DNR/DNI Status

We have a dilemma at work... A pt has a DNR status... What do we do to him, should he stopped breathing? 'cause he didn't wish NOT to be intubated - hence, just DNR. Any inputs about this? Thanks!
Our hospital has a sort of "a-la-cart" DNR, they can choose to have pressors with no intubation or compressions, compressions only, etc. For plain DNR we would not attempt resuscitation if they stop breathing: just call family and make them aware of the change in condition and reconfirm DNR status (just to be sure), and ask that they come in asap.

Same here. Where I work, DNR includes DNI unless the pt has specified otherwise. If he wishes to be intubated, he should be a "no compressions," "intubation only," or something along those lines. But really, I would specify with the patient or family, if I were you.

if a form was signed, and I sure hope it was, it should clearly outline your position. Maybe the case managers need to educate the staff on the aspects of advance directives.

If he has a official DNR status, I'd do nothing but hang the crepe.

Intubate. No compressions though should it come to that.

DNR means do not resuscitate period.DNI means do not intubate so you get everything (meds, compression, etc) but no intubation.That's how it goes in my facility.

They won't breathe long without their heart beating.

If you have an issue deciding... review your facilities policy.If you continue to have issues... take it to the ethics board. Seems clear if the person did not want resuscitation, it would include no intubation.Sheesh.. can't believe there is STILL no clear cut across the board .. nation .. efffing .. wide...definitions .. as towhat all the end of life terminology means!

Quote from BlueDevil,DNPIf he has a official DNR status, I'd do nothing but hang the crepe.

Of course, it's entirely up to your facility's policies around resuscitation and intubation but in my book, intubation and mechanical ventilation for respiratory arrest are elements of resuscitation and therefore covered by his DNR (unless otherwise noted).I'm with BlueDevil... if the DNR is in place, let him be on about his business.

If they are a DNR and their heart stops of they stop breathing; we do NOTHING.. If they are a DNI, we do compression's and push drugs, we just don't intubate. The pts can state what they want and don't want.. I however love the ones that are DNR's; some can get crazy with DNR's. We have had some want use to push drugs but no compression's or any combo they can think of..

Quote from Been there,done thatWow , I thought I was a hard a**.However.. things change when you have to pull the plug on your own father.