What would you do...

[Richard B the EMT]

In Missouri the only legally EMS recognized DNR is the Out of Hospital DNR which is on a bright orange piece of paper.

While a bit off topic, I like the idea of having it on a presumably easily locatable paper, due to the color. I do not know if New Yorks State or City have a color coding (pun unintended) for such paperwork; if they do not, they should.

[HERBIE1]

While a bit off topic, I like the idea of having it on a presumably easily locatable paper, due to the color. I do not know if New Yorks State or City have a color coding (pun unintended) for such paperwork; if they do not, they should.

Ours is supposed to be orange as well, but I don't recall ever seeing one that color. It's always been a fax or Xerox copy. I assume the originals are in the doctor or lawyers office.

[Just Plain Ruff]

Ours is supposed to be orange as well, but I don't recall ever seeing one that color. It's always been a fax or Xerox copy. I assume the originals are in the doctor or lawyers office.

Usually if it is a copy of the orange sheet we accept it.

Granted most of the doctors around our area are all known by the EMS crews so we don't put up much fuss clarifying the dnr.

But no matter how much we try to push the ORANGE sheet on the agencies putting the DNR's inthe patients hands, they keep using white paper.

[Richard B the EMT]

But no matter how much we try to push the ORANGE sheet on the agencies putting the DNR's inthe patients hands, they keep using white paper.

I guess not everyone has a color copier/printer, like some of us do (part of my Dell system).

[JPINFV]

I guess not everyone has a color copier/printer, like some of us do (part of my Dell system).

Put an orange piece of paper into the copier and you won't have to worry about whether the copier is black and white or color.

[Just Plain Ruff]

Put an orange piece of paper into the copier and you won't have to worry about whether the copier is black and white or color.

Yeah the paper is orange, not the printing.

[Richard B the EMT]

That would be making sense, and bureaucracies are well known for NOT making sense, in fact, it probably would be against their rules, regulations, or laws.

[ctmedic09]

To begin with this is a bad scenario, you have this patient that is 97 years old that more than likely has CAD and other coronary disease in a dangerous rhythm. My personal approach would be to contact medical control, depending on your service area and the meds that you carry, and request an alternate treatment plan that may include a calcium channel blocker ( Diltiazem, or Verapamil) , benzodiazepine (Lorazepam) , or beta-blocker (Metoprolol), at least with a CCB you have calcium chloride / gluconate to reverse the effects and it is a slow push that you can stop pushing if you notice undesired effects. I am not sure I am comfortable pushing adenosine as a first line drug in someone over the age of 85 or so. This is only my take on avoiding the cardiac arrest situation, now to the question of the DNR, it is what it is. Say you are called to the scene of an auto accident, the patient is a 20 year old male that is a terminal cancer patient that is unresponsive, has a pulse, with a respiratory rate of 6, do we intubate even though the DNR is second to the CA, the answer is no, it does not matter the situation of the arrest the DNR is a legal document and the family has the right to seek legal help and sue if the DNR is violated. I hope this helps and would like to get the opinion of other EMS professionals on the use of CCB, benzos, and beta blockers prior to adenosine in the high risk patient.

[FSU-EMT]

I would honor the DNR regardless of its cause, but that is an awful situation

[Alanna]

Not sure, just bringing it up, but isn't a DNR specific to a certain illness or etc?

Because I had this question when I was talking to one of my instructors during my EMT course. You have a pt with a DNR order,for a specific illness. They attempt suicide.. the suicide-caused effects were not listed as the purpose for the DNR, so in that instance you would do life-saving interventions, because it was not related to what the DNR was assigned for???