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DNAR vs DNR

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I'm currently updating protocols for our first responders. I'm trying

to remain consistent with state statutes regarding 'DNR'. No where in

Texas Health & Safety Code can I find mention of 'DNAR'; only 'DNR'.

To better reflect state code, I feel that in protocols I should

reflect the term 'DNR' instead of 'DNAR'. Thought please...Mark.

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Correct me if I'm wrong, but I believe " DNAR " is " DO NOT ATTEMPT RESUSCITATION "

and is a term used overseas---- as in the UK.

Now, my question: If someone from another country produces a " DNR " from their

country,

in whatever language--- even if we can't interpret it in English, but a family

member tells us what it says, do we honor it?

OK, I'll call the ER DOC and ask him------ (I heard someone say that in the

background).

and

" DIPLOMATIC IMMUNITY " -------- ( I HEARD THAT ON LETHAL WEAPON- 2 ? )

All kidding aside.

Mark Sastre wrote:

I'm currently updating protocols for our first responders. I'm trying

to remain consistent with state statutes regarding 'DNR'. No where in

Texas Health & Safety Code can I find mention of 'DNAR'; only 'DNR'.

To better reflect state code, I feel that in protocols I should

reflect the term 'DNR' instead of 'DNAR'. Thought please...Mark.

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In a message dated 1/9/2007 7:54:26 P.M. Central Standard Time,

airmedic51@... writes:

Now, my question: If someone from another country produces a " DNR " from

their country,

in whatever language--- even if we can't interpret it in English, but a

family member tells us what it says, do we honor it?

My gut says nope. But it's been wrong a few times in life.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

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In a message dated 1/10/2007 11:30:05 AM Central Standard Time,

lnmolino@... writes:

In a message dated 1/9/2007 7:54:26 P.M. Central Standard Time,

_airmedic51@sbcglobaairme_ (mailto:airmedic51@...) writes:

Now, my question: If someone from another country produces a " DNR " from

their country,

in whatever language--- even if we can't interpret it in English, but a

family member tells us what it says, do we honor it?

My gut says nope. But it's been wrong a few times in life.

speaking as a medical control physician, if the family is telling me that

that patient has a terminal condition and that they have a valid DNR/DNAR in

hand, I'll feel obliged to honor it in the situation where the patient is

already clinically dead...It's when part of the family is insisting on 'doing

everything' in the face of an apparently valid Living Will/DNR that things get

sticky.

ck

S. Krin, DO FAAFP

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In a message dated 1/10/2007 12:04:09 P.M. Central Standard Time,

krin135@... writes:

speaking as a medical control physician,

Hey if I'm telling you this via OLMC and you say DNR so be that.

I was answering in the " field " no OLMC aspect.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

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In a message dated 1/10/2007 2:45:40 PM Central Standard Time,

lnmolino@... writes:

In a message dated 1/10/2007 12:04:09 P.M. Central Standard Time,

_krin135@..._ (mailto:krin135@...) writes:

speaking as a medical control physician,

Hey if I'm telling you this via OLMC and you say DNR so be that.

I was answering in the " field " no OLMC aspect.

Understood...what I was pointing out was that if the family is supporting

the DNR/DNAR form, then the chances of having a bad outcome, either medically or

legally, are very slim.

ck

S. Krin, DO FAAFP

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In a message dated 1/10/2007 3:33:34 P.M. Central Standard Time,

krin135@... writes:

then the chances of having a bad outcome, either medically or

legally, are very slim.

Well yea but the outcome of the patient with CPR in progress is a fairly

safe bet and it ain't good <VBG in a sarcastic way>.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

Buddhist philosopher at-large

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

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In a message dated 1/10/2007 4:07:05 PM Central Standard Time,

lnmolino@... writes:

In a message dated 1/10/2007 3:33:34 P.M. Central Standard Time,

_krin135@..._ (mailto:krin135@...) writes:

then the chances of having a bad outcome, either medically or

legally, are very slim.

Well yea but the outcome of the patient with CPR in progress is a fairly

safe bet and it ain't good <VBG in a sarcastic way>.

mmm...was thinking more on the order of having to explain to one half the

family why there is a rutabaga with a vent attached because the other half the

family insisted that dear 99 yo blind deaf and demented tube fed but breathing

on her own granny stopped breathing and got intubated...and now can't be

weaned off the vent without a court order....

ck

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In a message dated 1/10/2007 4:15:10 P.M. Central Standard Time,

krin135@... writes:

mmm...was thinking more on the order of having to explain to one half the

family why there is a rutabaga with a vent attached because the other half

the

family insisted that dear 99 yo blind deaf and demented tube fed but

breathing

on her own granny stopped breathing and got intubated...and now can't be

weaned off the vent without a court order....

Hence why I prefer EMS to MD level issues but I hear YA.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

Buddhist philosopher at-large

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

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We got a little off topic here.......Back to the original question

please.....I appreciate your feedback.

>

> I'm currently updating protocols for our first responders. I'm

trying

> to remain consistent with state statutes regarding 'DNR'. No where

in

> Texas Health & Safety Code can I find mention of 'DNAR';

only 'DNR'.

> To better reflect state code, I feel that in protocols I should

> reflect the term 'DNR' instead of 'DNAR'. Thought please...Mark.

>

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The very first out of hospital DNR was exactly what you were asking for.

Simply put a DNR order that applied to all reas up to an including a

hospital ED.

Rinard

ESTI WMD EMS Program Supervisor

(office)

(NEW CELL NUMBER)

(fax)

john.rinard@...

>>> " Mark Sastre " 01/13/07 6:00 PM >>>

We got a little off topic here.......Back to the original question

please.....I appreciate your feedback.

>

> I'm currently updating protocols for our first responders. I'm

trying

> to remain consistent with state statutes regarding 'DNR'. No where

in

> Texas Health & Safety Code can I find mention of 'DNAR';

only 'DNR'.

> To better reflect state code, I feel that in protocols I should

> reflect the term 'DNR' instead of 'DNAR'. Thought please...Mark.

>

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