Timmy Posted April 10, 2008 Share Posted April 10, 2008 Wrong-O my friend. Once the father has requested your help, you have to carry it through. They can tell you to start, not stop. In this case a call to medical control is necessary. Perform good basic resuscitation until you receive an order to terminate. Our protocols are different here. Paramedics can’t sign a death certificate but can cease resuscitation. They can also render someone emotionally/mentally unable to make a decision. We don’t use medical control in Australia. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted April 10, 2008 Share Posted April 10, 2008 In AZ anyone can rescind a prehospital DNR order. Only a physician, or a patient can allow for one. If there is a conflict of any kind with carrying out the order as written, call medical control. Can you clarify this. You really didn't mean to say that anyone, meaning "anyone" can rescind a prehospital dnr? Does that mean that any bystander can rescind it? I'm sure you meant something else didn't you? Link to comment Share on other sites More sharing options...
CBEMT Posted April 11, 2008 Share Posted April 11, 2008 So if you decide to terminate, now what? Carry him back into the house? Link to comment Share on other sites More sharing options...
BEorP Posted April 11, 2008 Share Posted April 11, 2008 I had the same situation with an adult female terminal from ovarian cancer. Family wanted no resuscitation, husband wanted her worked. He actually tore up the DNR in front of me. I elected BLS only and transported to the hospital. ER Doc and our Med control Doc stood behind my decision. So if she were in VF/VT, you would not have shocked her? That seems like it would be a difficult decision to backup. Link to comment Share on other sites More sharing options...
FireMedic65 Posted April 11, 2008 Share Posted April 11, 2008 I didn't read everyone's reply or anything, because I just did not want to. Anyway, it is a valid DNR, signed by both parents. DNR is a legal document. If CPR was intinated already, and the DNR was presented afterwards, just to be safe, I would contact medical command, and inform them, and have the doc give me the order to stop CPR. Link to comment Share on other sites More sharing options...
AZCEP Posted April 11, 2008 Share Posted April 11, 2008 Can you clarify this. You really didn't mean to say that anyone, meaning "anyone" can rescind a prehospital dnr? Does that mean that any bystander can rescind it? I'm sure you meant something else didn't you? I wish I did mean something else. :roll: The way the law is written, anyone can. Unless time is taken away from the resuscitation to verify the authority of the person, EMS is obligated to proceed with all measures. It has happened in my own experience to have someone walk past with no knowledge of what the patient wants, and make the statement to "do something" and we had to until medical control was contacted. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted April 11, 2008 Share Posted April 11, 2008 I wish I did mean something else. :roll: The way the law is written, anyone can. Unless time is taken away from the resuscitation to verify the authority of the person, EMS is obligated to proceed with all measures. It has happened in my own experience to have someone walk past with no knowledge of what the patient wants, and make the statement to "do something" and we had to until medical control was contacted. for once in my life I was speechless for just a minute. But all I can say is HOLY SH...................................... Link to comment Share on other sites More sharing options...
Richard B the EMT Posted April 12, 2008 Share Posted April 12, 2008 It appears the consensus is, if a family member, and only a family member, requests the DNR be disregarded, we use all protocols we are supposed to use. We will also, at minimum, notify our On Line Medical Control of the situation. The consensus also seems to be, if resuscitation efforts are already started before a DNR order is presented to the on scene crew(s), the efforts will be continued until OLMC says otherwise, or arrival at the Emergency Department, when the onus (if any) will then fall on the ED crew, and not the EMS crew, if efforts are then terminated. Link to comment Share on other sites More sharing options...
tniuqs Posted April 12, 2008 Share Posted April 12, 2008 Wrong-O my friend. Once the father has requested your help, you have to carry it through. They can tell you to start, not stop. In this case a call to medical control is necessary. Perform good basic resuscitation until you receive an order to terminate. AGREED .... well partially: One step further: ALS intervention the all or none principle applied, I do not have the social code mentality, meh. OK Mom ??? PLEASE go sit up front and put your seat belt on. WE will let the Doctors sort this out. We will be in the Hospital really quick, I promise. SCENE SAFETY FIRST I think your all missing a THE point here, MOST IMPORTANTLY for scene safety: With any "possible" family disagreement and confrontation in progress, physically separate the parties asap. "STAT" Police back up for a legal witness AND if "one rules out a possible weapons call" GET OFF MY TRUCK your an freaking idiot ! This senario has HUGE potential for getting out of hand in a New York Heartbeat. OK first query: A signed DNR on a 3 year old ? WTF even hypothetical, I am SO VERY sceptical from the onset. Second question: Just how can EMS confirm the validity of signatures on a piece of paper for a DNR ORDER ? I can't and will never even try. Another point being can one in this situation can not even actually confirm or deny the LEGAL parents or whoever that may BE ... or NOT BE ..... OR if they are ARMED ! So just ONE family member says work it, who am I to say NO ? My job is a Paramedic no more no less I did not recieve law degree when I graduated, for those that THINK they can call this "CODE" just who the hell do you think you are ? On a 3 year old ? gimme a break ParaGod! Really, please do reality check and just quote doczilla your "Situational Awaerness" scale is minus 5000 for those that would have the arrogance to believe they know "the rules" of this engagement. Hell even a bread knife can kill you, wear a VEST ? You may need one very soon! Use your common cents first, so please Error on the side of caution always. Just think about the calls you have been to over just a romantic break up ? Suicide attempts ? ODs ? Domestic Violence? Rape? +++++ now factor in the death of a child. AGAIN: ANY Domestic disagreements (again this one is HUGE potential) is mandatory Police intervention, just my little rule in my book (s) for personal longevity is all. :shock: cheers ps ever been witness to a shooting .... just saying be careful out there kids. Link to comment Share on other sites More sharing options...
Kiwiology Posted April 12, 2008 Share Posted April 12, 2008 Yep valid DNR is final here provided we act in "good faith" and "resusciatation attempts are not in the best interests of the patient". Link to comment Share on other sites More sharing options...
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