National Guidelines for Statewide Implementation of EMS “Do Not Resuscitate” (DNR) Programs

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With the growth of hospice and home health care, more patients with terminal illness are electing to avoid hospitalization until the final stages of illness. Many of these patients, as well as others with advanced chronic illnesses, have decided with the help and support of their attending physicians, that they do not wish to be resuscitated in the event of cardiac or respiratory arrest. However, as death draws near, well-meaning family or friends, or perhaps the patient, may call emergency medical services (EMS) personnel to transport the dying patient to the hospital; the prehospital providers who respond to these calls may be the last medical persons to attend terminally ill patients at home or in nursing homes. In many cases, these calls to EMS personnel are intended only to obtain transportation or comfort measures for the loved one. However, unless the state provides statutory authority for EMS personnel to honor a “do not resuscitate” (DNR) order, there may be a requirement for such personnel to attempt resuscitation, regardless of the patient's wishes and the physician's directive.