Do Not Resuscitate Information
What is a do not resuscitate order?
A do not resuscitate (DNR) order is a type of advance
directive. A DNR is a request not to have
cardiopulmonary resuscitation (CPR) if your heart stops
or if you stop breathing. (Unless a DNR bracelet is
present, emergency responders must help all patients
whose heart has stopped or who have stopped breathing.)
Patients who are not likely to benefit from CPR
include people who have cancer that has spread, people
whose kidneys don't work well, people who need a lot of
help with daily activities, or people who have severe
infections such as pneumonia that require
hospitalization. If you already have one or more of
these conditions, you should discuss your wishes about
CPR with your doctor, either in the doctor's office or
when you go to the hospital. It's best to do this early,
before you are very sick and are considered unable to
make your own decisions.
DNR orders for non-hospitalized patients:
Wisconsin Act 2000
A person may refuse CPR in the institutional setting
such as hospitals and nursing homes by having his or her
physician write such an order. If this person has a
cardiopulmonary arrest outside the hospital or nursing
home, Emergency Medical Technicians have a duty to
revive him or her unless he or she is wearing a DNR
bracelet.
In 1996, the State Legislature passed Wisconsin Act
200, which allows certain individuals to request a DNR
bracelet. This allows an individual to remain outside of
a hospital or nursing home and still have control over
resuscitation efforts. In 1999, the law was amended to
allow the use of metal bracelets (Medic Alert-type
bracelets).
If a person has a written DNR order, but is not
wearing a state-approved DNR bracelet, EMTs are required
by law to begin life-saving efforts. In most cases,
it is recommended that individuals with DNR orders or
bracelets not call 911, but instead notify their hospice
agency/visiting nurse/funeral home/doctor. Speak with
your family physician to find out what option is best in
your case.
In order to obtain a bracelet, a DNR order form needs
to be filled out and signed by a physician. A patient
can receive a DNR bracelet order form from the Wisconsin
Department of Health and Family Services or from a
physician's office.
Who is eligible for a DNR bracelet?
The person must be at least age 18, not be pregnant,
and have any of the following:
- a terminal medical condition;
- a medical condition that makes it unlikely that
CPR will be successful (for example, severe disease
of the heart, lungs, kidneys, brain); or
- a medical condition that would make CPR cause
more harm than benefit (for example, severe bone
softening due to osteoporosis).
What may emergency responders do?
If you have a DNR bracelet, and emergency
responders are called, they may (as appropriate):
- clear airways;
- administer oxygen;
- position for comfort;
- splint injured bones;
- control bleeding;
- provide pain medication;
- provide emotional support;
- contact a hospice or home health agency if
either has been involved in the patient's care.
If you have a DNR bracelet, and emergency
responders are called, they may NOT:
- insert airways;
- perform chest compressions;
- administer cardiac resuscitation drugs;
- breathe for you;
- use electric shock to start your heart.
To Learn More...
For more information on DNR, including a DNR Order
Form, contact your physician or call the Wisconsin
Department of Health & Family Services at (608)
267-7147. |