Wednesday, July 15, 2015

DNR and emergencies

DNR's and ID's necklaces and bracelets. What is the difference?
While ID tags, or bracelets can identify that the wearer is a DNR patient, EMS or any hospital workers, including the doctors have to see a DNR signed by the patients doctor. 
As Keith Luce was saying, what these do is identify perhaps that the patient is a DNR, but it will not and cannot prevent EMS from doing life saving techniques which will include CPR, without a signed DNR.
And as far as a tattoo, trust me, EMS don't go by anything tattooed on anyone. In reality, EMS is trained to save lives. They will do a primary and a secondary assessment, but in a trauma situation, or medical emergency they will not go by any tattoos or jewelry that they find. 
These ID's would be for medical emergencies, and they work well for what they are for. If you have diabetes, dementia, allergies, things like that they are very useful. 
But, once again, it must have the persons name on the ID, and EMS must confirm that the person is who the ID says they are. They do this by identification. Which again, I worked EMS for close to 25 years and never once did I get in anyone's purse or wallet to see who they are.
It just doesn't matter in a medical emergency. The DNR will come into effect when the patient reaches the hospital in most cases. Unless like I said, there is a signed and dated DNR at the house that the family can provide.
Many, many times I have started life saving techniques because claims of a DNR were given by the family. By law, you have to see the DNR order and it must be signed and dated by the patients doctor. 
A family member cannot just tell you their loved one is a DNR patient. I used to tell people in these situations to have three copies of the DNR done.
One for the front of the refrigerator, one for the head of the bed, and one for safe keeping. In the midst of a medical emergency the only one there thinking clearly is usually EMS. 
The rest of what is going on is usually pure chaos. Family members are most likely in shock. You have to be able to figure out what is probably true, when it comes to the information you are given, and what is being said in the panic of the situation.
DNR's are the way to go for many people. We just need to understand that like in Ohio, there is more than one DNR. We have the usual DNR, then we have what is call DNRCC....it's the same as a DNR, but with "comfort care" added. Meaning everything can and will be done for the patient, up to and until their heart actually stops.
No life saving techniques, such as CPR, but things like fluids via IV's, and oxygen can be used for comfort care.
Google DNR and your State. Educate yourself about DNR's. Leeanne Chames and I have talked many times about having a Memory People Talks™ about this subject, DNR's, but they can be so confusing, and some people who think they know about these simply do not.
It is so important that I don't want to tackle it over the internet. This subject has to be talked about with the patients doctor. Not someone who thinks they know about DNR's.
They are great, if this is what the patient wants. The most important thing to me about DNR's is that the patient agrees with them. In other words that this has been discussed while they are of sound mind and body.
Not in the final stages, as most family members wait to do. Claiming this is want the patient would have wanted, when they never took the time to talk to them about it...