Question

You are on-scene with a 55-year-old cardiac history patient who suddenly collapsed during dinner with his family. He is found to be pulseless and apneic with his family performing adequate CPR on arrival. His wife is distraught and hands you a legal DNR order signed by his physician. She states that he does not have a terminal illness and begs you to ignore the legal order and "do everything in your capabilities to save him!"

Which of the following would be most appropriate in this situation?

A) Contact medical control, and open his airway while awaiting approval for resuscitation before initiating full resuscitation efforts
B) Take over CPR until you reach the ambulance, then stop all resuscitation efforts as per the legal order
C) Advise the family to stop CPR, and explain they cannot override the legal DNR order
D) Initiate full resuscitation efforts including advanced cardiac life support, and contact medical control

Answer 1

The most appropriate action in a situation where a patient has collapsed and there is a legal DNR order is to respect the order. However, if contested by the family, contacting medical control for guidance while providing basic support is advised until further direction is provided.

Step-by-step explanation:

The most appropriate action to take when encountering a patient with a Do Not Resuscitate (DNR) order would be to respect the legal DNR order. If the patient is confirmed to be pulseless and apneic, and there is a valid legal DNR signed by the physician, the orders within should be followed. However, the scenario described involves family members who are distraught and requesting that resuscitation efforts be ignored in favor of attempting resuscitation. In such a contentious situation, the best course of action may be to contact medical control for guidance while providing basic life support measures, such as opening the airway, until a decision is made by the appropriate legal and medical authorities. If medical control confirms that the DNR should be adhered to, then all resuscitation efforts should cease in accordance with the patient's wishes as legally documented in the DNR order.