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 itâs 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 didnât cost me anything. (Its over $1,000 for an ambulance ride).
I told them Iâm good now and got a ride to the ER. Expensive stitches after waiting for hours. I shouldâve 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 youâre helping is absolutely bonkers.
âI SAVED YOUR LIFE !â
âYou ruined my deathâ
Incredible
First responder here. The DNR doesnât mean a damn thing until it is literally in your hands. Until that time you respond as though there is no DNR. If youâre wrong and they did have one but just didnât have it on hand then you accidentally save someones life, youâre 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 didnât act just because you were told there was one then you just killed someone and youâre 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 doesnât 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 canât just take your word for it; they need the document in hand.
The DNR doesnât mean a damn thing until it is literally in your hands.
How does the DNR get into the first responderâs 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 itâs better than the alternative.
For your second question, by legitimate I basically just mean that itâs 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 youâre 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, thatâs why you have a whole ambulance crew.
Not illegal, good samaritan laws protect you either way. However, there is a âduty to rescueâ 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.
So if your spouse is drowning and youâre not a good swimmer you have to go die with them or you get in trouble? Obviously if there is a flotation device youâd use that but what if there isnât like in a river or something?
If employers must rescue employees, shouldnât Amazon be in more trouble when they just leave corpses hanging around for days on end?
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.
i asked my first aid instructor about DNR and he responded with a very firm âyou didnât see itâ.
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 ainât 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 donât 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 Iâm doing CPR.
Source: A very old and happily retired medic
So did you see the things that guy on YouTube sees? https://youtube.com/shorts/PokQVSrPcR8
yeah that makes perfect sense.
non-medical professionals should not care about DNR orders, bracelets, whatevers. Because what if itâs fake and you canât tell the difference from a real one? You could, unknowingly, help someone commit a murder, or let a temporarily unstable person die, sure youâd be innocent, but guilt and trauma doesnât care about your innocence
And even then, itâs 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 didnât 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 couldnât even make the call, it could only be done by the medical facility. Iâm pretty sure thatâs 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 Iâm wrong. CPR anyone you see down!
My understanding was always that CPR isnât meant to revive someone its meant to keep them viable for revival by people with better training/equipment.
If youâre really good at CPR they often regain consciousness while you are doing chest compressions and complain. Every time you pause, they die again
That ainât âbeing really goodâ - Thatâs being stupidly lucky. I spent 20 years in the back of the bus, and I never had a revival on scene or in the rig. Nor did I ever meet anyone who ever made such a claim.
Quite often patients that are brought in with CPR in progress are called dead by the ER Doctor after another 20 or 30 minutes of effort or they do get a patient back and keep them going for another few days or a week or so. Only for the patient to finally die in hospital.
But, every so often someone surprises the hell out of us and actually survives and goes on to live for years. This is why we try as hard and as best we can to keep you alive. Because there is always a chance.
Yeah, basically youâre 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 isnât very important, though the initial check to make sure the airway is clear is very important. If youâre doing the chest compressions right, youâll 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 thatâs in the way. Even if youâre in good physical shape, it is an exhausting thing to do. Itâs definitely something worth learning to do correctly - take a class if you can! You can absolutely save someoneâs life if their heart stops.
The class with a mannequin is really important to experience firsthand. Like to see that you should really start calling the emergency services and put them on speaker after youâve assessed the situation and before you start CPR. And to know how hard you have to do it. It doesnât take incredible skill, the modern mannequins will rate your performance, as long as you go fast enough and donât stop itâs good. I was in shape at the time and I found it easy enough if you use your weight to help, I donât think I could keep going hard for more than five minutes though.
I did CPR training a while back, including AED use. It was fun - and sobering. The takeaway was basically: the odds of your victim surviving this is low, but any chance is better than no chance. They also drilled into us that good CPR will likely crack some ribs. Which is again preferable to, you know, being dead.
They also had us training on two mannequins. First one was the âniceâ dummy thatâs easy to compress and teaches good form. Then they switched it out for a âlifelikeâ dummy, which supposedly simulates the actual strength needed for good CPR. And man, thatâs a workout for sure. After performing five minutes of solo CPR on that bad boy, I was about ready to need that AED myself. Iâm quite a chunky individual, and even leveraging my body weight that took a bit of strength. We had a petite girl in our class who couldnât manage it.
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.