Do Not Resuscitate Orders, ID Bracelets & Experiences

Posted by joko @joko, Mar 27, 2023

Do you have a DNR (Do Not Resuscitate Order) with your primary care physician? Do you wear a medical ID bracelets/necklace with DNR instructions? What experiences have you (or if you are a caregiver) had with Medical IDs, specifically with the DNR orders? Is there anything critically important that you should consider before you put this on your id and what has happened to people who wear it. (I mean do the EMTs follow instructions?) Appreciate insights.

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@casey1329

Thank you elimseoj. You made a lot of good points which I wasn't aware of. The aide didn't have to say much because me and my husband, who is an attorney, got right over there. However, the fireman just kept going at it bragging how he has a great record of reviving them, broken ribs and all.

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It seems like DNR's put a huge burden on caregivers, EMT, police. fire department, 911 etc.
Their mission is to render aid and save lives.

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@casey1329

Thank you elimseoj. You made a lot of good points which I wasn't aware of. The aide didn't have to say much because me and my husband, who is an attorney, got right over there. However, the fireman just kept going at it bragging how he has a great record of reviving them, broken ribs and all.

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I feel sad about that happening to your mother. My hope is that the fireman receives better training.

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@mazeppabob

It seems like DNR's put a huge burden on caregivers, EMT, police. fire department, 911 etc.
Their mission is to render aid and save lives.

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I would not wear a DNR bracelet, only an allergy bracelet…my father was dying of heart issues. He was being kept alive with chemicals. I’d always say to his doctors: give him the drugs..,I am not his god, his god will take him when he/she/it is nice and ready, not me!’ Gratefully, M

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@mazeppabob

It seems like DNR's put a huge burden on caregivers, EMT, police. fire department, 911 etc.
Their mission is to render aid and save lives.

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I agree and they have loads of other complex issues to deal with. They train, train, and train some more is all that I can hope for and try my best to make my wishes known.

This rather long article published in the Turkish Journal of Emergency Medicine has been around for some time and clearly documents your point. With respect to DNRs:
"Making the initiation of prehospital CPR more ethically complex is a Do-Not-Resuscitate (DNR) order. DNR has no basis towards making decisions about the current treatment but only avoids resuscitation.[23] DNR conflicts are one of the most frequent dilemmas reported by emergency medical technicians.[24]

"When confronting these challenges, the majority of the paramedics relied heavily on the advice of medical experts, but some had to make more autonomous decisions.[25] In general, if there is any doubt about the appropriateness of withholding resuscitative attempts, CPR should be initiated.[26]"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909960/

That quote is almost near the end of the article but before getting there covers some other complex issues.

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Hi. In the US, we now have electronic records that are available to all ER's immediately. It's almost universal in the US, in my realm of knowledge, that the first thing 1st Responders do when they find a person with death at or near imminent in their home, or work etc is check for DNR esp if they are seniors, disabled etc. They check the refrigerator, the purse/wallet as standard. They look for a DNR order. I keep copies of mine there plus I have a DNR sticker on my car dashboard. I notified my employer (HR) too. In the states I've lived in, this would be found and honored, no question. If I happened to cardiac arrest while shopping, I'll probably have some CPR done briefly before they find my paperwork in my purse/wallet. But I won't continue along that route for long. ER's would check for DNR too + get it immediately upon EHR search bc they are filed with your Dr or health system. They're accessible across the US.
I also have an Advanced Directive that details other medical measures prior to CPR also to be withheld. They are different documents, but for me, they work together to allow for a natural death with dignity.
A bracelet isn't a legal document + can't be construed by medical or law enforcement personnel as such to withhold CPR. But it does tip them off to hurry + search your wallet or fridge for a legally executed document to provide direction to them for what legally they can not do. Certain emergency providers must follow the law, and in the absence of a legal DNR, they can't make their own decision not to perform resuscitation.
I'm not a lawyer. But this gives you some information to research.

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...thing is, while they are searching a home for a dnr, and the patient doesnt have one or want one, wont that mean precious minutes going by and the person doesnt get help while they are searching? my ex husband went into local "old folks home" as they used to call them and his dnr was not the one sheet of paper I have signed; there were multiple scenarios on the page... and to check each one or not; whether or not he wanted life support; or feeding tube; or surgery; or many other things.... it got quite complicated. a co worker's brother in similar "home" had a DNR but he had a heart attack and family said should have sent him to hospital, they felt he would recover frome heart attack with treatment; they felt the DNR was for more complicated things or caner etc... its can become quite complex..... J.

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@rsfcowgirl

Hi. In the US, we now have electronic records that are available to all ER's immediately. It's almost universal in the US, in my realm of knowledge, that the first thing 1st Responders do when they find a person with death at or near imminent in their home, or work etc is check for DNR esp if they are seniors, disabled etc. They check the refrigerator, the purse/wallet as standard. They look for a DNR order. I keep copies of mine there plus I have a DNR sticker on my car dashboard. I notified my employer (HR) too. In the states I've lived in, this would be found and honored, no question. If I happened to cardiac arrest while shopping, I'll probably have some CPR done briefly before they find my paperwork in my purse/wallet. But I won't continue along that route for long. ER's would check for DNR too + get it immediately upon EHR search bc they are filed with your Dr or health system. They're accessible across the US.
I also have an Advanced Directive that details other medical measures prior to CPR also to be withheld. They are different documents, but for me, they work together to allow for a natural death with dignity.
A bracelet isn't a legal document + can't be construed by medical or law enforcement personnel as such to withhold CPR. But it does tip them off to hurry + search your wallet or fridge for a legally executed document to provide direction to them for what legally they can not do. Certain emergency providers must follow the law, and in the absence of a legal DNR, they can't make their own decision not to perform resuscitation.
I'm not a lawyer. But this gives you some information to research.

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Not all of us in here live in the USA, many live in Canada and others live throughout Europe. Please keep in mind that this is a global resource provided by the mayo clinic. Mayo may have 3 locations throughout the USA, however patients fly in from all over the world to get treatment…there & Cleveland clinic…IF NEEDED‼️Gratefully, Marianne

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@irinig

Not all of us in here live in the USA, many live in Canada and others live throughout Europe. Please keep in mind that this is a global resource provided by the mayo clinic. Mayo may have 3 locations throughout the USA, however patients fly in from all over the world to get treatment…there & Cleveland clinic…IF NEEDED‼️Gratefully, Marianne

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Thank you for your comment. I would appreciate your insight as to how your particular country handles this issue. Have you had any specific experiences with these issues in your country or while receiving medical treatment at either Mayo or the Cleveland Clinic? I have found in my travels that other people have developed their own approaches to these issues that can be helpful in discussions about U. S. health-related challenges.

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@irinig

Not all of us in here live in the USA, many live in Canada and others live throughout Europe. Please keep in mind that this is a global resource provided by the mayo clinic. Mayo may have 3 locations throughout the USA, however patients fly in from all over the world to get treatment…there & Cleveland clinic…IF NEEDED‼️Gratefully, Marianne

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Hi. Before there were the relatively new electric records I filed a copy of my DNR with my local fire dept/paramedic station. There are always ways to take action to make your wishes enforceable.

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@lacy2

...thing is, while they are searching a home for a dnr, and the patient doesnt have one or want one, wont that mean precious minutes going by and the person doesnt get help while they are searching? my ex husband went into local "old folks home" as they used to call them and his dnr was not the one sheet of paper I have signed; there were multiple scenarios on the page... and to check each one or not; whether or not he wanted life support; or feeding tube; or surgery; or many other things.... it got quite complicated. a co worker's brother in similar "home" had a DNR but he had a heart attack and family said should have sent him to hospital, they felt he would recover frome heart attack with treatment; they felt the DNR was for more complicated things or caner etc... its can become quite complex..... J.

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No one comes to a called-in top medical emergency alone. There is a standard procedure. It takes only seconds to look on the front of the refrigerator, the kitchen usually being near the front door where they enter. I didn't say someone searches through the whole house for a DNR. I said they look on the refrigerator.
That someone also looks in the medicine cabinet. It's just part of assessment. A person begins assessment+ then proceeds when they know what exactly they're dealing with.
You should get legal advice, available online, for your state to get specifics+ clarity.

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