Do Not Resuscitate (DNR) Maryland

Document Name

EMS Do Not Resuscitate and Medical Care Order.

Where do you get the form

A physician must complete the form on your behalf. You can print out the form: http://www.miemss.org/home/Portals/0/Docs/OtherPDFs/DNRorder_form.pdf

Who signs the form

The form is signed by the physician, the patient, and two witnesses and printed on brightly cooolored ORANGE paper.

Patient Identification

There is no requirement for a patient to wear a DNR identification bracelet. EMS will honor a DNR form signed by a physician, patient and 2 witnesses.

How do you obtain a DNR bracelet

The DNR form includes information about ordering a DNR bracelet. If a vinyl bracelet is to be used, have the physician sign the bracelet inserts at the bottom of the EMS/DNR. If a metal bracelet or necklace is desired contact Medic Alert® at 1-800-432-5378. They will send you the application and information. They will require a copy of this order in order to process your request.
If a vinyl bracelet will be used, be sure the insert has been completed and signed, tear the bracelet insert off of the original form, fold it, trim it along the dashed line, and insert it in the vinyl EMS/DNR bracelet that has been provided. The bracelet may be worn about the wrist, hung from a necklace, or pinned to clothing.

Revoking a DNR

An EMS/DNR Order may be revoked at any time by the patient’s request for resuscitation made directly to responding emergency medical services personnel OR by the physical cancellation or destruction of al l EMS/DNR Order forms, bracelets, and necklaces with the consent of the patient or the authorized decision maker signing the EMS/DNR Order. Destruction of an EMS/DNR Order, bracelet, or necklaces without consent carries penalties under the Health Care Decision Act.

Photocopy

Photocopies of a completed DNR form are valid.

State info link

http://www.miemss.org/home/PublicInformation/DNRDoNotResuscitate/tabid/118/Default.aspx

Other links

http://www.vialoflife.com/

DNR Bracelet links:

You can elect to purchase a DNR bracelet at these links.

Special Notes

Order a Vial of Life decal for your front door. The decal informs Emergency Medical Services team a DNR has been prepared and can be found in your refrigerator.

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