Tag Archives: do not resuscitate (DNR)

DNR order – should your pet have one?

Half Moon Bay 11-29-10 011

Do you know what a DNR (do not resuscitate) order is?  It is a medical document that alerts doctors and other medical and rescue personnel about whether you want them to do anything they can to revive you if your heart stops.

I have been in the local hospital a few times for various medical procedures and am used to the questions that the staff asks before admitting you.  And I have a DNR (do not resuscitate) document that I  keep on file there.  If my heart stops and reviving me will negatively impact my quality of life, I want my loved ones to let me go.

Information for and against human DNRs is readily available on the web and in books; anyone you ask will have an opinion.

However, for pets it’s a different story.  Last week I had to take my dog, Suzi, to the veterinary hospital for a minor medical procedure and was given several forms to sign.  One of them caught me totally off guard.  I was asked to sign either a DNR or an “administer CPR” form for her.    I had never thought about a DNR in relation to my dog and didn’t know what to do.  I had no idea about how easily a dog’s heart stops beating during surgery and how quickly it’s quality of life will be impacted after that stoppage.

The vet told me that asking for a pet DNR is becoming common practice for many animal hospitals but would give me no recommendation on which form to sign.

When I got home, I got on the web and tried to research a pet DNR to see what the recommended practice is.  I could find very little helpful information.  I called friends with pets and they had no idea what to do either.

Luckily, the procedure went smoothly and Suzi was fine.  But what if there is a next time?  What should I do then?

We at Die Smart would love to hear from you with your opinions on this subject.  To write a comment or to find out more about end of life planning, including human DNRs, go to www.diesmart.com.

National Healthcare Decisions Day – April 16, 2011

National, state and local organizations have joined together to ensure that all adults have the opportunity to communicate and document their healthcare decisions. Too often, someone’s wishes are not known and steps are taken during a critical medical situation that he or she would not have wanted.

Have you done any advance healthcare planning? Do you even know what your choices are? Have you prepared an advance healthcare directive and shared its contents with your loved ones?

The objectives of the National Healthcare Decisions Day are to provide information to the public and improve the ability of healthcare facilities and providers to offer guidance about advance healthcare planning to their patients.

Don’t force your family to make end of life decisions for you. Tell them what you want and confirm your choices in writing with a living will or other advance directive document. Make April 16th the day you have a discussion with your family, convey your wishes and sign the necessary paperwork.

For further information, go to http://diesmart.com/elder-law/living-wills/ or http://diesmart.com/elder-law/health-care-power-of-attorney/ or http://diesmart.com/elder-law/other-advanced-health-care-directives/

Do Not Resuscitate (DNR) Michigan

Document Name
Do Not Resuscitate Order
Where do you get the form
Physicians should have copies of the form.  You can also get a copy at most hospices or download one here:
http://michigan.gov/documents/mdch/Do_not_resuscitate.policy_298357_7.pdf
Who signs the form
A physician must sign the DNR.   However, people whose religion opposes medical treatment don’t need a doctor’s signature.

Who can request the form

It may be requested by any individual 18 years or over.

Patient Identification
EMS will act based uon the information contained in the DNR.
How do you obtain a DNR bracelet
Once you have your DNR form completed, you can call the Michigan Hospice and Palliative Care Organization at 800-536-6300 to request a bracelet.
Revoking a DNR
You can revoke a DNR by tearing up the DNR form and returning any DNR identification bracelets.
Photocopy
A photocopy is considered an authentic document
State info link
http://michigan.gov/mdch/0,4612,7-132-2940_3183_4895-19875–,00.html
Other link
http://www.vialoflife.com
DNR Bracelet links
You must call the Michigan Hospice and Palliative Care Organization at 800-536-6300. 
Special Notes

Do Not Resuscitate (DNR) Massachusetts – has transitioned to MOLST

Document Name
MOLST (Medical orders for life sustaining treatments) has taken the place of the Comfort Care/Do Not Resuscitate Verification.  However, existing DNRs will be honored.
Where do you get the form
You can find it on the mass.gov site or you can get it from your physician.
Who signs the form
The form is signed by the physician, a nurse practitioner or a physician’s assistant and the patient.

Who can request the form

Any adult can complete a MOLST form.

Patient Identification
The Comfort Care/DNR verification is the only document that EMS personnel can use to verify a DNR order is valid.  If a person has a MOLST, the form itself can be used.
How do you obtain a DNR or MOLST bracelet
Your physician must order a DNR bracelet for you.  The MOLST application contains bracelet inserts that can be used in generic wrist bracelets.
Revoking a DNR or MOLST
An EMS/DNR Order or MOLST may be revoked at any time.  
Photocopy
Photocopies of the form or the bracelet inserts are considered authentic DNR or MOLST documents. Because EMTs are trained to look for a bright pink form in outpatient settings, it is highly recommended that a bright pink-colored DNR or MOLST form stays with the patient at all times.
State info link
http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/oems/comfort-care/
http://www.molst-ma.org/
Other links
http://www.vialoflife.com/
DNR Bracelet links
Your physician must order a DNR braclet on your behalf.
Special Notes
Order a Vial of Life decal for your front door. The decal informs Emergency Medical Services team a DNR or MOLST has been prepared and can be found in your refrigerator.

Do Not Resuscitate (DNR) Georgia

Document Name
Do Not Resuscitate Order
Where do you get the form
Ask your physician to create a DNR on your behalf.  If your physician does not have a form, there is a sample as part of the Georgia statute.  Go to
http://www.lexisnexis.com/hottopics/gacode/Default.asp 

and then look for Title 31. Health Chapter 39. O.C.G.A. 31-39-4

Who signs the form
The physician will sign the form.

Who can request a DNR

Any patient who has a medical condition which can be expected to result in imminent death or for whom CPR would be medically futile because it might only restore cardiac and respiratory function for a brief period of time.  A legal representative can also request a DNR for a patient who is in a vegetative or other unconscious state.

Patient Identification
There is no requirement for a patient to wear a DNR identification bracelet but it is acceptalbe if the patient chooses to do so.  However, there are specific guidelines.  The bracelet must be similar to identification bracelets worn in hospitals and must provide the following information in boldface type: DO NOT RESUSCITATE ORDER.  Patient’s name: _____________; authorized person’s name and phone number, if applicable; patient’s physician’s printed name and phone number; date of order not to resuscitate.                                    
How do you obtain a DNR bracelet
For assistance with finding a vendor for bracelets or necklaces, contact the Office of Regulatory Services at (404) 657-4076.
Revoking a DNR
You, or your designated health care agent, can give different instructions at any time, either orally, or by notifying your physician in writing.
Photocopy
You can make a photocopy of the original DNR form.
State info link
http://aging.dhr.georgia.gov/sites/aging.dhs.georgia.gov/files/imported/DHR-DAS/DHR-DAS_Publications/ELAP-%20DNR-12.pdf
Other link
http://www.vialoflife.com/

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.