DNR Status

[Medsport, LPN]

What is the difference between DNR arrest and DNR comfort care? I'm thinking the arrest means you only do CPR and the comfort care you do nothing correct? I work in a long care facility and even the nurse that's been there the longest (appr. 6 months) is'nt sure. thanks.

[Reno1978, BSN, RN]

I'm not sure what terminology your facility uses, but a DNR order typically means that no action would be taken in the case of respiratory or cardiac arrest. This doesn't mean that normal medical care will be withheld...the patient still receives full treatment until such an arrest. Comfort care is usually initiated when a patient is near death. It involves care that doesn't treat the disease (usually all medications are d/c), but instead provides comfort to the patient...for example, where I work in the ICU, we typically use fentanyl to keep dying patients comfortable and sometimes ativan.

[Katnip, RN]

You'll need to check your facility's policy on the definitions. If there isn't one, go to the DON and ask for one. It could cause problems if you don't know the dfference and you do the wrong thing.

[chare]

the dnr comfort care identification/order form identifies comfort care interventions that the healthcare provider will implement, and resuscitative interventions that the health care provider will not implement. these are applicable to all patients with a dnr cc order. the difference between the dnrcc and dnrcc - arrest is the time at which the dnrcc order becomes effective.

dnrcc: the dnrcc order becomes effective at the time the order is signed. from that point on (unless the patient rescinds the dnrcc) only those interventions identified as comfort care measures are to be initiated and/or maintained.

dnrcc - arrest: the dnr order/protocol is becomes effective in the event of a cardiac or respiratory arrest, at which time only those interventions identified as comfort care measures are to be maintained. prior to that time many of the interventions identified as resuscitative measures might be appropriate.

you might find the following links helpful as well:

ohio's dnr law - marietta memorial hospital

policy on do not resuscitate - cleveland clinic

i hope you find this information helpful.

[geekgolightly, BSN, RN]

Generally speaking it's what reno describes. DNR means no CPR. All other care is given. DNR and comfort care means no CPR and no medications other than that which may provide the patient comfort in their last hours or days of life. Pain medication, medication for secretions etc. etc.

[Whispera, MSN, RN]

If I was reading orders for what you wrote, this is what I'd think (both are rather too-shortened, but doctors do shorten things):

"DNR arrest" = do not resuscitate if the patient has a cardiac arrest

"DNR comfort" = do not resuscitate if the patient has a cardiac arrest but provide comfort care

When in doubt, you can surely ask the doctor to clarify!