Where is the line with Out of Hospital DNR?

[Guest guest]

This may be a stupid question, and on the surface I would agree, but what does

the DNR mean? I have read some literature that says the DNR goes into effect

once there is no pulse and/or no respirations. Other literature says that

palliative care is appropriate if the provider " knows this is the end of life

event. " Those are the simple patients. What about the patient with a valid DNR

that is in CHF with tachycardia and hypertension? Do you withhold treatment

that could improve the patient like CPAP and Nitrates? What about the DNR

patient having an ischemic stroke? Do you transport the patient (by air in some

cases) to a stroke center for treatment? What about STEMI? Conscious alert

patient with normal vital signs, do you treat the STEMI per protocol and make

sure they get to a cath lab for interventions? I am curious to find out what

others have to say on the matter. The TX OOHDNR only lists a few items to

withold at the time of arrest.

Matt

[Guest guest]

is right.

CPR, TCP, Defib, Advanced airway management, artificial ventilation can be

withheld.

Do not resuscitate does not mean 'speed up the process', rather it means 'don't

reverse the process'.

Hatfield

" The main part of intellectual education is not the acquisition of facts but

learning how to make facts live. " - Oliver Wendell Holmes

This may be a stupid question, and on the surface I would agree, but what does

the DNR mean? I have read some literature that says the DNR goes into effect

once there is no pulse and/or no respirations. Other literature says that

palliative care is appropriate if the provider " knows this is the end of life

event. " Those are the simple patients. What about the patient with a valid DNR

that is in CHF with tachycardia and hypertension? Do you withhold treatment that

could improve the patient like CPAP and Nitrates? What about the DNR patient

having an ischemic stroke? Do you transport the patient (by air in some cases)

to a stroke center for treatment? What about STEMI? Conscious alert patient with

normal vital signs, do you treat the STEMI per protocol and make sure they get

to a cath lab for interventions? I am curious to find out what others have to

say on the matter. The TX OOHDNR only lists a few items to withold at the time

of arrest.

Matt

[Guest guest]

is right.

CPR, TCP, Defib, Advanced airway management, artificial ventilation can be

withheld.

Do not resuscitate does not mean 'speed up the process', rather it means 'don't

reverse the process'.

Hatfield

" The main part of intellectual education is not the acquisition of facts but

learning how to make facts live. " - Oliver Wendell Holmes

This may be a stupid question, and on the surface I would agree, but what does

the DNR mean? I have read some literature that says the DNR goes into effect

once there is no pulse and/or no respirations. Other literature says that

palliative care is appropriate if the provider " knows this is the end of life

event. " Those are the simple patients. What about the patient with a valid DNR

that is in CHF with tachycardia and hypertension? Do you withhold treatment that

could improve the patient like CPAP and Nitrates? What about the DNR patient

having an ischemic stroke? Do you transport the patient (by air in some cases)

to a stroke center for treatment? What about STEMI? Conscious alert patient with

normal vital signs, do you treat the STEMI per protocol and make sure they get

to a cath lab for interventions? I am curious to find out what others have to

say on the matter. The TX OOHDNR only lists a few items to withold at the time

of arrest.

Matt

[Guest guest]

is right.

CPR, TCP, Defib, Advanced airway management, artificial ventilation can be

withheld.

Do not resuscitate does not mean 'speed up the process', rather it means 'don't

reverse the process'.

Hatfield

" The main part of intellectual education is not the acquisition of facts but

learning how to make facts live. " - Oliver Wendell Holmes

This may be a stupid question, and on the surface I would agree, but what does

the DNR mean? I have read some literature that says the DNR goes into effect

once there is no pulse and/or no respirations. Other literature says that

palliative care is appropriate if the provider " knows this is the end of life

event. " Those are the simple patients. What about the patient with a valid DNR

that is in CHF with tachycardia and hypertension? Do you withhold treatment that

could improve the patient like CPAP and Nitrates? What about the DNR patient

having an ischemic stroke? Do you transport the patient (by air in some cases)

to a stroke center for treatment? What about STEMI? Conscious alert patient with

normal vital signs, do you treat the STEMI per protocol and make sure they get

to a cath lab for interventions? I am curious to find out what others have to

say on the matter. The TX OOHDNR only lists a few items to withold at the time

of arrest.

Matt

[Guest guest]

DNR only becomes effective at the time of arrest.

GG

Where is the line with Out of Hospital DNR?

This may be a stupid question, and on the surface I would agree, but what does

the DNR mean? I have read some literature that says the DNR goes into effect

once there is no pulse and/or no respirations. Other literature says that

palliative care is appropriate if the provider " knows this is the end of life

event. " Those are the simple patients. What about the patient with a valid DNR

that is in CHF with tachycardia and hypertension? Do you withhold treatment

that could improve the patient like CPAP and Nitrates? What about the DNR

patient having an ischemic stroke? Do you transport the patient (by air in some

cases) to a stroke center for treatment? What about STEMI? Conscious alert

patient with normal vital signs, do you treat the STEMI per protocol and make

sure they get to a cath lab for interventions? I am curious to find out what

others have to say on the matter. The TX OOHDNR only lists a few items to

withold at the time of arrest.

Matt

[Guest guest]

DNR only becomes effective at the time of arrest.

GG

Where is the line with Out of Hospital DNR?

This may be a stupid question, and on the surface I would agree, but what does

the DNR mean? I have read some literature that says the DNR goes into effect

once there is no pulse and/or no respirations. Other literature says that

palliative care is appropriate if the provider " knows this is the end of life

event. " Those are the simple patients. What about the patient with a valid DNR

that is in CHF with tachycardia and hypertension? Do you withhold treatment

that could improve the patient like CPAP and Nitrates? What about the DNR

patient having an ischemic stroke? Do you transport the patient (by air in some

cases) to a stroke center for treatment? What about STEMI? Conscious alert

patient with normal vital signs, do you treat the STEMI per protocol and make

sure they get to a cath lab for interventions? I am curious to find out what

others have to say on the matter. The TX OOHDNR only lists a few items to

withold at the time of arrest.

Matt

[Guest guest]

It is NOT do not TREAT.  It is do not rescusitate.Do not intubate, perform CPR,

pacing or any other procedures to rescusitate. If they need treatment, do

so. When they pass, that's it. Let em go. 

Subject: Where is the line with Out of Hospital DNR?

To: texasems-l

Date: Saturday, May 8, 2010, 2:44 PM

 

This may be a stupid question, and on the surface I would agree, but what does

the DNR mean? I have read some literature that says the DNR goes into effect

once there is no pulse and/or no respirations. Other literature says that

palliative care is appropriate if the provider " knows this is the end of life

event. " Those are the simple patients. What about the patient with a valid DNR

that is in CHF with tachycardia and hypertension? Do you withhold treatment that

could improve the patient like CPAP and Nitrates? What about the DNR patient

having an ischemic stroke? Do you transport the patient (by air in some cases)

to a stroke center for treatment? What about STEMI? Conscious alert patient with

normal vital signs, do you treat the STEMI per protocol and make sure they get

to a cath lab for interventions? I am curious to find out what others have to

say on the matter. The TX OOHDNR only lists a few items to withold at the time

of arrest.

Matt