Paramedics told: 'Let accident victims die if they want to' in new row over patient rights (UK)

UK Daily Mail ^ | 4/17/09 | Daniel Martin

[freekitty]

How crazy can people be?

[little jeremiah]

And how easy would it be to change the database without the person’s knowledge or consent??

[Polybius]

Is this not equivalent to a DNR? .... JoSixChip

Not really ~ an accident happens ~ someone is hurt ~ this particular order will cause a serious delay in assisting the injured because the bureaucrats want the first responders to call up and check the list first. .... muawiyah

Such systems have been around for years, right here in the U.S., and that's not the way it works.

After registering, if you do not want resuscitation, you MUST be wearing a DNR Bracelet to let the first responders know IMMEDIATELY what your wishes are.

You did not get a DNR Bracelet?

You get resuscitated.

You left you DNR Bracelet next to your toothbrush in the bathroom?

You get resuscitated.

Your DNR Bracelet got ripped off during the accident?

Sorry. Sh#t happens. You get resuscitated.

[Polybius]

Let's say an elderly person has a DNR due to a heart condition or something. They are walking down the street and get hit by a car and their leg is broken -- what then? Should they be left to suffer in agony with a broken leg? The trauma will surely kill them, but it will have NOTHING to do with the heart condition.

DNR means "Do Not Resucitate" as in "Her heart has stopped. Start CPR and call a Code Blue".

It does not mean "Do Not Remove from street".

Until her heart stops ..... on it's own, ...... you still have to treat them like any other live person. Them's the rules.

Monty Python: Not Dead Yet

[wagglebee]

You are correct and this is why this new policy is so dangerous.

[goat granny]

DNR are done everyday in hospitals in this country..My father signed one when he went into the hospital. Some hospitals use the term NO CODE and its written on the very front of the chart...patients choice, not government's or anyone else..

[Polybius]

I wonder how safe the online registry is.

As safe as FR is from anybody who wants to register for the first time.

Can someone go online and enter a DNR for somebody else without their knowledge?

Sure. That is why the registry means nothing in the field. Only the DNR Bracelet physically on the patient means something in the field. See Post 23.

You can register your mother-in-law and get her a DNR Bracelet.

The hard part is tricking her into wearing it without your wife killing you. ;-)

[The Great RJ]

I was a paramedic for many years and had on occasion to be called by the families of patients who were terminally ill. Our protocol was that if it was a 911 call we were obligated morally and legally to do everything possible no different than any other patient. However I did have one incident were a distraught family member called 911 when their terminally ill relative had cardiac arrest. We were met at the door by another family member who explained the situation and showed us a signed Do Not Resuscitate order. We canceled the call.

[wagglebee]

A heart attack victim with a legitimate DNR is TOTALLY DIFFERENT from an accident victim.

[Polybius]

You are correct and this is why this new policy is so dangerous.

Maybe you misunderstood my point.

My point is that "DNR" only means no "Resuscitation" after a respiratory or cardiac arrest.

"DNR" does not affect treatment short of respiratory and/or cardiac arrest.

An elderly patient with a broken leg and a DNR Bracelet will be treated just like any other patient ...... until her heart stops.

This policy has been in effect for years throughout the U.S.

If a mentally competent adult patient says, "No more!", the law says that you are required to back off. It's their body and it's their call.

How does an EMT know what "their call" is?

By seeing if the patient is wearing a DNR Bracelet. See Post 23.

Once a mentally competent adult patient has specifically communicated to you that you do NOT have permission to perform CPR or run a Code Blue on her or perform surgery on her or perform whatever else on her, treating that patient against their will is, legally, considered assault.

What if the patient changes her mind about DNR?

Simple.

Take the DNR Bracelet off.

Names on computer registries mean nothing. You only register to be issued an official DNR Bracelet.

Only an official DNR Bracelet physically on the patient means something. You are not wearing it - You get resuscitated.

After completing the Texas OOH DNR Order form, the patient may obtain, at the patient's expense, an optional means of identification. The OOH DNR ID device may only be obtained AFTER fully executing the Texas OOH DNR Order form. A recent amendment to 25 TAC 157.25 gives consumers greater choice in Texas OOH DNR identification devices by allowing more businesses to offer identification devices. The amendment now requires: ............ (1) An intact, unaltered, easily identifiable plastic identification OOH DNR bracelet, with the word "Texas" (or a representation of the geographical shape of Texas and the word "STOP" imposed over the shape) and the words "Do Not Resuscitate", shall be honored by qualified EMS personnel in lieu of an original OOH DNR Order form. ............ OR ........... (2) An intact, unaltered, easily identifiable metal bracelet or necklace inscribed with the words, "Texas Do Not Resuscitate - OOH" shall be honored by qualified EMS personnel in lieu of an OOH DNR Order form.

The field guidelines are strict.

"What if the bracelet is next to the patient and not ON the patient?"

Not valid.. The patient may have taken the bracelet off.

EMS personnel will honor either bracelet around the patient’s wrist as if it were a valid DNR Order Form. Do NOT honor a bracelet that is not attached to the patient. Do not remove the bracelet from the patient, even when the patient is deceased.

[muawiyah]

My coment was about the ambitions of the folks running the NHS in UK, not how our DNR system might work.

[Polybius]

My coment was about the ambitions of the folks running the NHS in UK, not how our DNR system might work.

In that case, you are absolutely correct since the socialized medicine bean-counters know that it costs much less to bury a DOA than to treat a still living patient.

[muawiyah]

And, they come up with new ideas for killing patients repeatedly. Must be a cottage industry in that sort of thing over there, or maybe their government paid nursing corps has attracted all the killer docs and killer nurses in the English speaking world.

[cycjec]

I don’t think so. Some frail sick ppl can defintely not
survive standard resuscitation. (The overuse of the DNR
and using it as a “DNT” Do Not Treat are other issues)
This is the equivalent of pressuring otherwise non
hospitalized persons to forego treatment in the broadest
terms. Would appreciate more from those with expertise.

[cycjec]

Yup there’s a definite possiblity of false registrations
seeing as it happens with DNR orders in hospitals. (The
first print reference that comes to mind is in the Jewish
Observer a few years back I don’t think it’s online)

[cycjec]

Julie Bailey had the right idea. IIRC Robert Mendelson
(Mendelsohn?) M.D. remarked years ago “A hospital is like
a war. Go in with as many allies as you can and get out
as soon as you can.” That’s from memory, might well not
be exact.
I must say I’ve had only excellent experiences in all
serious situation regarding my close kin.

[cycjec]

People named “Smith” or “Santos” etc. should be really
worried.

[wagglebee]

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