Medical Ethics

Emergency DNR

R426. Health, Health Systems Improvement, Emergency Medical Services.
R426-100. Emergency Medical Services Do not Resuscitate.

The EMS personnel will be responsible to provide proper assessment of the patient's status and the patient's personal needs through the completion of a primary and secondary assessment of the patient. Remember, that the directive only applies to cardiac and/or respiratory arrest in the patient as it is related to their terminal condition and only in those situations where the patient has an active and proper EMS/DNR directive in place, or when the have another aspect of the Living Will that meets all the criteria that has been established for that part of the Act.

The EMS personnel will determine the existence of the EMS/DNR directive as a part of the patient assessment. The EMS personnel may need to begin resuscitation efforts while they determine the status of the patient. Begin treatment of the patient including CPR if the directive has been revoked. Avoid confrontation with family. If the family demands care, provide palliative care while contacting medical control and provide them with the information pertinent to the situation.

Remember, if an EMS/DNR directive is valid, the EMS personnel should honor the patient's request by withholding CPR. If the EMS personnel have personal feelings concerning the Directive and are unwilling to honor the directive, they should allow someone else to assume responsibility for patient care. If the EMS personnel should have any questions, they should contact medical control.