what would you do in this situation as a EMT-B

[cosgrojo]

Med control, Med control, med control. Doctor trumps all protocol issues. He/she says don't work it, don't work it.... and by the way, get the doctor's name and document EVERYTHING. No problems!

[ccmedoc]

I think Lone Star should check his protocol book...May be in for a surprise!! :roll: I know this county well. :wink:

[ccmedoc]

That's ridiculous. I'm an EMT-B in Michigan, and if we have a valid DNR order, we sure as hell better not begin CPR. I don't know who told you that basics can't honor DNR orders, but that's wrong.

My bad, thats Bakerma, not lonestar. Sorry 'bout that :oops:

She is so very wrong.... :?

[Lone Star]

Are you referring to the Genesee County protocols?

[ccmedoc]

I'm sorry, I got mixed up...shouldn't respond that early in the morn... :oops: (it's morning for me)

Bakerma was correct with this:

Quote:

That's ridiculous. I'm an EMT-B in Michigan, and if we have a valid DNR order, we sure as hell better not begin CPR. I don't know who told you that basics can't honor DNR orders, but that's wrong.

Lone star is wrong with this, as is supported in the following Genesee county protocol::

Lone Star wrote:

Per my state and local protocols, I have no choice but to work the code. As an EMT-B in Michigan, I cannot honor a DNR order, whether valid or invalid.

I'd hate to think that Genesee County Medical Control was 'wrong' about anything!

Lonstar:

Are you referring to the Genesee County protocols?

Yes. Genesee County Michigan, as follows:

A Do-Not-Resuscitate order is applicable to all prehospital life support agencies and personnel. A Do-Not-Resuscitate order may be executed by an individual 18 years of age or older and of sound mind OR by an individual 18 years of age or older and of sound mind, and adherent of a church or religious denomination whose members depend upon spiritual means through prayer alone for healing OR by a patient advocate of an individual 18 years of age or older. Per Attorney General Opinion 7056, a court appointed guardian of a developmentally disabled adult ward, does not have the authority to sign this form on behalf of a disabled adult ward when that ward is not of sound mind.

1. EMS providers shall not attempt resuscitation of any individual who meets ALL of the following criteria:

A. 18 years of age or older.

B. Patient has no vital signs. This means no pulse or evidence of respiration.

A. Patient is wearing a Do-Not-Resuscitate identification bracelet which is clearly imprinted with the words “Do-Not-Resuscitate Order,” name and address of declarant, and the name and telephone number of declarant’s attending physician, if any.

OR

The EMS provider is provided with a Do-Not-Resuscitate order form for the patient. Such an order form shall be in substantially the form outlined in Annex 1 or 2 and shall be dated and signed by all parties.

Notice the initial sentence in which it is applicable to all agencies and personnel....I believe Basic EMT is included in this statement

Again, sorry about the confusion, Bakerma you were absoltely correct! :oops:

[Lone Star]

Hey, I got no problem admitting that I'm wrong about things. I live in Genesee county and worked in Oakland and Wayne counties (primarily), so you can see the confusion about local protocols.

The problem here is that there are too many different local protocols to try to remember, especially when in direct conflict with each other.

I am thoroughly chastised, and for that, I retract my original statement.

[ccmedoc]

Understandable, however,( not to be argumentative (well, maybe)), but I believe that Genesee, Wayne, Lapeer, Macomb, Oakland, and Washtenaw/Livingston counties participate in the Southeastern Michigan Regional Protocols. I do believe that this and most of the EMT protocols are similar, if not verbatim. The main variance is in ALS protocols...Just my experience. :twisted:

Just Goes to show, especially in the DNR situation, know your protocols, the extent to which they apply to you, and who to call if you have a conundrum... :-k

I think calling Med control would have been a safe way out in the initial question...when in doubt, farm it out [-o<

[marcum1235]

If I would have had no signed DNR, I would work it as a full code, however I thank you done the right thing in getting medical dir. from ED Dr. when in question ask form medical dir. gets the monkey off your back.

[ittybitty82]

We actually almost had a similar call like that recently that i myself was not on but had another emt-b call me and ask later what I would have done.

Personally if it were me on the call, I would have had my partner initiate CPR and explain to the family the deal with the DNR. At this time I would call Medical control and found out what to do.

Per our protocols in our rural county, we have to do CPR unless it is valid, to have my rear covered this is what I would unfortunately have to do.

[mrmeaner]

Err, what if you DON'T have online medical control at the BLS level? Not everyone has the ability to punt decesions to the nearest base hospital.

:shock: Isn't that an EMS requirement? I understand that in some desolate areas there are communication problems where you can't get someone online, but that's the only exception.