry.

If the patient IS in respiratory or cardiac arrest and DNR status is confirmed, EMS providers WILL NOT initiate CPR, provide ventilatory assistance, initiate cardiac monitoring (unless to confirm death), defibrillate the patient, or administer resuscitative medications.  They will however provide comfort care and emotional support to the patient and family members.

If the patient is NOT in respiratory or cardiac arrest, EMS providers will attempt to determine if the patient has a POST form and will follow the patient's treatment choices listed on the patient's POST form, if available.

After care of the patient is accomplished, complete the Idaho EMS Patient Care Report, stating in the narrative how the patient was identified, what events occurred during the EMS run, what verbal attending physician orders were, and the patient's outcome.

My sources are:
Idaho EMS Guidelines for DNR v.0708
Idaho Senate Bill No. 1418 (not used for this research, but still fascinating)

It was a good reminder that life is sacred and that the life is in the blood.

For the life of the flesh is in the blood...for it is the blood that maketh an atonement for the soul.

~ Leviticus 17:11 ~