jerryc41 Loc: Catskill Mts of NY

Lots of people don't want to spend the last years of their lives hooked up to a machine until someone decides to "pull the plug." That's why we have the DNR notice. It can be confusing, though.

https://gizmodo.com/unconscious-patient-with-do-not-resuscitate-tattoo-caus-1820881602

MichaelH Loc: NorCal via Lansing, MI

Unless this man was the tattoo artist he could not have signed the tattoo.
Google ' "No Regerts" tattoo ' and you will see that a tattoo should never be used as a legal document.

jerryc41 Loc: Catskill Mts of NY

He probably signed a paper, and the tattoo artist used that.

firtree Loc: Florida, USA

Apparently even with a signed DNR order in someone's medical file mistakes can happen. I would think, in the case of this story, that a tattoo is Not a legal document, regardless of the wearer's intentions.

tracs101 Loc: Huntington NY

Many folks are hooked up to a machine now. It is called a cell phone.

firtree Loc: Florida, USA

Architect1776 Loc: In my mind

dragonfist Loc: Stafford, N.Y.

My wife worked as a nurse in a nursing home for 28 years. She told me that even if you have a DNR there are times when family can override it. I guess there is no way to be sure of your wishes being followed. Unfortunately the hardest part of dying at times is being allowed to do it.

DragonsLady Loc: Los Alamos, NM

I was told, that our emergency room will not honor someone's DNR if they are brought in by ambulance. Both my children know my wishes as does my husband (and he feels the same as I do.)

buckbrush Loc: Texas then Southwest Oregon

[quote=jerryc41]Lots of people don't want to spend the last years of their lives hooked up to a machine until someone decides to "pull the plug." That's why we have the DNR notice. It can be confusing, though.


The Oregon Health & Science University have developed a (POLST), document that is signed by the patient and their Physician to indicate what actions are required by any Health care professional. POLST stands for Physician Orders for Life-Sustaining Treatment. The instructions on the form are entered into a State of Oregon Registry that is available to any Physician. I have signed one 5 years ago and am glad the document exists. The registry sends the person having signed a POLST a card to be kept for presenting to any Physician.

It has sections for:
A) Cardiopulmonary Resuscitation
B) Medical Interventions
C) Artificially Administered Nutrition
D)Documentation of Discussion and Signature of patient or Surrogate
E) Signature of Physician

If anyone is interested they can look at the online links at:

www.polst.org or at polst@ohsu.edu

Alex

jeep_daddy Loc: Prescott AZ

I have had a lot of trouble trying how to fill out my DNR or EOL form. The wording isn't easily understandable by me. I'm not that stupid, but it uses phrases and words that may not be exactly how I'd like things to go if brought into a hospital unconscious. I simply wouldn't want a machine to keep me alive forever, nor would I want to be in a vegetative state with feeding tubes until I die. But if some life saving procedure might save my life, then yes, I'd want them to try.

wrangler5 Loc: Missouri

I've been told that first responders WILL perform CPR (and perhaps other lifesaving techniques they're licensed to do) on site/during transport, regardless of any DNR orders in place. I suspect that's a combination of (1) having standard procedures that are always done, to insure that nothing gets forgotten, and (2) an institutional reluctance to stop for legal evaluations of exactly what to do/not do in seconds-may-count emergency situations. Does something like the Oregon statewide registry, which at least arguably might be available to first responders instantly, change that practice in OR?

buckbrush Loc: Texas then Southwest Oregon

Wow, Good question.
I'll call my doctor next week and ask her about first responders having access to the OR registry. She is very up-to-date on many things so she may have been asked this question before.

buckbrush Loc: Texas then Southwest Oregon

[quote=wrangler5]I've been told that first responders WILL perform CPR (and perhaps other lifesaving techniques they're licensed to do) on site/during transport, regardless of any DNR orders in place.
Wrangler5,
I just looked up the POLST website directive for Oregon and it gives the following explanations about EMTs using POLST data:

Question. Why do I need to find and follow POLST orders?
ANS. Patients have the right to express their preferences regarding life-sustaining treatments.
The Scope of Practice for Emergency Medical Providers states, “An Oregon-certified First Responder or EMT, acting through standing orders, must respect the patient’s wishes including life-sustaining treatments. Physician supervised First Responders and EMTs must request and honor life-sustaining treatment orders executed by a physician, nurse practitioner or physician assistant if available.”

When do POLST orders apply?
ANS. POLST orders apply any time EMS is called or the patient is transferred to the ED. However, a patient with decision-making capacity can request other treatment at any time. Patients with Comfort Measures Only usually would not want to go to the hospital, unless comfort cannot be achieved without transport.

Are copies and eSignatures valid?
ANS. Yes! Copies of POLST forms are valid. Electronically completed forms (ePOLSTs) may have eSignatures that don’t look like a handwritten signature, these are 100% valid. POLST form copies and ePOLSTs may be printed on white paper that is OKAY, they are valid.

How will EMS & Emergency Departments access the POLST Registry? Call the POLST Registry Hotline 24/7/365 at the OHSU Emergency Communications Center (ECC) for immediate POLST form requests.

So it looks like EMTs will follow your instructions documented in a POLST directive but if any patient doesn't have a POLST number readily seen by the EMT then they won't know to look for your POLST instructions. That lookalike a case for one of those medical bracelets.

BTW, by my looking up this info for you I found that the POLST system is nationwide but most states have not developed the complete system. It looks like West Virginia, California and Oregon are the only three states that have a 'mature' POLST system.
Hope this helps.
Alex

Earworms Loc: Sacramento, California

Well Jerry, if I find you flat on the floor, I wont be administering any mouth to mouth resuscitation!