No, a DNR does not mean “witholding care” such as antibiotics and fluids. It only applies to heroic measures such chest compressions, electrical defibrillation and mechanical respiration in case of cardiopulmonary arrest.
No, a DNR does not mean “witholding care” such as antibiotics and fluids. It only applies to heroic measures such chest compressions, electrical defibrillation and mechanical respiration in case of cardiopulmonary arrest.
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not anymore. and it means sedation unto death too.
It does mean withholding some treatments depending on the patient. I apologize for being unclear about that.
I”ve had attending physicians tell me that (for an elderly patient) IV fluids were “extraordinary”. I encouraged family to insist on continuing antibiotics for my FIL. The attending spent a fair amount of time telling us that treatment “would not prolong life”. The old guy lived for 2 more years after that.
Perhaps they would have been treated the same even with a DNR (they didn’t indicate that) but it can be an excuse to not treat.
Notice what happens in this report on hydomorphone fatalities -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378545/- “The discontinuation order for morphine was not transcribed and the patient was administered both the morphine and hydromorphone for 3 days. She was found unresponsive, with a low respiratory rate. The orders were then reviewed, and the error was detected. The opioids were held and opioid toxicity was treated with 1 dose of naloxone (0.2 mg intravenously). The patient’s vital signs normalized after the administration of naloxone. An hour later, the patient was found unresponsive with a low respiratory rate. because there was a “do not resuscitate” (DNR) order in place, no resuscitation was started. Opioid toxicity was deemed to have caused death.”
In this case the physicians seem to be using the regular definition of “resuscitate” i.e. to revive from unconciousness. They could have given her a second dose of naloxone but didn’t because of the DNR.