Out of Hospital “No Code” Orders
In 1997, the State of Wisconsin passed a law which allows an adult (over 18) who is not in the hospital to have a Do Not Resuscitate bracelet. This bracelet tells emergency care providers (EMTs/paramedics/ER staff) not to do anything in the event your heart stops beating or you stop breathing.
What is Resuscitation?
When your heart or breathing stops, CPR (cardiopulmonary resuscitation) is started unless you have a DNR (Do Not Resuscitate) order. In the hospital, you may hear doctors and nurses call this a "code". Health care workers try to start the heart by doing chest compressions or using a defibrillator to shock your heart. They can put a tube down your throat to help you breathe.. They may put you on a breathing machine (a ventilator). IVs with life-saving drugs may also be started in your veins. All of these things are called cardiopulmonary resuscitation (CPR). If you do not want these things done to you in the community, you may ask your doctor for a Do Not Resuscitate (DNR) bracelet.
Who can have an Out of Hospital DNR bracelet?
By law, you can choose to wear a DNR bracelet if:
- You are an adult (18 years or older).
- You have a terminal disease.
- You and your doctor decide that CPR would not work in your case.
- You and your doctor decide that the pain and suffering of resuscitation/CPR would be greater than the benefits.
How do you get an Out of Hospital DNR bracelet?
Talk with your doctor, nurse or social worker. They will get you information you need to make the decision. You and your doctor will need to sign a form which allows the DNR order to take effect. You will then receive a bracelet which you must wear at all times.
What if I change my mind about having a DNR Order?
You have a right to cancel a DNR Order at any time. You can cancel the order by:
- Telling your care givers that you have changed your mind.
- Cutting the DNR bracelet off.
- Asking someone else to cut it off.
Does a Power of Attorney for Health Care affect Out of Hospital DNR Orders?
A Power of Attorney for Health Care can be helpful in guiding the care given to you when you are no longer able to make health care decisions for yourself. Your health care agent or guardian should know your wishes. You may want to put these wishes in writing in the Special Provisions section of the Wisconsin Power of Attorney for Healthcare form. Based on these, your activated health care agent or guardian can request or cancel an Out of Hospital DNR Order for you at any time.
What if my friends or family ask the emergency workers to resuscitate me?
If a patient is wearing a DNR bracelet, the EMTs and other emergency workers will not begin the code.
Will I receive pain medicine and other types of treatment if I have a DNR order?
Yes. Patients with DNR bracelets receive all other treatment. This includes pain relief and medicines as agreed upon by you and your doctor. A DNR bracelet does not affect other aspects of patient care.
Is the DNR bracelet valid in the hospital and in other states?
Out of Hospital DNR Orders are not automatically followed when you are in the hospital. If your wishes have not changed, your doctor may write a DNR Order for the time you spend in the hospital. Other states' emergency workers are not legally bound to forgo resuscitation of a patient wearing a Wisconsin DNR bracelet.
Who can I call with questions?
The UW Hospital Department of Patient Relations (608) 263-8009, your clinic, or your social worker.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/05/2010
Copyright © 08/05/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #5214
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