I have heard that some medical professionals wear this on a medallion on a chain around their necks, if this is so what is the likely hood of this being adhered to?
>“Do not resuscitate”
Seems a bit open-ended. If these are happy, healthy people, surely it would depend on circumstances.
Bubblecar said:
>“Do not resuscitate”Seems a bit open-ended. If these are happy, healthy people, surely it would depend on circumstances.
70+ year old with unstated medical problems, or perhaps the medical problems should be stated?
I don’t mean you bob, I mean the medical professionals you mentioned in the OP.
But yes, if you’re going to wear a “Do not resuscitate” tag, it might be an idea to include on it an explanation as to why not, in finer print :)
There could at least be a number to call to confirm that this person has put themselves on a do-not-resuscitate database somewhere. Otherwise it might just be someone who passed out while drunk and his mates put that around his neck for a laugh.
Bubblecar said:
There could at least be a number to call to confirm that this person has put themselves on a do-not-resuscitate database somewhere. Otherwise it might just be someone who passed out while drunk and his mates put that around his neck for a laugh.
Bubbles, yeah good point, thankyou, will look into that.
i would imagine there is a register with this info on. just like for organ donors etc. you just wouldn’t go buy a tag and hope for the best. or if you did then you aren’t worth resuscitating.
Maybe they should have “DNR” tattooed on their neck instead.
JudgeMental said:
i would imagine there is a register with this info on. just like for organ donors etc. you just wouldn’t go buy a tag and hope for the best. or if you did then you aren’t worth resuscitating.
Thanks Judge, will check with my local Dr,
Nursing homes ask for a DNR choice on entry, and update it every year in case they change their minds. There is no requirement for an underlying medical issue, it is just the persons choice.
http://www.resus.org.au/policy/guidelines/section_10/guideline-10-5-%20july-2012.pdf
I’d like to know why medical professionals are wearing DNR tags.
Divine Angel said:
I’d like to know why medical professionals are wearing DNR tags.
In many cases, the resus is futile but just part of the process…just prolongs, something, that isn’t ‘living’…
Divine Angel said:
I’d like to know why medical professionals are wearing DNR tags.
Divine Angel said:
I’d like to know why medical professionals are wearing DNR tags.
I have heard that serious damage can be done by poorly applied resuscitation methods.
poikilotherm said:
Divine Angel said:
I’d like to know why medical professionals are wearing DNR tags.
In many cases, the resus is futile but just part of the process…just prolongs, something, that isn’t ‘living’…
Oh right, I was thinking these were medicos wandering around, happy and healthily wearing DNR tags, not patients!
(I watch too much TV)
Divine Angel said:
Maybe they should have “DNR” tattooed on their neck instead.
Predicts explosion in litigation against hospitals turning off people with GnR tatts!!
You say that like it is a bad thing. I have no problem with people liking a particular band but it takes a special level of stupidity to get their name tattooed onto your person…
poikilotherm said:
http://www.resus.org.au/policy/guidelines/section_10/guideline-10-5-%20july-2012.pdf
Thankyou poik.
Divine Angel said:
Maybe they should have “DNR” tattooed on their neck instead.
Department of Natural Resources?
furious said:
- hospitals turning off people with GnR tatts
You say that like it is a bad thing. I have no problem with people liking a particular band but it takes a special level of stupidity to get their name tattooed onto your person…
i said it like hospitals would get sued regardless!!
bob(from black rock) said:
I have heard that serious damage can be done by poorly applied resuscitation methods.
Serious damage? Like what? If they need resuscitation, they’re dead. You can’t really do much damage to a dead person. The worst that can happen is that they remain dead. Or in the case of really poor CPR, they may become less dead with a broken rib or two.
Teleost said:
bob(from black rock) said:
I have heard that serious damage can be done by poorly applied resuscitation methods.
Serious damage? Like what? If they need resuscitation, they’re dead. You can’t really do much damage to a dead person. The worst that can happen is that they remain dead. Or in the case of really poor CPR, they may become less dead with a broken rib or two.
I thought a broken rib or two was a sign of good CPR, at least that’s what used to get taught.
Teleost said:
bob(from black rock) said:
I have heard that serious damage can be done by poorly applied resuscitation methods.
Serious damage? Like what? If they need resuscitation, they’re dead. You can’t really do much damage to a dead person. The worst that can happen is that they remain dead. Or in the case of really poor CPR, they may become less dead with a broken rib or two.
I did my Senior First Aid a while back and they urge you to try even if you crack a rib. DNR is weird because the first instinct is to try and help, just standing there and watching someone pass away would be incredibly difficult if the person seemed ok just before it happened, I had such a situation happen to me and it was very hard.
DNR as far as I know is for people that fear being resuscitated will lead them to being a “vegetable”
Vegetable meaning that the brain is there but cannot function properly in a meaningful way.
tauto said:
DNR as far as I know is for people that fear being resuscitated will lead them to being a “vegetable”Vegetable meaning that the brain is there but cannot function properly in a meaningful way.
It should be. But I think the definition is blurred by a lot of people.
Fee said:
tauto said:
DNR as far as I know is for people that fear being resuscitated will lead them to being a “vegetable”Vegetable meaning that the brain is there but cannot function properly in a meaningful way.
It should be. But I think the definition is blurred by a lot of people.
No. It’s about futile care, being resuscitated after something like a haemorrhagic stroke, shifting in and our of conciousness in ICU then properly carking it 3-7 days later, what was the point in resus apart from making onlookers feel better?
poikilotherm said:
Fee said:
tauto said:
DNR as far as I know is for people that fear being resuscitated will lead them to being a “vegetable”Vegetable meaning that the brain is there but cannot function properly in a meaningful way.
It should be. But I think the definition is blurred by a lot of people.
No. It’s about futile care, being resuscitated after something like a haemorrhagic stroke, shifting in and our of conciousness in ICU then properly carking it 3-7 days later, what was the point in resus apart from making onlookers feel better?
Or that their quality of life is so poor, or outlook so bleak, like a chronic pain sufferer or MND patient respectively, that to resuscitate them is almost an act of cruelty even if you return them to pre emergency health (if they expressed they didn’t want to be resuscitated).
Anywho said:
poikilotherm said:
Fee said:It should be. But I think the definition is blurred by a lot of people.
No. It’s about futile care, being resuscitated after something like a haemorrhagic stroke, shifting in and our of conciousness in ICU then properly carking it 3-7 days later, what was the point in resus apart from making onlookers feel better?
Or that their quality of life is so poor, or outlook so bleak, like a chronic pain sufferer or MND patient respectively, that to resuscitate them is almost an act of cruelty even if you return them to pre emergency health (if they expressed they didn’t want to be resuscitated).
Doesn’t anyone realise that why medical personnel wear these DNR medallions is so they can slip it over someone’s neck when they make the diagnosis.
Anywho said:
poikilotherm said:
Fee said:It should be. But I think the definition is blurred by a lot of people.
No. It’s about futile care, being resuscitated after something like a haemorrhagic stroke, shifting in and our of conciousness in ICU then properly carking it 3-7 days later, what was the point in resus apart from making onlookers feel better?
Or that their quality of life is so poor, or outlook so bleak, like a chronic pain sufferer or MND patient respectively, that to resuscitate them is almost an act of cruelty even if you return them to pre emergency health (if they expressed they didn’t want to be resuscitated).
Absolutely, I agree. In the situation I was involved in, had I succeeded in resuscitating my partner, all he would have had to look forward to was incredible pain and misery but it was still hard not to want to do something even knowing that. DNR is a wonderful way of having some control over what happens to you, it is only concerning that it will be ignored or obeyed at the wrong time. Having read some of your posts poikilotherm it sounds like you know what you are talking about and would have more knowledge of it than I. :)
That’s possible
Something like a medallion wouldn’t guide resus. We use three things to guide resus – discussion with patient and/or family, real documentation (eg paperwork) and medical futility. That’s all for in-patients.
If someone is 90 and from high level care and demented and gets angina on moving from wheelchair to bed and has metastatic cancer, they won’t get CPR, intubation, ICU etc.
If someone is younger (say up to 70) and previously completely well and there is no documentation saying otherwise, they’ll get the whole shebang.
The grey area is if you don’t fit either of those. Then it would depend on the three things that I mentioned. Default pathway is generally to attempt to resuscitate someone and then during the code there would be discussion between the team present, the treating consultant +/- the family (ie the 3am phonecall that you dread when a loved one is in hospital).
Documentation however can be in many ways. It can be hand-written on the transfer letter from a nursing home. It can be a formal document compiled with a lawyer. Or it can be me writing in an admission note – ‘discussion with patient and family, not for CPR / intubation / ICU’ which is followed until someone documents otherwise. We now have official resus plan pages for admissions, which get put at the very front of the patients chart, and is also included in the nursing hand-over notes.
The important thing to note in Australia is that no-one can demand resuscitation. This is where medical futility comes into play. The gaga 90 year old above won’t get CPR etc, regardless of the family’s wishes.
In an out-of-hospital arrest it’s completely different and you obviously can’t have formal guidelines – can’t tell Joe Blow what to do if he’s at the park and someone collapses. No-one in Australia has been successfully sued for attempting first aid, which includes CPR (Good Samaritan law).
I’ve heard stories of people who have a “DNR” tattooed across their chest.
Would a medico take any notice of that?
Probably not, in the absence of anything else. Could just be a drunken tattoo…
OCDC said:
Something like a medallion wouldn’t guide resus. We use three things to guide resus – discussion with patient and/or family, real documentation (eg paperwork) and medical futility. That’s all for in-patients.If someone is 90 and from high level care and demented and gets angina on moving from wheelchair to bed and has metastatic cancer, they won’t get CPR, intubation, ICU etc.
If someone is younger (say up to 70) and previously completely well and there is no documentation saying otherwise, they’ll get the whole shebang.
The grey area is if you don’t fit either of those. Then it would depend on the three things that I mentioned. Default pathway is generally to attempt to resuscitate someone and then during the code there would be discussion between the team present, the treating consultant +/- the family (ie the 3am phonecall that you dread when a loved one is in hospital).
Documentation however can be in many ways. It can be hand-written on the transfer letter from a nursing home. It can be a formal document compiled with a lawyer. Or it can be me writing in an admission note – ‘discussion with patient and family, not for CPR / intubation / ICU’ which is followed until someone documents otherwise. We now have official resus plan pages for admissions, which get put at the very front of the patients chart, and is also included in the nursing hand-over notes.
The important thing to note in Australia is that no-one can demand resuscitation. This is where medical futility comes into play. The gaga 90 year old above won’t get CPR etc, regardless of the family’s wishes.
In an out-of-hospital arrest it’s completely different and you obviously can’t have formal guidelines – can’t tell Joe Blow what to do if he’s at the park and someone collapses. No-one in Australia has been successfully sued for attempting first aid, which includes CPR (Good Samaritan law).
Thanks OCDC, it’s the out of hospital arrest I was thinking about, rather than the futile, in hospital one.
Divine Angel said:
poikilotherm said:
Divine Angel said:
I’d like to know why medical professionals are wearing DNR tags.
In many cases, the resus is futile but just part of the process…just prolongs, something, that isn’t ‘living’…
Oh right, I was thinking these were medicos wandering around, happy and healthily wearing DNR tags, not patients!
(I watch too much TV)
I still don’t understand.
Skeptic Pete said:
Divine Angel said:
poikilotherm said:In many cases, the resus is futile but just part of the process…just prolongs, something, that isn’t ‘living’…
Oh right, I was thinking these were medicos wandering around, happy and healthily wearing DNR tags, not patients!
(I watch too much TV)
I still don’t understand.
Skeptic Pete said:
Divine Angel said:
poikilotherm said:In many cases, the resus is futile but just part of the process…just prolongs, something, that isn’t ‘living’…
Oh right, I was thinking these were medicos wandering around, happy and healthily wearing DNR tags, not patients!
(I watch too much TV)
I still don’t understand.
+1
The OP was strange to start with, then it just got more confusing.
http://www.theage.com.au/world/paralysed-hunter-tim-bowers-chooses-to-turn-off-own-life-support-20131107-2×2jr.html
Can’t believe you just left me in a cave.
- Wait, doesn’t that say “DNR”? Wait … my mistake … “INRI”.
OCDC said:
Skeptic Pete said:
Divine Angel said:Oh right, I was thinking these were medicos wandering around, happy and healthily wearing DNR tags, not patients!
(I watch too much TV)
I still don’t understand.
From: bob(from black rock)
ID: 426270Subject: “Do not resuscitate”
I have heard that some medical professionals wear this on a medallion on a chain around their necks, if this is so what is the likely hood of this being adhered to?