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Topic: Do not resuscitate

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	Do Not Resuscitate -- Facts, Info, and Encyclopedia article (Site not responding. Last check: 2007-11-07)
		A DNR, or Do Not Resuscitate order, is a written order from a (A licensed medical practitioner) doctor that resuscitation should not be attempted if a person suffers (Click link for more info and facts about cardiac) cardiac or (Click link for more info and facts about respiratory arrest) respiratory arrest.
		This is done when a person with an inevitably fatal illness does not wish to prolong the suffering, and wishes to have a more natural (The event of dying or departure from life) death without painful or invasive medical procedures.
		A pensioner and former nurse in the UK has a tattoo which reads 'Do Not Resuscitate' tattooed across her chest, while an 80 year-old emergency medicine specialist in Australia has done the same.
	www.absoluteastronomy.com /encyclopedia/d/do/do_not_resuscitate.htm (384 words)

	Stroke patients with "do not resuscitate" orders are treated worse than those without -- Dobson 331 (7522): 926 -- BMJ
		Stroke patients with "do not resuscitate" orders on their medical notes are almost seven times more likely to die in the first 30 days after their stroke than stroke patients without such orders, an English study concludes.
		DNR patients were less likely to receive most of their care in a stroke or rehabilitation unit (20% of DNR patients versus 57% of other patients; P< 0.0001), to be cared for on a stroke unit or by a stroke team (42% versus 70%; P<0.0001), or to be given aspirin (30% versus 42%; P= 0.007).
		Patients with a DNR order were about 60% less likely to be cared for by a stroke team than their counterparts without such an order.
	bmj.bmjjournals.com /cgi/content/full/331/7522/926-b (540 words)

	Policy On Do Not Resuscitate
		Resuscitation is a medical procedure which seeks to restore cardiac and/or respiratory function to individuals who have sustained a cardiac and/or respiratory arrest.
		DNR orders generally should be given with the informed consent of the patient or the patient I s surrogate decision-maker.
		A DNR order should be affirmed, modified, or revoked only after a discussion between the primary physician and the patient, if possible, or the surrogate(s) if appropriate, and the consent of the patient or surrogate.
	www.clevelandclinic.org /bioethics/policies/dnr.html (1753 words)

	Texas Out-of-Hospital DNR Information (Site not responding. Last check: 2007-11-07)
		Those resuscitative measures specifically listed in the OOH DNR legislation are cardiopulmonary resuscitation (CPR), advanced airway management, defibrillation, artificial ventilations and transcutaneous cardiac pacing.
		After completing the Texas OOH DNR Order form, the patient may obtain, at the patient's expense, an optional means of identification.
		An OOH DNR Order form must be properly executed in accordance with the instructions on the opposite side to be considered a valid form by emergency medical services personnel.
	www.tdh.state.tx.us /hcqs/ems/dnrhome.htm (680 words)

	State of California - Do Not Resuscitate
		When DNR orders are written in a long term care facility or other licensed facility, the burden for determining the appropriateness of the order and compliance with regulatory requirements lies with the facility administration and the patient's physician, not the prehospital care provider.
		In rare instances, when the patient is unable to state his or her desire and a family member is present and requests resuscitative measures for the patient, the family member's objection may call into question the validity or applicability of the DNR Form.
		Resuscitation attempts may be initiated until the form (or medallion) is presented and the identity of the patient is confirmed.
	www.emsa.cahwnet.gov /aboutemsa/dnr.asp (4937 words)

	SchoolNurse.com
		Many parents have given serious thought to a DNR order for their severely medically fragile child and the law may be on their side.
		To not resuscitate is a new and frightening prospect for most school districts, but it is a situation that will eventually have to be faced.
		In one state, nurses were told by an official of their state board of nurse examiners that performing resuscitation despite written orders to the contrary could be considered an assault on the child.
	www.schoolnurse.com /med_info/dnro.html (1169 words)

	American Family Physician: Practical guidelines for do-not-resuscitate orders - includes patient information sheet (Site not responding. Last check: 2007-11-07)
		Do-not-resuscitate (DNR) orders are directives in the medical record that preclude the use of resuscitative measures such as chest compressions, artificial respiration, cardioversion and/or cardioactive medications in the event of cardiopulmonary arrest.
		Also, resuscitative attempts in patients who had a period of hypoxia sometimes resulted in the loss of higher cortical function but the preservation of brainstem function, leaving patients in a vegetative state for varying amounts of time.
		As with any DNR order, these orders should be discussed with patients or their designated decision-makers, and the decision should be carefully documented in the medical record.
	www.findarticles.com /p/articles/mi_m3225/is_n6_v50/ai_15863864 (982 words)

	``DO NOT RESUSCITATE'' ORDERS MORE COMMON
		Do not resuscitate orders have been around for several years, but they've become more commonplace in the past couple of years.
		A do not resuscitate order is simply a prescription for emergency personnel to follow.
		Kiley said he believes that do not resuscitate orders reduce the stress on the spouse and the family but add to a paramedic's tension.
	scholar.lib.vt.edu /VA-news/VA-Pilot/issues/1995/vp951124/11210129.htm (863 words)

	Do Not Resuscitate Orders: Ethical Topic in Medicine (Site not responding. Last check: 2007-11-07)
		Like many other medical decisions, deciding whether or not to resuscitate a patient who suffers a cardiopulmonary arrest involves a careful consideration of the potential likelihood for clinical benefit with the patient's preferences for the intervention and its likely outcome.
		Cardiopulmonary resuscitation (CPR) is a set of specific medical procedures designed to establish circulation and breathing in a patient who's suffered an arrest of both.
		It is the policy of the UWMC, Harborview and VA that so-called "slow-codes," in which a half-hearted effort at resuscitation is made, are not ethically justified.
	eduserv.hscer.washington.edu /bioethics/topics/dnr.html (1264 words)

	About a Do-Not-Resuscitate Order
		If the patient is in a nursing home, a DNR order instructs the staff not to perform emergency resuscitations and not to transfer the patient to a hospital for such procedures.
		If you lose the capacity to decide and did not leave advance instructions, a DNR order can be entered only with the consent of someone chosen by you in advance, or by a family member or another person with a close personal relationship to you.
		A DNR order can be entered in the record for a patient under the age of 18 only with the consent of the patientÕs parent or guardian.
	www.bethabe.org /DNRs70.html (1156 words)

	Do not resuscitate decisions: flogging dead horses or a dignified death? -- Ebrahim 320 (7243): 1155 -- BMJ
		Do not resuscitate decisions: flogging dead horses or a dignified death?
		Resuscitation after a cardiopulmonary arrest is effective in only one in five patients.
		Do not resuscitate orders are increasingly used and have greater implications than merely not calling the resuscitation team.
	www.bmj.com /cgi/content/full/320/7243/1155 (1260 words)

	DNR-guidebook for patients and families
		DNR orders may be written for patients in a hospital or nursing home, or for patients at home.
		If the patient is in a nursing home or at home, a DNR order tells the staff and emergency medical personnel not to perform emergency resuscitation and not to transfer the patient to a hospital for CPR.
		A DNR order can be entered for a child with the consent of the child's parent or guardian.
	wings.buffalo.edu /faculty/research/bioethics/dnr-p.html (1461 words)

	do not resuscitate
		These are in addition to the case which led to Bunny losing her own job in opposing a instruction not to resuscitate a disabled child; the carers of the child complained to the UKCC in 1998 when Bunny 's replacement Nurse accepted the instruction.
		The RCN made a joint statement with the BMA and the Resuscitation Council (UK) in June 1999; Bunny’s case represents clear breaches of this in that “responsibility for a DNR [Do Not Resuscitate] decision rests with the consultant or general practitioner in charge of the patient’s care” (para.
		It was as a result of Bunny's case that the Welsh Assembly set up an all-Wales Study of Do Not Resuscitate (DNR) Orders in Schools- but the Assembly refused to take up the issue of her losing her job through whistleblowing on behalf of the life of a child.
	www.freedomtocare.org /page146.htm (2731 words)

	Do Not Resuscitate Guidelines
		Finally, this policy was not intended to address the needs of all DNR (do not resuscitate) patients, nor does it deal with the issue of patients with living wills who may choose to refuse medical care.
		An intact DNR (do not resuscitate) bracelet must be attached to the patient's wrist in order for the program to be valid.
		If the patient has an intact DNR (do not resuscitate) bracelet in place, Medical Direction should be consulted prior to endotracheal intubation, defibrillation, cardioversion or external chest compressions.
	nncf.unl.edu /eldercare/info/dnr.html (1099 words)

	Do Not Resuscitate Order - What is it?
		You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition.
		A new Michigan law allows competent adults to complete a form that states you do not wish to be resuscitated if your breathing and heart stop while you are in a home setting.
		The law requires the individual signing the Do Not Resuscitate Order to keep the document accessible and in his or her possession.
	www.med.umich.edu /1libr/aha/umlegal05.htm (587 words)

	Do Not Resuscitate Order (DNR)
		Also known as a do-not-attempt-resuscitation (DNAR) order or "no code," a DNR order specifies what efforts should or should not be taken in order to revive a patient who has experienced cardiac or pulmonary arrest and what level of care should be provided in the case of an arrest.
		Since there is always presumed consent for CPR (as currently practiced in the U.S.), it can be withheld only when a DNR order or other advance directive is present or in cases where CPR is judged to be futile according to the standard of care.
		A DNR order does not imply that no treatment whatsoever should be given, but only that the patient does not want to be resuscitated.
	www.ascensionhealth.org /ethics/public/issues/dnr.asp (159 words)

	Do Not Resuscitate (DNR) (Site not responding. Last check: 2007-11-07)
		A DNR Order generally means that no effort will be made to reestablish the heartbeat or breathing of a patient suffering cardiac or respiratory arrest.
		The Princip Allowing a patient to die from the underlying illness or injury is not the same as killing him or her.
		A DNR must be written by a physician (1) at the request of a competent patient, (2) or according to the patient's Advance Directives, (3) or at the direction—or with the consent—of the patient's surrogate decision maker.
	www.sclhsc.org /mission_vision_values/ethics/dnr.asp (147 words)

	Do Not Resuscitate (Site not responding. Last check: 2007-11-07)
		I understand DNR means that if my heart stops beating or if I stop breathing, no medical procedure to restart breathing or heart functioning will be instituted.
		I give permission for this information to be given to the prehospital care providers, doctors, nurses, or other health care personnel as necessary to implement this directive.
		I hereby agree to the "Do Not Resuscitate" (DNR) directive.
	www.agingkansas.org /kdoa/publications/alzheimers/dnr.htm (263 words)

	CATHOLIC ENCYCLOPEDIA: Character of Jesus Christ
		There may be solid ground for both views; but they do not exhaust the character of Jesus.
		It is a beautiful way of doing the right thing, in the right way, at the right time, therefore opens all hearts to its possessor.
		Even the hardest sacrifices do not prevent Jesus from complying with His Father's Will: "My Father, if this chalice may not pass away, but I must drink it, thy will be done" (Matt., xxvi, 42).
	www.newadvent.org /cathen/08382a.htm (3051 words)

	Guardian Unlimited \| Special reports \| Parents ask court to overturn order not to resuscitate disabled daughter
		The parents of a profoundly disabled baby girl, who a judge ruled last year should not be resuscitated if she fell critically ill, returned to the high court yesterday in an effort to overturn their daughter's "non ventilation" order.
		Everything they said she would never do she has done.
		Earlier, the judge heard that the trust wanted to avoid a situation where the focus in the final hours of Charlotte's life was not on providing her with the best care but on making an application to the courts.
	www.guardian.co.uk /medicine/story/0,11381,1592099,00.html (701 words)

	Comfort Care / Pre-Hospital Do Not Resuscitate Program
		This protocol is not intended to alter the standard of practice in issuing DNR orders in any way, but to provide a standardized mechanism for the verification of the DNR order so that it may be recognized in out-of-hospital settings..
		A nurse practitioner may write a DNR order, where this activity is agreed upon by the nurse practitioner and the collaborating physician in written practice guidelines (244 MCR 4.22 (1)).
		Comfort Care /DNR Order Verification Bracelet ("bracelet"): A bracelet modeled after a hospital identification bracelet, which shall include the patient's name, date of birth, gender, date of expiration of underlying DNR order, if there is one, and the signature and telephone number of an attending physician.
	www.mbemsc.org /provider/cc-dnr.html (2394 words)

	ADHS - Bureau of EMS - Do Not Resuscitate (DNR) Form
		The Prehospital Medical Care Directive (or commonly known as the Do Not Resuscitate form) allows people to decide if they do not want to be resuscitated if they stop breathing and their heart stops beating.
		Those resuscitative measures specifically listed in the DNR statutes are: cardiac compression, endotracheal intubation and other advanced airway management, artificial ventilation, defibrillation, administration of advanced cardiac life support drugs and related emergency medical procedures.
		The bracelet shall be on an orange background and state: 1) Do Not Resuscitate; 2) Patient's name; and 3) Patient's physician.
	www.hs.state.az.us /bems/dnr.htm (316 words)

	Advance Directives and Do Not Resuscitate Orders -- familydoctor.org (Site not responding. Last check: 2007-11-07)
		A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing.
		DNR orders are accepted by doctors and hospitals in all states.
		If you do not have time to put your changes in writing, you can make them known while you are in the hospital.
	familydoctor.org /handouts/003.html (1024 words)

	BBC NEWS \| Health \| Pensioner's 'Do Not Resuscitate' tattoo
		It reads "Do Not Resuscitate" in capital letters and is set around a red heart with a line through it.
		She feels it is the only way to ensure that doctors take account of her wishes, and that anybody opening her blouse to try to restart her heart will stop immediately.
		Her granddaughter Dr Claire Polack, a GP in Edinburgh, told the BBC her grandmother was right that the medical profession did not discuss the issue of resuscitation enough.
	news.bbc.co.uk /1/hi/health/2819149.stm (447 words)

	End-of-Life Issues and the Do-Not-Resuscitate Order : Who Gives The Order and What Influences the Decision? -- Karnik ...
		do not apply to iatrogenic cardiac arrests and that patients
		do not consider the possibility of an iatrogenic cardiac arrest
		We do not have simple answers to the questions of life and death.
	www.chestjournal.org /cgi/content/full/121/3/683 (1704 words)

	Compliance with Do-Not-Resuscitate Orders for Hospitalized Patients Transported to Radiology Departments -- Heffner and ...
		DNR orders do not always fulfill these purposes.
		Ethical guidelines for the anesthesia care of patients with do not resuscitate orders or other directives that limit treatment.
		Statement of advance directives by patients: do not resuscitate in the operating room.
	www.annals.org /cgi/content/full/129/10/801 (2295 words)

	DNR directives are established early in mechanically ventilated intensive care unit patients: [Les directives PDR sont ...
		DNR directives are established early in mechanically ventilated intensive care unit patients: [Les directives PDR sont etablies tot chez les patients sous ventilation mecanique a l'unite des soins intensifs] -- Sinuff et al.
		DNR directives are established early in mechanically ventilated intensive care unit patients
		DNR directives established early during their ICU stay after
	www.cja-jca.org /cgi/content/abstract/51/10/1034 (499 words)

	Arch Intern Med -- Abstract: Do-Not-Resuscitate Orders in Patients Hospitalized With Acute Myocardial Infarction: The ...
		mellitus or stroke were more likely to have DNR orders.
		DNR orders were significantly more likely to die during hospitalization
		From the Division of Cardiovascular Medicine, Department of Medicine (Drs Jackson, Yarzebski, Goldberg, and Gore and Ms Lessard), and the Department of Surgery (Dr Wheeler), University of Massachusetts Medical School, and Meyers Primary Care Institute (Drs Goldberg and Gurwitz), Worcester; and the Lown Cardiovascular Research Foundation, Brookline, Mass (Dr Bedell).
	archinte.ama-assn.org /cgi/content/abstract/164/7/776 (302 words)

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