A DNR order means that a patient should not be given CPR or other life-saving measures in the event of cardiac arrest or other medical emergencies. Different types of DNR orders exist, and patients should be specific in their advanced directive to ensure their wishes are followed. In the absence of an advanced directive, someone else must take responsibility for the patient’s wishes. Brain dead patients have the potential to donate their organs.
A do not resuscitate (DNR) order is a type of advance directive that states that a patient should not be offered CPR or other life-saving measures in the event of cardiac arrest or other medical emergencies. Typically, a DNR is requested by or for a terminally ill patient, to avoid potentially painful and invasive procedures. Patients who are very elderly or in other circumstances may also require a DNR.
There are different types of DNR orders, and it’s helpful to know the difference between them, especially if you’re considering a DNR request for yourself. Although most people associate a DNR with cardiopulmonary resuscitation (CPR), other life-saving measures can also be used in a hospital setting, including intravenous drug administration, intubation to protect the airways, and the use of defibrillator pads. Some of these measures are traumatic and invasive and may not always be effective if a patient is critically ill.
Under a basic DNR order, none of these measures will be provided to a patient in respiratory or cardiac arrest. However, hospital staff and nurses will continue to work to keep the patient comfortable through the administration of oxygen, patient movement, and intravenous fluid hydration. A DNR’s intention is not to kill a patient, but to keep them comfortable as death approaches.
Ideally, a patient should request a DNR from their doctor, setting what is known as a “specific DNR”. This type of DNR is much more extensive, indicating specific wishes for certain conditions. For example, a patient may request a DNR if he ends up in a coma, but not if he has a heart attack while awake. By being specific in an advanced directive, the patient can be sure that his wishes will be followed in the event of a major medical catastrophe.
In a patient who cannot make medical decisions and an advance directive has not been dictated, someone else must take responsibility, such as a next of kin or in some way the parent has vested power of attorney. Persons in this position should think carefully about the patient’s wishes, especially if the patient is experiencing multiple organ failure or brain death. It may be helpful to remember that brain dead patients have the potential to donate their organs, thus saving lives even if they are no longer able to enjoy life.
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