Notes – Do Not Resuscitate Status/Advance Directives/Healthcare Power of Attorney (POA) Status

Patient Safety Considerations

In cases where the patient’s status is unclear and the appropriateness of withholding resuscitation efforts is questioned, EMS personnel should initiate CPR immediately and contact direct medical oversight.

Notes/Educational Pearls

Key Considerations

If there is a personal physician present at the scene who has an ongoing relationship with the patient, that physician may decide if resuscitation is to be initiated
If there is a registered nurse from a home healthcare or hospice agency present at the scene who has an ongoing relationship with the patient, and who is operating under orders from the patient’s private physician, that nurse (authorized nurse) may decide if resuscitation is to be initiated
If the physician or nurse decides resuscitation is to be initiated, usual direct medical oversight procedures will be followed
Special Consideration: For scene safety and/or family wishes, provider may decide to implement CPR even if all the criteria for death are met

Pertinent Assessment Findings

Quality Improvement

Associated NEMSIS Protocol(s) (eProtocol.01)

9914201 – Cardiac Arrest-Determination of Death/Withholding Resuscitative Efforts
9914169 – Cardiac Arrest-Do Not Resuscitate
9914171 – Cardiac Arrest-Special Resuscitation Orders

Key Documentation Elements

Detailed description of the valid exclusion to resuscitation documentation used to guide resuscitation including a copy of the document if possible
Names/contact information for significant bystanders

Performance Measures