Many of our patients have Durable Do Not Resuscitate (DDNR) orders. Durable indicates that it can be used by multiple facilities and doesn’t need to be renewed. No matter what the patient’s life threatening condition may be, they have decided they do not wish to be resuscitated. Therefore, a patient with a DDNR should not receive the following:
- BVM or artificial ventilation
- Cardiac resuscitation medications (epi, norepi, atropine, etc)
You may provide comforting measures and care. This includes oxygen, IV’s, pain medications and IV fluids. Certain conditions and illnesses that may not be directly related to the patient’s terminal condition can be treated per protocol such as hypoglycemia, opiate overdose (narcan, not a BVM), allergic reactions and seizures. Hypotension can be treated with fluids but not medication. In some instances comforting words and reassuring the patient and their family may be enough.
If you have any questions about giving a medication or performing a procedure, you can always consult with online medical control.
For previous information on DNR vs Advanced directives or other documents, please go here: https://www.vbems.com/2017/05/16/dnr-ddnr-advanced-directive-living-will-physician-order-which-one-can-i-use/
VOEMS information can be found here: http://www.vdh.virginia.gov/emergency-medical-services/other-ems-programs-and-links/durable-do-not-resuscitate-program/