DNR Orders

What is a DNR Order?
A “Do Not Resuscitate” (DNR) Order allows the patient, or patient’s representative, to refuse CPR (cardiopulmonary resuscitation) attempts when the patient has stopped breathing and/or the patient’s heart has stopped beating. The DNR Order, written by the physician on a special form, instructs health care providers to withhold CPR.

Where can a DNR Order be obtained?
Patients, or their representative, may request a DNR Order from the patient’s physician.

Where can the DNR Order be used?
The DNR Order can be used anywhere in North Carolina – in the hospital, at the patient’s place of residence, or anywhere in between.

What care will EMS offer to a patient with a DNR Order?
A DNR Order applies only to CPR. This does not mean that all other care stops. Emergency Medical Services and other health care providers will continue to provide all other appropriate care. If the patient is dying, every effort will be made to make the patient as comfortable as possible, such as measures to stop pain or ease breathing. If the patient requires transportation or treatment other than CPR, Emergency Medical Services will provide such services.

What are the patient’s rights in obtaining a DNR Order?
The patient has the right to control his or her medical care, including whether or not to have a DNR Order. If the patient is not able to make health care decisions, the patient’s representative may make health care decisions on behalf of the patient. The patient, or the patient’s representative, has the right to ask questions and receive answers about DNR Orders from the patient’s physician and to discuss the patient’s wishes regarding a DNR Order with family, friends, ministers, a lawyer, etc. The patient, or the patient’s representative, may revoke (cancel) a DNR Order at any time. The patient, or the patient’s representative, and the physician will decide the date on which the DNR takes effect and the date it will expire. A DNR Order must be re-authorized at least once a year.

Who is involved in completing a DNR Order?
Both the physician and the patient, or the patient’s representative, must agree that a DNR Order is appropriate before the physician will write a DNR Order. A DNR Order must be signed by a physician.

Is a DNR Order the same as a Living Will, Health Care Power Of Attorney, or other advance directive?
No. Advance directives such as a Living Will or Health Care Power Of Attorney are directions written by an individual about his or her health care wishes. A DNR Order is an order written by the patient’s physician. A DNR Order may be based on an advanced directive, if the patient has a written one. But a patient who has not written an advanced directive may still have a DNR Order.

What should the patient, family, or friends do if someone wants to call Emergency Medical Services (EMS)?
Sometimes the patient, family, or friends may want to call EMS because the patient’s condition has worsened or because transportation or other emergency care is desired. When the patient’s condition has worsened, it may be very hard for family and friends not to call EMS, even when they know the patient does not want CPR. If the patient and family discuss this situation in advance with the patient’s providers and a plan is agreed upon, everyone may feel better when the situation arises. If transportation is needed, EMS should be called even though there is a DNR order. If possible, tell EMS of the DNR Order when a call is made. In all cases, present EMS with the original DNR Order upon their arrival.

Where can I get additional information about DNR Orders?
Contact Brunswick County EMS at (910) 253-5383 or your private physician.

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