Fun fact. I slashed my wrist with a broken bottle at a party once. Had someone call an ambulance. They said nothing major hit. Wrapped me up. Asked if I wanted a ride.
I said no cause it's dumb money. Then I asked how to pay them. They said they only charge for rides. It blew my mind. My potentially life saving call didn't cost me anything. (Its over $1,000 for an ambulance ride).
I told them I'm good now and got a ride to the ER. Expensive stitches after waiting for hours. I should've taken off the bandage and walked in dripping blood.
It blows my mind that calling an ambulance could ever cost money.
When you need an ambulance, seconds could mean the difference between life and death.
Putting a decision in front of it that could financially ruin you or the person you're helping is absolutely bonkers.
First responder here. The DNR doesn't mean a damn thing until it is literally in your hands. Until that time you respond as though there is no DNR. If you're wrong and they did have one but just didn't have it on hand then you accidentally save someones life, you're still legally in the clear, and I guess they can just die sometime later. But if the DNR turns out not to be real/legitimate and you didn't act just because you were told there was one then you just killed someone and you're completly fucked.
If you have a family member that has a DNR then be damn sure everyone knows where that thing is because unless you have it physically there when they are dieing then it doesn't mean anything.
Of course in places like nursing homes there is a different procedure. They know who has one on file and they will usually tell dispatch about it before the ambulance is even sent. But if it happens just in your home or someplace then the ambulance crew can't just take your word for it; they need the document in hand.
The DNR doesn’t mean a damn thing until it is literally in your hands.
How does the DNR get into the first responder's hand in practice? Do you get an emergency call and drive there as fast as you can through red lights with your siren on only to be greeted by a relative that made the call handing you the DNR document?
But if the DNR turns out not to be real/legitimate
Are you responsible for validating its legitimacy while in the field, when every second counts?
Sometimes, yes, many times a family member may call EMS to hand them the DNR, this ensures proper procedures are followed when dealing with the body, less mess, and a quicker certification of death. It may also be important in situations where the person is influencial or rich and ensures you cannot be accused of foul play.
No, DNRs have certain things that make them official, signatures and notarized markings. Usually one person will begin life saving measures while the ither verifies the DNR. EMS never work alone.
For the first question. The responders will act exactly as if there is no DNR until you give it to them. Yes, that sometimes means wasted effort but it's better than the alternative.
For your second question, by legitimate I basically just mean that it's not written in crayon on a piece of notebook paper or something. Generally speaking the forms are pretty standard and issued by the healthcare provider. Generally you're just looking for a physicians signature and a date. Some states also allow DNR medical jewelry. The exact specifics on the DNR do vary a lot based on state and county so the local responders will know what they need for their area. As far as every second counting goes, that's why you have a whole ambulance crew.
You've usually planned out the end with your partner/family/caretaker if you have a DNR and they would more than likely be ready to produce your DNR (and medical history) when you need to call an ambulance or go to a hospital for any reason.
Not illegal, good samaritan laws protect you either way. However, there is a “duty to rescue” if:
1: You created the hazard that lead the person into danger, you must provide rescue.
2: A special relationship exists. Spouses must rescue each other, parents must rescue children, employers must rescue employees, property owners to invitees but not trespassers.
3: In some jurisdictions you have a duty to notify, which is usually calling the police, but you do not have to take any measures to help them beyond that. Only 10 states require this and is never actually enforced.
No, courts have ruled the tattoo could mean anything, and you need to provide the documentation for it to count. The tattoo could lead to them looking for a DNR though.
And we are only bound by a DNR IF we have the actual document in hand. Or as EMS, if CPR has already been started when we arrive, we are automatically obligated to continue. If it ain't written down, it never happened. Nursing homes are supposed to provide the documents any time we transport such a patient as part of their medical history papers. And yes, we treat and transport a lot of such patients with a DNR that needs to go to a hospital for some reason.
Worst case scenario, entering a home with family gathered and grandma has a heart attack. And half the family wants me to start CPR and the other half tries to tell me grandma to let grandma go. I will ask them if they have the documents and they don't answer me because they are too busy fighting each other to respond to me. And my poor driver is trying to literally breakup a fight while I'm doing CPR.
non-medical professionals should not care about DNR orders, bracelets, whatevers. Because what if it's fake and you can't tell the difference from a real one? You could, unknowingly, help someone commit a murder, or let a temporarily unstable person die, sure you'd be innocent, but guilt and trauma doesn't care about your innocence
And even then, it's not a piece of paper that you can just accept like a death coupon. It has to be signed and not contentious, and things need to line up very correctly.
My Dad had a DNR in his legal name, but the nursing staff and his room all used the common shortening of that name. Because the names didn't line up when things went bad and there was no one with authority to clarify they, correctly, operated under the assumption that they did not have an order.
At one point EMS providers couldn't even make the call, it could only be done by the medical facility. I'm pretty sure that's no longer the case anywhere in the US though.
I was gonna call this cap because CPR that long after collapse has infinitesimally small odds, but I looked it up and turns out I'm wrong. CPR anyone you see down!
Yeah, basically you're trying to force some circulation through the brain by manually pumping the heart - which is as much about clearing the waste buildup out of the brain as it is getting fresh oxygen to the brain, and also about preventing clots (which will later cause aneurysms when the blood starts flowing normally). Everything else is essentially expendable/repairable/replaceable.
Even the breathing part isn't very important, though the initial check to make sure the airway is clear is very important. If you're doing the chest compressions right, you'll force some airflow through the lungs anyway. The important part is getting the blood to circulate. Having stagnant blood sitting in the brain is really bad.
The current CPR procedure recommends 100-120 chest compressions of at least 2" (5cm) per minute. You are going to hurt them. You may crack their ribs. You need to compress the heart through their ribs and muscle and other tissue that's in the way. Even if you're in good physical shape, it is an exhausting thing to do. It's definitely something worth learning to do correctly - take a class if you can! You can absolutely save someone's life if their heart stops.
Survival rates of a heart attack are upwards of 90% from what I can find online. There are certain types where the survival rate for that type alone is much lower though.
In cancer world this is why patients are instructed to print in large letters “AMBULANCE” on an envelope pasted to their fridge. It informs anyone coming to their house to not resuscitate . So likewise it Should be on neighbour to inform everyone of his DNR before calling a lawyer or laying any blame. You have no ability to see his chart as a bystander. He should own that. Nothing was stopping him from going around and informing his neighbours to not try to resuscitate if he expected any less. And that is on him.
Could have been worse. He could have been from a culture in which saving someone’s life means that you become responsible for them for the rest of their life. Then you’d have had to rig up some kind of situation in which he saves your life so you become even.
Couldn't find anything on "blood debt" or "life debt", with the closest being a reddit article that references a Kung-Fu movie in 70s that popularises the idea
DNR is more for unexpected death. Planned death, such as suicide (whether medically assisted or not), still requires a DNR.
The only way a DNR is applicable is if the party who is performing the life saving is aware of the order (generally medical professionals). Unless you have it tattooed on you or something, how could a random person know not to try to save your life.
If the green text in the OP is true, I have no idea what their lawyer was thinking. There's no way to win that argument.
By the time paramedics arrived, the patient was alive by way of this passerby resuscitating them already. Even if the paramedics were aware of the DNR, it no longer applies because the patient is alive. So reasonable measures to keep them alive are appropriate. As long as they don't flatline again, the paramedics are in the clear.
I'm any case, DNR has a place. Including for those that don't want to die, but understand the aftermath of CPR is pretty unpleasant (broken ribs, for a start). So rather than suffer through the recovery from CPR, they have a DNR, so that if they go, that's it.
They're not in pain, nor seeking death, they just don't want to suffer through the trauma and recovery of CPR and related procedures.
This is very separate from palliative care, though most of the time they overlap. Palliative care is basically comfort care for people near death. Often palliative patients have a DNR, but not always.
Additionally, on the subject of palliative care, anyone who is not of sound mind, cannot consent to medically assisted suicide, and nobody can consent for them. So in any case where there is a mental aspect, such as dimentia, Alzheimer's, etc, such procedures are impossible. Even a power of attorney cannot consent on their behalf, one of few things that a POA cannot do on the patients behalf.
Palliative care, DNR, and medically assisted suicide are all parts of the equation, all with different purposes, frequently related, and often are administered together.
Source: my father died in January of 2022. He long started his desire to not become a burden like his mother was (Alzheimer's). His most frequent statement on this was that if he were to go "that way" to simply "hand him a gun and he would take care of the rest". By the time my brother and I realized he had "gone that way", he was too far gone to be able to do that, and too far gone to pass the required psychiatric exam to be eligible for medical assistance in the matter. He had to be put in a care home and we quickly got him a DNR. He was in there for... I think 5+ years? Before passing away "naturally". For us, he died a long time prior to his body giving out, and we would visit his corpse in the nursing home from time to time.
Because you aren't allowed medically assisted suicide. The democratic government mandates a rough and tough death for you, because a merciful death is too awful for a fucking voter to think any more on than " Oh no, no death please. I don't want to talk about this anymore, go away or I call the police."
Life insurance might not pay out for suicides. If he has family or anyone else mentioned in his policy he may not want to jeopardise that. No idea if that applies to OP's neighbour, but it's one potential reason.
I have done CPR on people before, and it is astonishingly brutal. To do it correctly, you have to cave their sternum in to be able to apply enough pressure to the heart to actually move blood around. For "Out of Hospital Cardiac Arrest" patients that receive bystander CPR, the survival to discharge is around 10%, give or take. The most common outcome of CPR (if it is successful and you get a pulse back) is days to weeks of dying slowly and painfully in the ICU. The older someone is, or the more health problems they have, the much lower the chance of recovery is.
CPR is absolutely reasonable for a younger person that stands a good chance of walking out of the hospital at the end of it, but 90 pound 90-year-old is extremely unlikely to survive in a meaningful way. It is very reasonable to request to not be put through that massive amount of suffering for a very low chance of any meaningful benefit.
There's also degrees of DNR. There's separate options for CPR, intubation, supportive care, active treatment, palliative care, etc. It's a lot more nuanced than CPR yes/no in most situations.
Where's your tattoo that says you're an ignorant cunt?
EMTs and paramedics aren't allowed to acknowledge DNR tattoos, you literally have to file paperwork in your fucking county to have a signed, notarized DNR mean anything.
And they're still going to break every goddamn rib in your chest before they look up the paperwork
An honest, actual recovery with CPR is less than half of that 3% 'success' rate that gets bandied about. A true, 'this person actually healed up and had a life afterwards' recovery is less than half a percent.
It's freak accidents that happen to young people. Like 45 or younger.
Most people getting CPR are medically fragile already-hence the fucking heart stoppage-and foisting a chestful of broken ribs on top of whatever chronic ailments they already have does nothing but extend their suffering.
It’s on you for not telling anyone your intentions. Your decision. Your responsibility to make sure it’s adhered to. So start with informing people. Don’t get shocked that no one understands what you want without you telling them first. Own yourself.
And how, precisely, am I supposed to tell random fucking jackoffs like in the story?
None of you fucks even know what a DNR is, means, what it looks like, and not a single one of you cunts could be expected to uphold it even if you were told.
You don't get a special bracelet. This isn't the 'life alert' infomercial. Tattoos mean absolutely nothing to medical professionals.
You literally have to have a DNR on file, active, in your county of residence, and they have to look it up. Which will not happen until you're already admitted.
And if you get sent to a hospital in a different county? Because you're visiting family or something? You're fucked. You're on a machine, keeping you alive. As long as your shitty relatives feel like it.
I have no desire to die incoherent in a hospital with no concept of what's going on other than everything is uncomfortable. And with the united state's version of healthcare, I will have to make sure I die somewhere else.