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Some medical facilities apparently do not understand what a Do Not Resuscitate (DNR) form means. Make sure you and your family do and be a good patient advocate.

Most of us have seen television shows where almost every patient survives every imaginable scenario, sometimes after a few seconds of Cardiopulmonary Resuscitation (CPR). In reality, that just doesn’t happen. According to the American Heart Association (AHA), in 2020, there were 436,852 sudden cardiac arrest events with a survival rate of less than 10%. In 2021, the survival rate, meaning discharged from the hospital, was only 9.1% You can view the complete statistics from the AHA here.

Traumatic cardiac arrest (resulting from shootings, stabbings, car accidents, etc.) survival rates at one time were one tenth of one percent. With advancements such as EMS units carrying whole blood in the field, that number has risen to around 2% which is obviously still not that good.

As you can see, television is for dramatic effect and not a true representation of real life. That being the case, many people understand that resuscitation efforts are costly, time and manpower consuming and they simply do not want to go through that when their time comes. It may be because they have a chronic disease, they are concerned they may be resuscitated even though their brain has been without oxygen too long and they are alive but non-functional or they may simply feel as though they have lived a long enough life. Regardless of the reason, many talk to their healthcare provider and request a Do Not Resuscitate (DNR) form to be filled out so they are not subjected to the violence of CPR which is possibly futile in their situation anyway. Therein lies the problem. A DNR simply means what it says: Do Not Resuscitate. That means no CPR, no defibrillation, no tubes inserted in the airway or medication concoctions to stimulate the heart.

All of that sounds simple, right? Wrong. So many times patients that have valid DNR’s are left to suffer in hospitals and nursing homes simply because staff thinks a DNR means do nothing for the patient. That is not correct. Support therapy such as oxygen, pain relief medications and breathing treatments to name a few, are NOT restricted by a DNR because they are not resuscitative measures. Just because someone wants to die with their dignity intact by refusing advanced procedures does not mean they wish to suffer up to the point of cardiac arrest. You always must treat and comfort your patient up to the point of needing resuscitating. Manually opening an airway and providing oxygen is not an advanced procedure. A nebulizer treatment to ease the breathing of a patient with a DNR is providing care and comfort and within the acceptable scope of treatment.

As a family member or close friend, if you know someone in this situation, make sure someone is at that hospital as frequently as possible. Be a pain in the butt to make sure supportive care is provided and don’t let them convince you supportive care is covered by the DNR. ANYONE that goes into the hospital these days needs a patient advocate. It really is that important.

To those in the medical field, please treat your patient and don’t lean on the DNR to make your job easier.