EMT's (emergency medical technicians), provide rapid response and treatment to patients in cardiac arrest or with other life-threatening conditions. EMT's also transport seriously ill patients between nursing homes and hospitals. All patients are considered a Full Code (desire resuscitation and life prolonging interventions), unless the EMT's are given explicit information to the contrary. If during transport a patient requires heroic measures to save their life, it is the EMT's responsibility to perform basic and advanced life support procedures. Unfortunately, EMT's are often called for their transport services during an emergency and the patient generally doesn't have the ability to state their wishes. And many patients with advanced illnesses may not want all of the interventions offered by the EMT's.
Out-of-hospital do-not-resuscitate (DNR) orders have been developed to provide EMT's written orders regarding resuscitation. In general, out-of-hospital DNR policies specify circumstances under which EMS providers should withhold attempts at resuscitation for pulseless and apneic (breathless) patients. For example, Connecticut has a program using DNR bracelets. The program specifies that EMTs must honor these DNR orders and provides immunity from liability for honoring the order. A recent study found that 89% of a national sample of EMTs was willing to honor a state-approved DNR order.
Reference:
Schmidt, Terri, MD, MS, Susan Hickman, PhD, Susan Tolle, MD, and Heather Brooks, BS. "The Physician Orders for Life Sustaining Treatment Program: Oregon Emergency Medical Technicians' Practical Experiences and Attitudes." Journal of American Geriatrics Society 52 (2004): 1430-34.
Picture obtained at:
http://www.allposters.com/-sp/Emt-Posters_i914019_.htm
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