Advanced Life Support (ALS) Level 3 (VTQ)

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DNAR (Do Not Attempt Resuscitation): Legal and Ethical Considerations


Understanding the Significance of DNAR Orders

In specific cases where a patient's condition is deemed terminal or where resuscitation is unlikely to be beneficial, healthcare providers implement a legal document known as a DNAR (Do Not Attempt Resuscitation) order. DNAR orders are integral to pre-hospital care and are documented in a patient's medical records. These orders guide healthcare professionals in deciding whether or not to initiate CPR (Cardiopulmonary Resuscitation) in the event of cardiac arrest.

Key Points about DNAR Orders

When CPR May or May Not Be Administered

  • DNAR Content: The DNAR document specifies the patient's circumstances in which CPR should not be attempted.
  • Permissible Situations: If a cardiac arrest occurs due to a cause listed on the DNAR, healthcare professionals are legally allowed not to initiate CPR.
  • Unlisted Causes: If the cause of cardiac arrest is not listed on the DNAR (e.g., choking), healthcare providers are obligated to perform life-saving interventions.
  • Signature and Date: The DNAR must be signed and dated, and this verification must be witnessed by the healthcare practitioner at the time the decision is made not to commence CPR.

Legal and Ethical Considerations

Balancing Patient Wishes and Medical Judgment

The implementation of DNAR orders involves a delicate balance between respecting the patient's wishes, medical ethics, and the duty of care by healthcare professionals. These orders are legally binding documents that guide critical decisions in emergency situations, ensuring that patient autonomy and healthcare standards are upheld.