Out-of-Hospital Do Not Resuscitate Orders

This specialized medical instruction is now portable or enforceable outside of the walls of a medical facility. Should medical circumstances warrant, a physician may, upon consultation with her patient or the patient’s agent, write a DNR or Do Not Resuscitate Order. This instruction in a patient’s chart means that should their heart stop beating on its own or should they stop breathing, no CPR (cardiopulmonary resuscitation) should be performed. For example, a DNR order might be appropriate for a terminally ill cancer patient who has been admitted to Hospice care or a very frail and very elderly person who lacks the physical vitality to respond to or recover from CPR.

Until 2002, a DNR was only enforceable within a medical facility. This meant that a person with a DNR could not enforce it outside the hospital. Thus, if they were well enough to travel and then be in an accident, EMS or similar emergency medical service responders would be required to perform CPR (because their public charge is to save lives at all cost), even though this was against the patient and doctor’s orders.

Now, Pennsylvania joins many other states that have procedures to protect patient’s rights, ensure EMS compliance and still protect the professional integrity of our Police, Fire, EMT and invaluable emergency responders. Now a person can have a “mobile DNR” and wear a special bracelet to safely advise the emergency responder of the existence of the DNR order. The official advisory on the bracelet permits the emergency responder to respect the patient’s and doctor’s orders.

You can find more information regarding the Pennsylvania Mobile DNR at the Pennsylvania Department of Health Website.