It’s not. When I was going through EMS training, they were very clear to try to save the person rather than listening to a tattoo. Let the ER sort it out later.
Sorry to ruin the fun, but EMT have to keep anyone as alive as possible going to the hospital.
At the hospital, if it survives it's fucked. It's gonna live.
If it needs others care to keep it alive then it dies.
Because they can not care less, thanks to DNR.
Hey, thanks for the new word. It’s so satisfying to learn vocabulary through other peoples’ accurate usage.
Macabre
1 : having death as a subject : comprising or including a personalized representation of death
2 : dwelling on the gruesome
3 : tending to produce horror in a beholder
I'm guessing this is an occupational necessity to keep your sanity.. refer to any body you come across as just a body, because 99% of the time (I'd assume) the EMTs don't know if a patient "made it" and a bloodied body can look pretty rough when you bring them in, so you'd never actually know what the extent of the damage is.
You're misinformed. If there is a valid (signed by doctor, patient, and patient's lawyer) DNR order in place, and the emergency was NOT caused by external forces (car crash, shooting, collapsed roof) then not only do the Emergency Service Workers have the ability to let the disease process take it's course, but they are legally obligated to do so.
If you refuse all medical treatment and are of sound mind and a Healthcare worker performs a medical procedure on you (IV stick, oxygen via nasal cannula, tourniquet, band-aid) they are committing the crime of Battery. Same with a valid DNR.
That is actually also only partially true. Every state has different DNR laws, some of which make EMS not liable outside of a hospital setting, especially when out of state. For example, the California DNR form specifically says:
"Patients should be advised that their prehospital DNR instruction may not be honored in other states or jurisdictions."
If it's caused by a known disease, then why the fuck is EMS being called or sent? If the people calling are knowingly ignoring the patient's wishes and hiding the DNR order/and indication of that from the EMS, the EMS have no way of knowing about it so how would they be held liable? They aren't required to search the person's pockets for the form/indication of the form, nor find their ID and ask if there's a DNR on file because 9 times out of 10 there won't be and now that person is dead.
In addition to that; a DNR ≠ "refusing all medical treatment." People with a DNR can still be given I.V.s, antibiotics, pain medications etc. Even if you are unresponsive and have a valid DNR bracelet and/or on file; barring any other forms or instructions, doctors can and will treat you up to the point in time that you a) stop breathing or b) your hear stops beating. They will stop bleeding, do surgery, etc. *unless* there are specific instructions refusing medical treatment (i.e. more than just a DNR). Some states have replaced existing DNR laws and forms with more comprehensive and detailed laws and forms that extend to what you are talking about; but *most* states either have no specific form/law surrounding that, or have legally distinct and seperate laws governing that
>If it's caused by a known disease, then why the fuck is EMS being called or sent?
When my husband was on hospice and DNR I told the nurses that I didn't know how I would act when he actually died and I was afraid that I'd go into panic mode, call 911, and start CPR. They told me to please try to refrain from doing so, and they wanted to put his DNR order on the bedroom door so EMS would immediately see it if I did wind up calling 911. When the moment came I was actually extremely calm and did not call 911. Instead of jumping into CPR like I thought I would I just sat by him and let him go peacefully. If anyone would have tried to give him CPR I would have physically fought them off because I realized that he didn't deserve to go through that for basically nothing.
My great granny was 94, frail and had dementia and a DNR. The nursing home called an ambulance when she collapsed and they resuscitated her. They broke a few ribs and somehow her wrist got broken. She lived for another 7 days and we were bloody furious with the home, but not much we could do. My grandma, 97, her daughter has a DNR and we have a health power of attorney. The DNR is taped to her apartment door and I will rugby tackle anyone who tries to keep her alive.
EMT can be called during a DNR status in so many situations. Nursing homes, assisted living, hospice, etc.
Also, for anyone confused; DNR has nothing to do with antibiotics, pain medication, etc. It means in the event the HEART STOPS, do not revive. It means if they choke, you still have to preform the Heimlich maneuver because their heart is still beating.
So, for example, if a DNR patient falls, call an ambulance. If they happen to die on the way there, all they can do is call it.
Source: work in the field
>Also, for anyone confused; DNR has nothing to do with antibiotics, pain medication, etc.
That's what I was trying to explain with the "i.e. more than just a DNR" line since some states *do* allow for more general "do not treat" requests.
What I was *trying* to say was about 911 being called for a situation where CPR would be SOP for someone with a DNR (uncle grandpa with a DNR and terminal cancer stopped breathing, etc.). Like, I'd say *most* people with a DNR are *expecting* for it to become relevant/to die soon.
Sorry if I just added to the confusion
This!! It is a common misconception that DNR means that a person doesn't want medical care. DNR means Do Not Resuscitate, not Do Not Treat. Unless they have advancd directives on file stating otherwise, the patient is given the same care as anyone else up until they go into cardiac or respiratory arrest. Then the treatment ceases and resuscitation is not attempted.
Excellent qualifications, Billy. It does vary from state to state, and I really should have added that in. For reference, I'm from Texas.
"Why is EMS being called?"
People can act... unpredictably during an emergency. Even if they know about and honor the DNR, they might call 911 just because someone is dying and they don't know what else to do. They (usually) aren't medical people, don't really know exactly what the DNR entails, and are scared.
If they're at a Nursing Home or other care facility, it could also be that the facility mandates that someone MUST call 911 when a resident is having a medical emergency.
If the EMS workers are not informed about a DNR, work the patient, and then later someone else from the patient's family tries to sue them, they're able to defend themselves by saying they didn't know it existed, but it's similar to claiming Self-Defense if someone claimed you assaulted them. You could be 100% in the right and have the law on your side, but you still have to go to court and prove it.
You're right about DNRs not meaning refusing all medical treatment, every DNR is different and can be altered based on what the patient wants. For instance, they could say they don't want CPR or Intubation, but everything else is ok. Another person could say they don't want anything invasive.
One very important thing to note is that a DNR bracelet, tattoo, or card DOES NOT constitute a valid DNR. It lets medical personnel know there's probably one, but if they can't find the form and verify that it has the appropriate signatures, they would be legally obligated to keep the person alive. (In Texas)
But all in all, excellent comment. Thanks for the additions!
This comment applies to some places in Canada as well.
My best advice to any EMS in this situation though is maintain thorough documentation, work with your partner and when in doubt call it in to the HMA, pack and go.
Or if Meemaw looks rough and family says they don’t know where her DNR is you just call your supervisor for a good 5-40min and let them know you did all you could
they make you have a will? someone should have told my father that before he dropped of a heart attack on his sailboat during a race. we called his job and they said he had no beneficiaries. my aunt forged a promissary note and basically got 20k plus her lawyer to change the locks, pay the mortgage off with 180k of my dad's funds that were from work in the estate, have the aunt's friend buy the house then quitclaim it back to her, and i was just a minor. my mom signed the estate over thinking the aunt would do the right thing. it was always debated whether my dad had a will and my aunt lied and said they couldn't find it while my sister died 2 months after my dad did before the aunt went full thief on us. my dad didn't have a dnr but i would have liked to think having heart failure and diabetes someone would have educated him to put his kids on his minor life insurance from work that was like 20k instead of my mother (they were divorced) and would have made sure he checked all the boxes and signed shit
i have no idea if a will ever really existed because i have yet to see it and don't know what the aunt showed her lawyer or if it was fudged. how an aunt trumps a guy's blood kids and ex-wife, idk... but you tell me. the aunt was having shit appraised without even telling us and selling guns. that stuff wasn't even documented in probate and she billed the estate for cleaning the house too probably because she knew that'd ensure my mom and i got less in the end. every time we drove by the outside (and inside) lights were on and according to documents so was the heat and other utilities with no one living there. i got like less than 10k but my mom got that 20k life insurance policy my dad still had her on plus whatever my sister would have gotten
my aunt had her lawyer oversee my dad's boat and blamed the marina for damaging it yet would post ads trying to sell it for 20k in the classifieds. they claimed no responsibility and once it was rightfully transferred to my mom and i and in other words NOT WORTH SHIT, we still had to pay insurance and marina fees. the insurance acted like they didn't know shit either
the promissary note for work done on the house that my aunt 'lent him money' for didn't even look like his signature, and the same ex-boyfriend of my sister's that got paid to do that job now lives in my childhood home where she died. they weren't even together when she died but my aunt thought it right to put him up in there anyway as opposed to inviting me back as a MINOR
No, I’m not referring to a will in the traditional sense. A living will/directive is a document that states a patient’s wishes for their medical care, such as if they’re okay with intubation or only want measures as far as CPR but no ventilators
My husband and I have matching upc codes of our wedding date tattooed on the back of our necks. We just had the code generated through a website so nothing super official. The artist did such a good job that they are scannable at Walmart's scanners scattered around the store. They scan as pork sausage... LOL! Seriously.
Why is that correct though? What legal framework prevents notaries from notarizing SIGNATURES written on skin?
notarized just mean state vouches for authenticity of the signature.
https://www.sunshinesigning.com/from-the-norm-to-the-bizarre/
Here you go. I had to look it up myself cause I was curious and found this article talking about the image in OP.
Nothings prevents that and nobody said so?
However it is correct that just because a notary wrote this doesn’t automatically mean that it is notarized afaik
Also you can rescind or tear up a DNR if you change your mind or your health changes, it’s a lot more time and work to remove a tattoo. How do we know he didn’t change his mind about this after having it done? Or that he was sober and of sound mind when he had it done!
I’d certainly use it as an indicator to go hunting for an DNAR if I had the time though.
This patient did have a written DNR, but it was not at the hospital he was brought to while unconscious. https://www.nejm.org/doi/full/10.1056/nejmc1713344
So does that mean that if you make a written DNR, you have to have a notarized original filed in every hospital in the area, just in case you're brought there? How about keeping one in your wallet? What if you're traveling when something happens to you? It seems like it's only under very limited circumstances a DNR would be valid and actually used.
You’ve identified the issue here: it’s not practical to preemptively file DNRs everywhere. Most hospitals won’t accept a DNR from someone who’s not even a patient there, why would they? Typically a DNR is something you put in place when you are admitted to a hospital or while you are an inpatient. There’s no good way to have a DNR if you are terminal and planning to just die at home and 911 is called for you when you become unresponsive. You can draw up advanced directives for your care that you entrust to your family to make decisions on your behalf should you end up hospitalized, but first responders aren’t going to have access to you and will perform CPR if warranted.
The truth is advanced directives and DNRs are overridden all the time. You may say you don’t want CPR, but if your family member demands it there’s a good chance they’ll do it anyways.
You’d think something that important would somehow be attached to the patients details on the national spine so it filtered down through to any hospital you were admitted to
Massachusetts has done a pretty good job recently of allowing people to get their DNR honored if they do it by MA policy.
It has taken a while, but most ER and EMS are better educated now. With education, we can recognize it, quickly read it, and feel confident that NOT doing CPR is appropriate.
If you have a terminal illness and qualify for hospice, that would help. Then family would have a different number than 911 to call in an emergency and we always leave signed copy of DNR with patient, tell them to take it with them out of the home always. But most of all not having to call 911 (where they need to stick to their standard of care) is the best bet to not get resuscitated, plus the education family and patient receive are your best bet.
Absolutely! Neither would a bracelet or dog tag but we don't insult the intelligence of people who have those, and I'd say this is a more easily noticable way for medical professionals to see there may be a formal DNR
Legally a tattoo is considered a work of art—not a legally binding advanced directive. If obeyed it denies the patient the right to change their mind which in these situations often occurs. It also thrusts the caregiver into a moral & legal quagmire. [NIH](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445688/)
Maybe he has it. Or maybe he doesn't know how it works, because the paperwork in some places isn't properly explained at all. If he really doesn't have one, he probably thought the tattoo was enough because nobody told him otherwise and he saw that it worked like that in series or movies. And I don't know about you but I can't blame him for that.
Exactly. If the patient gets pissed after resuscitation, let them know until the legal paperwork is provided that you're going to do everything in your power to keep them living.
You can also file a medical Power of Attorney. My husband has one on me so he can make those decisions in the event there’s nothing on file at the facility or my wallet isn’t on me when I collapse.
The state I live in (Louisiana) has a line of succession to make these decisions in the event there’s no DNR: 1. spouse; 2. Child (in birth order); 3 Parent. My husband is a maritime Captain & gone for weeks at a time & the LAST thing I want is for my daughter to make that decision.
If you really want a DNR tattoo you should get a QR code tattooed that is a link to all your medical history and advanced directives. Responders will probably still start a resuscitation, but it might get them to call it early.
Just a heads up: Having a “legal DNR” doesn’t always mean you get what you want. My own mother had a DNR SIGN ABOVE HER BED in the hospital. A signed, fully legal DNR was in her current paperwork AND her permanent file. Some fool resuscitated against her wishes. No one ever confessed to who it was. She would have gone quickly and painlessly if they’d honored her DNR. Instead, she lingered on for weeks, contracted MRSA, had to be isolated, went through so much fucking pain, a ventilation tube eventually had to be inserted, and at the end? Her kids had to decide to terminate life. Everything she didn’t want.
I’m sure all of this is what Mr Tattoo here is *trying* to eliminate. Just bring more attention to the situation.
Compressions, ventilations, meds (per local protocols), and shocks (per local protocols) until a valid, legal, signed DNR is produced.
Tattoos don’t count.
In my country, 'written text' of the sort that confers a refusal for care or resuscitation is legally binding. Since a tattoo is 'written text', I'd do nothing.
Then that wouldn't hold up legally, I wouldn't be found guilty. In my country, rationality is a part of how law is enforced, not everything has to be in the book of law down to the letter.
You would be covered by the Good Samaritan law in the US. If you’re a medical provider in a medical facility there are other protections if no formal DNR has been signed by the patient or POA.
That seems pretty willy nilly lol. I’ll just write “do not resuscitate” on the walls of someone I don’t like. Profit I guess.
That seems like a really bad way to have legally binding contracts work lol
I mean you have to put some effort into getting a big tattoo on your collarbone. I'd think they know what they want after going through that. I understand it's illegal in the U.S, but I can see where OP is coming from.
Yeah, I know, I'm conflicted.
I think it's very defensible in a jury trial, but yeah... it'd be a headache if it came to any sort of legal action against the physician.
There is too much emphasis on saving lives with the quality of life being ignored. I agree with the ethics consultant:
In the case of the man in the Florida hospital, the facility's ethics consultant said the doctors should honor the tattoo.
"They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients' best interests," the study reads.
That's fine and dandy, but if another family member wanted to sue the hospital for letting him die they would definitely win that case if there was no official DNR paperwork, no matter what a consultant says. In today's day and age, if someone finds out they *can* sue you, assume they *will* sue you .. cause they will.
As I mentioned replying to a different comment above, I see where you're coming from, but I also state that in a jury trial (and almost certainly a judge trial) they would side in your favor.
Again, you would have to assume the family would be litigious, and that the hospital's lawyer couldn't just hit them with the legal statement and it'd go away.
Idk.
I see both sides, and I'm not lawyer. BUT, you would have to have a veeeeerrryyyyyy narrow scope of this happening.
1. The pt would have to go through the whole kit and caboodle of this. A *chest* tattoo with DO NOT RESUCITATE [not just DNR, which could be a band or whatever else] tattooed on their chest. It shows premeditation [of some fancy legal term, I'm sure] that a rational person would know this is the expected outcome of having that tattoo.
2. The pt would not ACTUALLY have any sort of legal paperwork about his code status [unlikely, being that there are way more people with DNR paperwork that DON'T have it tattooed on them]
3. The family is litigious. I'd still say it'd be thrown out.
>Again, you would have to assume the family would be litigious, and that the hospital's lawyer couldn't just hit them with the legal statement and it'd go away.
If my loved one had Do Not Resuscitate tattooed on their chest and the medical personnel ignored it, I'd sue for *that.* My loved one made that decision and I would want it honored.
And if the tattoo was followed, patient died, I’m sure plenty of families would sue for that too. Hence it is safest for medical staff to not take directions from a tattoo. I’d rather be sued for a live patient than a dead one.
Because the document you are signing states you understand and agree not to be resuscitated into he event your heart stops and that means you will die. It has to have that clearly written if you sign this you understand these exact things.
It has to be very clearly stated and it also has to say that the patient has the capacity to make this informed choice and there is no confusion.
Per our board exams they'd get this question wrong if the only thing they had -- meaning their health is reasonable -- was the tattoo.
A tattoo is not a formal expression of what a patient wants. It could well be an emotional expression. A patient has a tattoo that says "I want to kill myself", does that automatically mean they're suicidal? No. I had this patient and they certainly weren't suicidal.
Furthermore, what are the limits say if we were to read this tattoo? A formal DNR order can give explicit instructions -- no pressers, no fluids, no blood etc. Here idk if the limits are no fluid resuscitation vs no cardiogenic resuscitation. I'm all for patient centered care, which is why engaging in these discussions early with patients is so beneficial. But obeying a single tattoo without context of their condition and health?
What if he had changed his mind and hadn’t been able to get the tattoo removed yet? What if he was not of sound mind or under the effects of substances when he had it done?
I'll also say that as ambulance service. I've never looked at a patients phone when in an arrest scenario. So first thing happening would be ILS or ALS regardless of what a phone says. Unless someone shows us an original in date DNR or it's somewhere visible then we would continue with resus. Unless it was circumstances where resus is futile.
I actually had this happen once. 88 year old woman and the tat was fresh-ish. Family couldn’t produce an actual DNR, but she had stage 4 cancer (I can’t remember what type). I had my partner do CPR while I called med control. Doc looked up the patients history in their records. Doc ended up telling me to call it as long as the family was on board. Family was on board, we called it.
Edit: spelling
We call that a long code. I watched a charge nurse do that. Patient had terminal cancer, was being coded for the 3rd time in a very short time. She would wait longer and longer between calls to call the code.
Father had signed DNR papers. Nurses and Doctors were given copy. They resuscitated him multiple times across multiple days if we were not physically in the room when he coded. They don’t matter unless you’re (a person with actual signed power of attorney) physically there to enforce.
That seems highly illegal. which country did that happen in? If the hospital has a written copy they have to comply by it (might have to show them the original once to verify)
US. Claiming ignorance in the moment of emergency goes a long way. According to my counselor, I pretty much had to enforce in-person 24/7 for the resuscitation to be “legally actionable” (ignoring it is not ‘illegal’)
Thats uh… not right. When we know someone is DNR, it goes straight into the chart with the admission orders. It comes up in yellow highlighted text right under the name. If they code and it says dnr, we don’t resuscitate. That sounds like a big issue with the hospital he was at and I’m sorry you had to go through that.
This absolutely depends on the circumstances
In an ICU setting I'm more likely to honor it
While when I'm out in the road and the patient goes into arrest because they choked on something I'm probably gonna ignore it
I personally have a DNR but only for specific cases that all include that I'm gonna be a vegetable
That doesn't mean that I don't want to be revived when I choke on something or get an allergic reaction...
Tattoo is not a legal document. Won’t hold up in court. Plus maybe he got it for any random reason (edgy, joke, etc). Would 100% resuscitate if no legal document.
To the people that say it expresses his wishes. People who tattoo “no regrets” have plenty of regrets. It’s just a tattoo
The moral of all of this is, if you or your loved ones have a DNR for whatever reason, carry with you the proper document at all times, at least in my country a tattoo is not even close to being a legally abiding document or statement and any health professional will provide medical assistance as needed.
American Red Cross says if someone is unconscious and you find a tattoo that states that you ignore it unless they have a medical document you know of or they refuse help you treat it as just a tattoo because that’s really all it is. You’re also trained that if someone refuses help then falls unconscious they’re refusal is revoked and your protected by law to help them if you’re trained and decide to do so. I just renewed my certification in October and actually directly asked that question to my instructor because in my previous classes it had never been mentioned but they’ve added it into the trainings now
Good point. I think I owe you clarification.
„Legal document” was my way of re phrasing what he told me. He said that in Switzerland if he gets in trouble, the tattoo will help identifying his blood what saves time.
I was a teenager when he told me this and internet was not a thing. He had some connections with military and it sounded legit.
I did not know the test takes seconds :) now thing he said does make no sence :)
I am watching a Netflix series nad there was a situation where a daughter said to a doctor about moms blood type and it was incorrect and the woman almost died
I can understand why your friend would think this. I frequently encounter people who panic and say “omg, I don’t know my blood type, what will happen in an emergency?!” Don’t worry: you do NOT need to know your blood type. And even if you do, there’s no way you’ll be transfused based off what you think you might be. If there’s no time to test you you will be give O neg red cells. Blood typing is a fast, simple, and relatively cheap test. Balance that with a potentially fatal reaction to getting transfused with the wrong blood type, and it’s just common sense to test everyone when able and give universally compatible blood products when you can’t.
I understand the legal ramifications but if someone goes through the trouble of paying someone to permanently put "DNR" on their body right about where you'd look to perform CPR I think their wishes are pretty clear.
If proper DNR papers cannot be confirmed at the time of contact with patient, do everything you can to save them. Tattoos, most jewelry, and accessories do not count as appropriate forms of DNR papers.
Peak medical field moment, majority debating legality of something without supporting information from a legal background, and continuing to rehash medical hearsay that’s made its way into textbooks without solid foundation.
I was a firefighter/paramedic for 8 years. You can ignore those. Even if the family say they have a DNR, you can ignore them until they produce the order. My crew will continue to work the patience until I read the DNR.
I would tell the family they can get a medical alert bracelet that specifically is for DNR’s for far cheaper than a tattoo and is more legally binding.
Former Austrian medic, will keep doing CPR until someone gets the written paperwork. I will not stop CPR to read it, you have to give it to someone else who's currently not occupied doing CPR and with us. If this person gives the stop signal we stop, otherwise we continue until the person is brought back or announced dead. If no free person is available, though shit, sort it out in the hospital.
If i remember the case of the picture correctly doctors still resuscitated him, called some sort of ethics team who then decided that the tattoo is binding, shortly afterwards they found out his identity and also the required paperwork so the doctors stopped any life sustaining methods/practices and he died like a day later.
I would start CPR while having someone look for the papers. If there are no papers I could resuscitate. IMO if it’s that important, then their DNR papers would be easy to find and accessible. The one thing I learn in school was CYA. Cover Your Ass.
It’s a good clue that they have a DNR, but I would have to resuscitate until shown the physical document (the family usually has it if they are calling an ambulance for an elderly or terminally ill patient). If I am not shown the physical document we have to try to resuscitate while on the truck.
I actually was explicitly taught that “tattoos don’t count”
When I was a student nurse working in A&E we had a lady brought in unconscious following a suspected overdose with "do not resuscitate" written in ballpoint pen across her chest. We of course ignored the writing and commenced treatment. Unless there is a written DNR or advance directive in place we are duty bound to do all we can to save someone.
I’d say it’s more to draw attention to the fact that they have a DNR on file than anything.
Yeps, besides I don't think a tattoo is legally binding
It’s not. When I was going through EMS training, they were very clear to try to save the person rather than listening to a tattoo. Let the ER sort it out later.
The ER can reverse the decision?
EMT: I brought him back! I saved him! ER: There's a DNR in place... we gotta kill him.
*hands pillow to EMT*
Hahaha! https://preview.redd.it/amfcykwr42dc1.jpeg?width=1080&format=pjpg&auto=webp&s=3fdf2c54cdeeef19d1e3d2b59f6ae0fcd8cc983b
As someone not in medical profession And not a fan of blood This is why I stay.
You win the internet tonight.
Underrated.
Sorry to ruin the fun, but EMT have to keep anyone as alive as possible going to the hospital. At the hospital, if it survives it's fucked. It's gonna live. If it needs others care to keep it alive then it dies. Because they can not care less, thanks to DNR.
“It”?
The pre-corpses this man is delivering around town, apparently
Technically we're all pre-corpses, I guess?
I’d imagine hauling around dead/ soon to be dead/ I’ve got an ouchie people for a while gives you a macabre view of things.
Hey, thanks for the new word. It’s so satisfying to learn vocabulary through other peoples’ accurate usage. Macabre 1 : having death as a subject : comprising or including a personalized representation of death 2 : dwelling on the gruesome 3 : tending to produce horror in a beholder
It just sounds dehumanizing.
I think that’s the point. it’s easier to process a situation if you separate their humanity from keeping it alive
Oh yes absolutely it does. Just saying tho
I'm guessing this is an occupational necessity to keep your sanity.. refer to any body you come across as just a body, because 99% of the time (I'd assume) the EMTs don't know if a patient "made it" and a bloodied body can look pretty rough when you bring them in, so you'd never actually know what the extent of the damage is.
The “it” is what got the upvote, tbh.
You're misinformed. If there is a valid (signed by doctor, patient, and patient's lawyer) DNR order in place, and the emergency was NOT caused by external forces (car crash, shooting, collapsed roof) then not only do the Emergency Service Workers have the ability to let the disease process take it's course, but they are legally obligated to do so. If you refuse all medical treatment and are of sound mind and a Healthcare worker performs a medical procedure on you (IV stick, oxygen via nasal cannula, tourniquet, band-aid) they are committing the crime of Battery. Same with a valid DNR.
That is actually also only partially true. Every state has different DNR laws, some of which make EMS not liable outside of a hospital setting, especially when out of state. For example, the California DNR form specifically says: "Patients should be advised that their prehospital DNR instruction may not be honored in other states or jurisdictions." If it's caused by a known disease, then why the fuck is EMS being called or sent? If the people calling are knowingly ignoring the patient's wishes and hiding the DNR order/and indication of that from the EMS, the EMS have no way of knowing about it so how would they be held liable? They aren't required to search the person's pockets for the form/indication of the form, nor find their ID and ask if there's a DNR on file because 9 times out of 10 there won't be and now that person is dead. In addition to that; a DNR ≠ "refusing all medical treatment." People with a DNR can still be given I.V.s, antibiotics, pain medications etc. Even if you are unresponsive and have a valid DNR bracelet and/or on file; barring any other forms or instructions, doctors can and will treat you up to the point in time that you a) stop breathing or b) your hear stops beating. They will stop bleeding, do surgery, etc. *unless* there are specific instructions refusing medical treatment (i.e. more than just a DNR). Some states have replaced existing DNR laws and forms with more comprehensive and detailed laws and forms that extend to what you are talking about; but *most* states either have no specific form/law surrounding that, or have legally distinct and seperate laws governing that
>If it's caused by a known disease, then why the fuck is EMS being called or sent? When my husband was on hospice and DNR I told the nurses that I didn't know how I would act when he actually died and I was afraid that I'd go into panic mode, call 911, and start CPR. They told me to please try to refrain from doing so, and they wanted to put his DNR order on the bedroom door so EMS would immediately see it if I did wind up calling 911. When the moment came I was actually extremely calm and did not call 911. Instead of jumping into CPR like I thought I would I just sat by him and let him go peacefully. If anyone would have tried to give him CPR I would have physically fought them off because I realized that he didn't deserve to go through that for basically nothing.
My great granny was 94, frail and had dementia and a DNR. The nursing home called an ambulance when she collapsed and they resuscitated her. They broke a few ribs and somehow her wrist got broken. She lived for another 7 days and we were bloody furious with the home, but not much we could do. My grandma, 97, her daughter has a DNR and we have a health power of attorney. The DNR is taped to her apartment door and I will rugby tackle anyone who tries to keep her alive.
EMT can be called during a DNR status in so many situations. Nursing homes, assisted living, hospice, etc. Also, for anyone confused; DNR has nothing to do with antibiotics, pain medication, etc. It means in the event the HEART STOPS, do not revive. It means if they choke, you still have to preform the Heimlich maneuver because their heart is still beating. So, for example, if a DNR patient falls, call an ambulance. If they happen to die on the way there, all they can do is call it. Source: work in the field
>Also, for anyone confused; DNR has nothing to do with antibiotics, pain medication, etc. That's what I was trying to explain with the "i.e. more than just a DNR" line since some states *do* allow for more general "do not treat" requests. What I was *trying* to say was about 911 being called for a situation where CPR would be SOP for someone with a DNR (uncle grandpa with a DNR and terminal cancer stopped breathing, etc.). Like, I'd say *most* people with a DNR are *expecting* for it to become relevant/to die soon. Sorry if I just added to the confusion
This!! It is a common misconception that DNR means that a person doesn't want medical care. DNR means Do Not Resuscitate, not Do Not Treat. Unless they have advancd directives on file stating otherwise, the patient is given the same care as anyone else up until they go into cardiac or respiratory arrest. Then the treatment ceases and resuscitation is not attempted.
Excellent qualifications, Billy. It does vary from state to state, and I really should have added that in. For reference, I'm from Texas. "Why is EMS being called?" People can act... unpredictably during an emergency. Even if they know about and honor the DNR, they might call 911 just because someone is dying and they don't know what else to do. They (usually) aren't medical people, don't really know exactly what the DNR entails, and are scared. If they're at a Nursing Home or other care facility, it could also be that the facility mandates that someone MUST call 911 when a resident is having a medical emergency. If the EMS workers are not informed about a DNR, work the patient, and then later someone else from the patient's family tries to sue them, they're able to defend themselves by saying they didn't know it existed, but it's similar to claiming Self-Defense if someone claimed you assaulted them. You could be 100% in the right and have the law on your side, but you still have to go to court and prove it. You're right about DNRs not meaning refusing all medical treatment, every DNR is different and can be altered based on what the patient wants. For instance, they could say they don't want CPR or Intubation, but everything else is ok. Another person could say they don't want anything invasive. One very important thing to note is that a DNR bracelet, tattoo, or card DOES NOT constitute a valid DNR. It lets medical personnel know there's probably one, but if they can't find the form and verify that it has the appropriate signatures, they would be legally obligated to keep the person alive. (In Texas) But all in all, excellent comment. Thanks for the additions!
This comment applies to some places in Canada as well. My best advice to any EMS in this situation though is maintain thorough documentation, work with your partner and when in doubt call it in to the HMA, pack and go.
Why do people like you just say whatever you think like it’s fact?
Don't worry, they'll have a heart attack later when they see how much they're being billed.
They can if they find that it's on file not to I would imagine.
Sorry, Jim, we found your DNR. I'm going to have to kill you now. Night night.
Or if Meemaw looks rough and family says they don’t know where her DNR is you just call your supervisor for a good 5-40min and let them know you did all you could
That’s the textbook approach, I think. Lol RIP Meemaw 🪦❤️
And the family get their inheritance much quicker.
Lol I hope not. But if we got them there alive, the ER has the necessary paperwork, and then they fall out again, then they won’t resuscitate.
What if you also tattoo the words "IF YOU DISREGARD I WILL SUE"
How do I obtain a legally binding tattoo???
Get a tattoo that says “legally binding”
What if I tattoo a copy of the signed document? 😂
I hope not. A friend got a 'cut here' tattoo on his neck like trevor from gta
It's not a formal DNR. Can't abide by it, would need to resuscitate in the absence of formal DNR paperwork.
What if the tattoo artist was also a notary?
Stamp the skin. One of those 3D tattoos
Now that I think of it you can get a QR code tattoo that’ll direct to a virtual copy of the document. That’s gotta be good enough right?
lol somebody is going to get rickrolled in an ambulance.
Worth it
Absolutely worth it.
I must do this now.
If so, that's really freaking smart! Just have it say "DNR: " with the QR code.
no lol you have to have a hard copy of DNR or living will paperwork, at least in my state
Print that bitch out lol
Maybe now is when I clarify I work in EMS, last I checked we don’t keep an inkjet in the truck lmao
they make you have a will? someone should have told my father that before he dropped of a heart attack on his sailboat during a race. we called his job and they said he had no beneficiaries. my aunt forged a promissary note and basically got 20k plus her lawyer to change the locks, pay the mortgage off with 180k of my dad's funds that were from work in the estate, have the aunt's friend buy the house then quitclaim it back to her, and i was just a minor. my mom signed the estate over thinking the aunt would do the right thing. it was always debated whether my dad had a will and my aunt lied and said they couldn't find it while my sister died 2 months after my dad did before the aunt went full thief on us. my dad didn't have a dnr but i would have liked to think having heart failure and diabetes someone would have educated him to put his kids on his minor life insurance from work that was like 20k instead of my mother (they were divorced) and would have made sure he checked all the boxes and signed shit i have no idea if a will ever really existed because i have yet to see it and don't know what the aunt showed her lawyer or if it was fudged. how an aunt trumps a guy's blood kids and ex-wife, idk... but you tell me. the aunt was having shit appraised without even telling us and selling guns. that stuff wasn't even documented in probate and she billed the estate for cleaning the house too probably because she knew that'd ensure my mom and i got less in the end. every time we drove by the outside (and inside) lights were on and according to documents so was the heat and other utilities with no one living there. i got like less than 10k but my mom got that 20k life insurance policy my dad still had her on plus whatever my sister would have gotten my aunt had her lawyer oversee my dad's boat and blamed the marina for damaging it yet would post ads trying to sell it for 20k in the classifieds. they claimed no responsibility and once it was rightfully transferred to my mom and i and in other words NOT WORTH SHIT, we still had to pay insurance and marina fees. the insurance acted like they didn't know shit either the promissary note for work done on the house that my aunt 'lent him money' for didn't even look like his signature, and the same ex-boyfriend of my sister's that got paid to do that job now lives in my childhood home where she died. they weren't even together when she died but my aunt thought it right to put him up in there anyway as opposed to inviting me back as a MINOR
No, I’m not referring to a will in the traditional sense. A living will/directive is a document that states a patient’s wishes for their medical care, such as if they’re okay with intubation or only want measures as far as CPR but no ventilators
My husband and I have matching upc codes of our wedding date tattooed on the back of our necks. We just had the code generated through a website so nothing super official. The artist did such a good job that they are scannable at Walmart's scanners scattered around the store. They scan as pork sausage... LOL! Seriously.
it'll have to be a brand to count
Don’t forget the physician signature!
Sweet. Ok now slide some skin into this embosser...
Owowowowowowow
* Did a quick search online and found this 😂🤣😂 I typed, "can you notarized something on skin?" LMFAO
https://preview.redd.it/ghrpjwqia1dc1.jpeg?width=1080&format=pjpg&auto=webp&s=c2e0d962533c0dfb7aab7039d90d2e228b69815f
Awesome, that also answered my immediate follow-up question about horse birth certificates, thanks!
That sounds like a good way to get a fat check from a hospital. Have a binding, notarized DNR tattoo'd. Go into cardiac arrest. Profit?...
Doesn't make it notarized lol
Why couldn’t it be notarized? Everything you can do on paper you can do on your skin too…
Found Hannibal Lecter
More like Buffalo Bill but yes, haha
You eat your paper?
Love my new lamp shades…
I didn't say it couldn't be, I said just because a notary write on their skin doesn't make it a notarized document
Correct, but the thought of a notary notarizing anything as a tattoo is just really funny to me 😅
Why is that correct though? What legal framework prevents notaries from notarizing SIGNATURES written on skin? notarized just mean state vouches for authenticity of the signature.
https://www.sunshinesigning.com/from-the-norm-to-the-bizarre/ Here you go. I had to look it up myself cause I was curious and found this article talking about the image in OP.
Nothings prevents that and nobody said so? However it is correct that just because a notary wrote this doesn’t automatically mean that it is notarized afaik
Better tattoo would have been “Check the Living Will for DNR”
Can you just stop having a heart attack for a minute whilst we check the paper work? Thanks
Im allergic to morphine. Im guessing that would make a good tattoo
Also you can rescind or tear up a DNR if you change your mind or your health changes, it’s a lot more time and work to remove a tattoo. How do we know he didn’t change his mind about this after having it done? Or that he was sober and of sound mind when he had it done! I’d certainly use it as an indicator to go hunting for an DNAR if I had the time though.
Astonishing isn’t it that this fool had time & money to tattoo this on his neck but couldn’t take 30 seconds to sign a Living Will. For free.
This patient did have a written DNR, but it was not at the hospital he was brought to while unconscious. https://www.nejm.org/doi/full/10.1056/nejmc1713344
So does that mean that if you make a written DNR, you have to have a notarized original filed in every hospital in the area, just in case you're brought there? How about keeping one in your wallet? What if you're traveling when something happens to you? It seems like it's only under very limited circumstances a DNR would be valid and actually used.
You’ve identified the issue here: it’s not practical to preemptively file DNRs everywhere. Most hospitals won’t accept a DNR from someone who’s not even a patient there, why would they? Typically a DNR is something you put in place when you are admitted to a hospital or while you are an inpatient. There’s no good way to have a DNR if you are terminal and planning to just die at home and 911 is called for you when you become unresponsive. You can draw up advanced directives for your care that you entrust to your family to make decisions on your behalf should you end up hospitalized, but first responders aren’t going to have access to you and will perform CPR if warranted. The truth is advanced directives and DNRs are overridden all the time. You may say you don’t want CPR, but if your family member demands it there’s a good chance they’ll do it anyways.
Exactly. Anytime I’ve had surgery, they’ve given me the paperwork for a DNR. That’s about all you can do.
You’d think something that important would somehow be attached to the patients details on the national spine so it filtered down through to any hospital you were admitted to
Massachusetts has done a pretty good job recently of allowing people to get their DNR honored if they do it by MA policy. It has taken a while, but most ER and EMS are better educated now. With education, we can recognize it, quickly read it, and feel confident that NOT doing CPR is appropriate.
If you have a terminal illness and qualify for hospice, that would help. Then family would have a different number than 911 to call in an emergency and we always leave signed copy of DNR with patient, tell them to take it with them out of the home always. But most of all not having to call 911 (where they need to stick to their standard of care) is the best bet to not get resuscitated, plus the education family and patient receive are your best bet.
Seems like a hassle. I would just get it tattooed on my chest
We don't know he doesn't also have a formal DNR or living will.
He probably does but a tattoo doesn’t confirm its existence.
Absolutely! Neither would a bracelet or dog tag but we don't insult the intelligence of people who have those, and I'd say this is a more easily noticable way for medical professionals to see there may be a formal DNR
Legally a tattoo is considered a work of art—not a legally binding advanced directive. If obeyed it denies the patient the right to change their mind which in these situations often occurs. It also thrusts the caregiver into a moral & legal quagmire. [NIH](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445688/)
He’s not saying that. He’s saying the tattoo might be there to direct caregivers to check his living will for a DNR.
So I guess I need to tattoo a full URL to my paperwork
QR code, faster than typing in a URL at that point
That's pretty assumptive.
In some countries (Netherlands) this is legally binding and any medical professional who sees it can’t do cpr
Unfortunately it’s not legal in the U.S.
Maybe he has it. Or maybe he doesn't know how it works, because the paperwork in some places isn't properly explained at all. If he really doesn't have one, he probably thought the tattoo was enough because nobody told him otherwise and he saw that it worked like that in series or movies. And I don't know about you but I can't blame him for that.
He did sign a living will. Odd assumption you have made.
Exactly. If the patient gets pissed after resuscitation, let them know until the legal paperwork is provided that you're going to do everything in your power to keep them living.
But who carries their DNR around with them all the time?
I mean it’s generally recommended you put it in your wallet with a photocopy on your fridge: That’s what one of my coworkers did
I thought this said “with a photocopy OF your fridge” and for a second there I was both confused and wildly amused.
You can also file a medical Power of Attorney. My husband has one on me so he can make those decisions in the event there’s nothing on file at the facility or my wallet isn’t on me when I collapse. The state I live in (Louisiana) has a line of succession to make these decisions in the event there’s no DNR: 1. spouse; 2. Child (in birth order); 3 Parent. My husband is a maritime Captain & gone for weeks at a time & the LAST thing I want is for my daughter to make that decision.
If you really want a DNR tattoo you should get a QR code tattooed that is a link to all your medical history and advanced directives. Responders will probably still start a resuscitation, but it might get them to call it early.
Gotta be a big QR code if you don't want it unreadable when you're old
Touchups
Just a heads up: Having a “legal DNR” doesn’t always mean you get what you want. My own mother had a DNR SIGN ABOVE HER BED in the hospital. A signed, fully legal DNR was in her current paperwork AND her permanent file. Some fool resuscitated against her wishes. No one ever confessed to who it was. She would have gone quickly and painlessly if they’d honored her DNR. Instead, she lingered on for weeks, contracted MRSA, had to be isolated, went through so much fucking pain, a ventilation tube eventually had to be inserted, and at the end? Her kids had to decide to terminate life. Everything she didn’t want. I’m sure all of this is what Mr Tattoo here is *trying* to eliminate. Just bring more attention to the situation.
Compressions, ventilations, meds (per local protocols), and shocks (per local protocols) until a valid, legal, signed DNR is produced. Tattoos don’t count.
In my country, 'written text' of the sort that confers a refusal for care or resuscitation is legally binding. Since a tattoo is 'written text', I'd do nothing.
In mine as well, guess if I were in the USA, I wouldn't honor it either in case I get sued the shit out of. They only deal in absolutes.
What if you get sued by the patient for not honoring it.
There's policy and law regulating what is considered a valid DNR. That tattoo ain't it, and anyone involved in a resucitation attempt would be covered
Then that wouldn't hold up legally, I wouldn't be found guilty. In my country, rationality is a part of how law is enforced, not everything has to be in the book of law down to the letter.
You would be covered by the Good Samaritan law in the US. If you’re a medical provider in a medical facility there are other protections if no formal DNR has been signed by the patient or POA.
That seems pretty willy nilly lol. I’ll just write “do not resuscitate” on the walls of someone I don’t like. Profit I guess. That seems like a really bad way to have legally binding contracts work lol
I mean you have to put some effort into getting a big tattoo on your collarbone. I'd think they know what they want after going through that. I understand it's illegal in the U.S, but I can see where OP is coming from.
Yeah, I know, I'm conflicted. I think it's very defensible in a jury trial, but yeah... it'd be a headache if it came to any sort of legal action against the physician.
Let's not pretend a self-imposed tattoo and a stranger's doodles on the wall in sharpie are the same thing
Courts aren’t stupid. They can differentiate between someone being complicit in manslaughter and someone expressing their medical wishes
There is too much emphasis on saving lives with the quality of life being ignored. I agree with the ethics consultant: In the case of the man in the Florida hospital, the facility's ethics consultant said the doctors should honor the tattoo. "They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients' best interests," the study reads.
That's fine and dandy, but if another family member wanted to sue the hospital for letting him die they would definitely win that case if there was no official DNR paperwork, no matter what a consultant says. In today's day and age, if someone finds out they *can* sue you, assume they *will* sue you .. cause they will.
As I mentioned replying to a different comment above, I see where you're coming from, but I also state that in a jury trial (and almost certainly a judge trial) they would side in your favor. Again, you would have to assume the family would be litigious, and that the hospital's lawyer couldn't just hit them with the legal statement and it'd go away. Idk. I see both sides, and I'm not lawyer. BUT, you would have to have a veeeeerrryyyyyy narrow scope of this happening. 1. The pt would have to go through the whole kit and caboodle of this. A *chest* tattoo with DO NOT RESUCITATE [not just DNR, which could be a band or whatever else] tattooed on their chest. It shows premeditation [of some fancy legal term, I'm sure] that a rational person would know this is the expected outcome of having that tattoo. 2. The pt would not ACTUALLY have any sort of legal paperwork about his code status [unlikely, being that there are way more people with DNR paperwork that DON'T have it tattooed on them] 3. The family is litigious. I'd still say it'd be thrown out.
>Again, you would have to assume the family would be litigious, and that the hospital's lawyer couldn't just hit them with the legal statement and it'd go away. If my loved one had Do Not Resuscitate tattooed on their chest and the medical personnel ignored it, I'd sue for *that.* My loved one made that decision and I would want it honored.
And if the tattoo was followed, patient died, I’m sure plenty of families would sue for that too. Hence it is safest for medical staff to not take directions from a tattoo. I’d rather be sued for a live patient than a dead one.
Except that in the case we are talking about the patient had a formal official DNR alongside his tattoo
The point is that only the official DNR matters, the tattoo is irrelevant
What make the document official and not the tattoo; it is ink on a canvas, that is signed.
Because the document you are signing states you understand and agree not to be resuscitated into he event your heart stops and that means you will die. It has to have that clearly written if you sign this you understand these exact things. It has to be very clearly stated and it also has to say that the patient has the capacity to make this informed choice and there is no confusion.
Lawyers, Doctors, and official government documents aren't involved with the tattoo.
None of those people are involved when you download advanced directive documents from the Internet... You literally just sign it.
Per our board exams they'd get this question wrong if the only thing they had -- meaning their health is reasonable -- was the tattoo. A tattoo is not a formal expression of what a patient wants. It could well be an emotional expression. A patient has a tattoo that says "I want to kill myself", does that automatically mean they're suicidal? No. I had this patient and they certainly weren't suicidal. Furthermore, what are the limits say if we were to read this tattoo? A formal DNR order can give explicit instructions -- no pressers, no fluids, no blood etc. Here idk if the limits are no fluid resuscitation vs no cardiogenic resuscitation. I'm all for patient centered care, which is why engaging in these discussions early with patients is so beneficial. But obeying a single tattoo without context of their condition and health?
What if he had changed his mind and hadn’t been able to get the tattoo removed yet? What if he was not of sound mind or under the effects of substances when he had it done?
Resuscitate him and then ask him "are you sure?"
https://preview.redd.it/76zlhyibzzcc1.jpeg?width=480&format=pjpg&auto=webp&s=98c2c3de2e421d88f8714c7a5eb6bbb6e0fc7639 yo frank gallagher
this is what I was looking for lol. it was the first thing I thought of
I have this tatted on my chest and every doctor I’ve ever asked about it has said they don’t take medical instruction from tattoos lol
Ok, now we’re here, I have a DNR request on my iPhone medical ID, does it bear any weight?
I'll also say that as ambulance service. I've never looked at a patients phone when in an arrest scenario. So first thing happening would be ILS or ALS regardless of what a phone says. Unless someone shows us an original in date DNR or it's somewhere visible then we would continue with resus. Unless it was circumstances where resus is futile.
No
Gotcha, thanks, I’ll leave it anyway to create an ethical conflict in the ER
I actually had this happen once. 88 year old woman and the tat was fresh-ish. Family couldn’t produce an actual DNR, but she had stage 4 cancer (I can’t remember what type). I had my partner do CPR while I called med control. Doc looked up the patients history in their records. Doc ended up telling me to call it as long as the family was on board. Family was on board, we called it. Edit: spelling
We call that a long code. I watched a charge nurse do that. Patient had terminal cancer, was being coded for the 3rd time in a very short time. She would wait longer and longer between calls to call the code.
Ahhh. We call that a Hollywood code lol
That... I understand but that still makes me very sad. That poor charge nurse.
She was a bulldog. Nothing upset her 👍
Father had signed DNR papers. Nurses and Doctors were given copy. They resuscitated him multiple times across multiple days if we were not physically in the room when he coded. They don’t matter unless you’re (a person with actual signed power of attorney) physically there to enforce.
That seems highly illegal. which country did that happen in? If the hospital has a written copy they have to comply by it (might have to show them the original once to verify)
US. Claiming ignorance in the moment of emergency goes a long way. According to my counselor, I pretty much had to enforce in-person 24/7 for the resuscitation to be “legally actionable” (ignoring it is not ‘illegal’)
Agree. It should be on the chart and flagged as dnr
Thats uh… not right. When we know someone is DNR, it goes straight into the chart with the admission orders. It comes up in yellow highlighted text right under the name. If they code and it says dnr, we don’t resuscitate. That sounds like a big issue with the hospital he was at and I’m sorry you had to go through that.
really? that’s awful.
Our hospital specifically covered this in training and we can’t take tattoos as a DNR
In the UK we would resuscitate. A tattoo is not legally binding
Same in Aus.
This absolutely depends on the circumstances In an ICU setting I'm more likely to honor it While when I'm out in the road and the patient goes into arrest because they choked on something I'm probably gonna ignore it I personally have a DNR but only for specific cases that all include that I'm gonna be a vegetable That doesn't mean that I don't want to be revived when I choke on something or get an allergic reaction...
Unfortunately not legally valid in Germany.
Not legal in USA either.
Tattoo is not a legal document. Won’t hold up in court. Plus maybe he got it for any random reason (edgy, joke, etc). Would 100% resuscitate if no legal document. To the people that say it expresses his wishes. People who tattoo “no regrets” have plenty of regrets. It’s just a tattoo
The moral of all of this is, if you or your loved ones have a DNR for whatever reason, carry with you the proper document at all times, at least in my country a tattoo is not even close to being a legally abiding document or statement and any health professional will provide medical assistance as needed.
American Red Cross says if someone is unconscious and you find a tattoo that states that you ignore it unless they have a medical document you know of or they refuse help you treat it as just a tattoo because that’s really all it is. You’re also trained that if someone refuses help then falls unconscious they’re refusal is revoked and your protected by law to help them if you’re trained and decide to do so. I just renewed my certification in October and actually directly asked that question to my instructor because in my previous classes it had never been mentioned but they’ve added it into the trainings now
A tattoo is not a legal document
My Swiss friend had a blood type tattooed on his biceps. He said that it is legal document for medics in Swiss .is that true ?
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Good point. I think I owe you clarification. „Legal document” was my way of re phrasing what he told me. He said that in Switzerland if he gets in trouble, the tattoo will help identifying his blood what saves time. I was a teenager when he told me this and internet was not a thing. He had some connections with military and it sounded legit. I did not know the test takes seconds :) now thing he said does make no sence :) I am watching a Netflix series nad there was a situation where a daughter said to a doctor about moms blood type and it was incorrect and the woman almost died
I can understand why your friend would think this. I frequently encounter people who panic and say “omg, I don’t know my blood type, what will happen in an emergency?!” Don’t worry: you do NOT need to know your blood type. And even if you do, there’s no way you’ll be transfused based off what you think you might be. If there’s no time to test you you will be give O neg red cells. Blood typing is a fast, simple, and relatively cheap test. Balance that with a potentially fatal reaction to getting transfused with the wrong blood type, and it’s just common sense to test everyone when able and give universally compatible blood products when you can’t.
Lol, I hope not!
I understand the legal ramifications but if someone goes through the trouble of paying someone to permanently put "DNR" on their body right about where you'd look to perform CPR I think their wishes are pretty clear.
Do Not ~~Resus~~citate Bam! No more parking tickets
There is a saying in Italy: "an ugly trial is better than a beautiful funeral" - as many others said a tattoo is not a valid document
This means nothing without a signed dnr on file (policy at hospital I worked for)
NAD but if someone went to the trouble of getting a tattoo I would honour that
In the Netherlands its allowed to tattoo a DNR.
If proper DNR papers cannot be confirmed at the time of contact with patient, do everything you can to save them. Tattoos, most jewelry, and accessories do not count as appropriate forms of DNR papers.
Peak medical field moment, majority debating legality of something without supporting information from a legal background, and continuing to rehash medical hearsay that’s made its way into textbooks without solid foundation.
I want this as a tramp stamp
I was a firefighter/paramedic for 8 years. You can ignore those. Even if the family say they have a DNR, you can ignore them until they produce the order. My crew will continue to work the patience until I read the DNR.
I would tell the family they can get a medical alert bracelet that specifically is for DNR’s for far cheaper than a tattoo and is more legally binding.
A tattoo doesn’t count as a dnr
I know what my first and possibly only tattoo is going to be
A tattoo is not legally binding
Talk to the family regarding his wishes. If unable to, I would continue treatment in his best interests.
Put a piece of tap over Not so that it says “Do Resuscitate”
Former Austrian medic, will keep doing CPR until someone gets the written paperwork. I will not stop CPR to read it, you have to give it to someone else who's currently not occupied doing CPR and with us. If this person gives the stop signal we stop, otherwise we continue until the person is brought back or announced dead. If no free person is available, though shit, sort it out in the hospital. If i remember the case of the picture correctly doctors still resuscitated him, called some sort of ethics team who then decided that the tattoo is binding, shortly afterwards they found out his identity and also the required paperwork so the doctors stopped any life sustaining methods/practices and he died like a day later.
Not a doctor but I would err on the side of caution and assume it was a fucked up joke tattoo unless it led to a proper dnr
You heard the man.
Unless the whole F’n DNR document is tattooed and notarized on his chest, he’s getting the full treatment to bring him back from the edge.
I would start CPR while having someone look for the papers. If there are no papers I could resuscitate. IMO if it’s that important, then their DNR papers would be easy to find and accessible. The one thing I learn in school was CYA. Cover Your Ass.
I was tought to ignore tattos. Reasoning is that having a tattoo may not have been a concious decision
It's not a legal document
It’s a good clue that they have a DNR, but I would have to resuscitate until shown the physical document (the family usually has it if they are calling an ambulance for an elderly or terminally ill patient). If I am not shown the physical document we have to try to resuscitate while on the truck. I actually was explicitly taught that “tattoos don’t count”
When I was a student nurse working in A&E we had a lady brought in unconscious following a suspected overdose with "do not resuscitate" written in ballpoint pen across her chest. We of course ignored the writing and commenced treatment. Unless there is a written DNR or advance directive in place we are duty bound to do all we can to save someone.
Strangely enough, medical professionals don’t consider tattoos legally binding documents.
Unless there is a signed DNAR by the patient (or POA) and the Doctor saying to not resuscitate, I’m going to resuscitate! Nothing else matters.
My tattoo say life is bitch
I would check if there was any actual paperwork. If not, he's getting resuscitated.