Do Not Intubate

[emt3225]

Hello all.......Has anyone ever heard of a DNI (do not intubate)..My day job is working in a Nursing Home and for the first time today i heard a Social Worker tell a family member about a DNI...This PT doesnt want a DNR and doesnt want to be on any life support...Soo they are asking that if he goes into cardiac arrest to perform CPR but tell the ambulance drivers not to intubate...I dont get it...What do we do at this point..I think the family is filling out a living well....Do we abide by this living well....Any info would be helpful

[hammerpcp]

It is not uncommon for poeple to have specific treatment (or non treatment) wishes. Whether you can honour these or not depends entirely on your local legislation, your service and your base hospitals policies.

[emt3225]

It is not uncommon for poeple to have specific treatment (or non treatment) wishes. Whether you can honour these or not depends entirely on your local legislation, your service and your base hospitals policies.

Ok thanks for your input...I will ask them at the ambulance corp what i should do....Thanks again

[Nate]

This is what I like about Texas. Your either a full code or your a DNR when it comes to out of hospital care.

[Ridryder 911]

Texas does not acknowledge living health wills ?....

With living wills, determination is made on each segment of care not to or to be performed...

Be safe,

R/R 911

[AZCEP]

AZ doesn't accept living wills, or hospital issued DNR's either. For EMS to accept a DNR at face value it has to be a "Prehospital DNR". This is f@#$ing ridiculous, but what are you gonna do.

Now, when the situation presents itself, most medical control physicians are willing to allow for the patient's wishes to be followed. We just have to contact them first. The pattern is to initiate a BLS resuscitation, contact medical control, follow their guidelines. That way the responsibility for what we do falls more directly on the MD/DO.

[medstudent30]

Ohio does not accept living wills either. You are either a DNR-CC or DNR-CCA.[/font:b089ffb85f]

[Nate]

Texas does not acknowledge living health wills ?....

With living wills, determination is made on each segment of care not to or to be performed...

Be safe,

R/R 911

Only in the hospital. Out in the field, your either a full code or a DNR.

[Doczilla]

To clarify Ohio's policy...

DNR- Comfort Care means that all aggressive resuscitative measures such as surgery, pressors, pacing, cardioversion, and intubation will be withheld, and care will focus on palliation of pain and maximizing comfort.

DNR- Comfort Care Arrest means that everything listed above will be done up until the point of actual cardiac arrest, at which point resuscitation will cease.

'zilla

[ALERT Medic]

Never heard of do not intubate orders but I'll throw this one your way...I had a doc recently get pissed because I treated septic shock in a nursing home patient who had a DNR. Last time I checked, intubation and cpr were considered resucitation, not dopamine, iv fluids and oxygen.