My soon to be hubby came home the other day with DNR tattooed midline center chest in 1 inch high black block letters. (I am totally serious!)
How would that be interperted in the event (god forbid!) that something really happened to him? He does not have an actual DNR order, and we have talked about wishes in the event of something terrible, but would EMS have to comply with his tattoo??
Hubby is a fireman/paramedic so he knows the consequences/outcomes of CPR and all, and I think this had lots to do with his decision to tattoo this, but I wish he had told me he was doing it :icon_roll
Having a DNR tatooed on your chest probably looks pretty cool, but it is about as useful as dudes who have "Organ Donor" listed on their driver's license. Unless the family gives final consent with sigs, Old man rivers' cant donate his favorite kidney or have the junior resident pop off the blower and let him meet Jesus if he is clinically brain dead.
I had a patient once in his 20's, who wrote DNR on his chest in black marker and then proceeded to OD on a bottle full of antihypertensives. He called to say goodbye to a family member who called EMS.
Luckily he arrived at the hospital prior to cardiac arrest, so it never became a code situation but he bought himself a ventilator and all the finest treatment that toxicology medicine has to offer.
Had he coded, he would have been treated as a full code, reguardless of the obvious wishes written out clearly on his chest. (We never made our suicide attempts a DNR).
We had a 74 y/o patient who had DNR tatooted on her left breast because her children would not agree to make her a DNR.
I run into this situation so often in Case Management. Since when do families get to decide if mom doesn't want to be resuscitated? Unfortunatly, too often, or at least when they can all agree. I carry Advanced Directive forms with me in my bag, and I discuss the issue with every patient I have. Most patients tell me they are afraid to discuss the issue with their children because the kids will not agree to what they want. It's not a matter of agreeing, it's a matter of finding a MPA designee who will have the backbone to carry out your wishes. Granted, many hospitals are reluctant to go up against family members if mom is unable to make a decision, but a well documented and executed Advanced Directive (on file with PCP) is becoming more accepted by hospitals as a legally binding document for them.
I suppose it *might* be helpful if, in smaller letters under DNR, his tattoo said:
"See legal paperwork, left upper drawer of desk in office on main floor of house on 1403 S. 18th St, XXXXX, NY. Note paperwork already on file at XXXX Hospital."
I can understand the sentiment, completely. I've often thought of that myself (tounge in cheek, mostly). I personally would NEVER honor a DNR tattoo, but if I assessed a pt and saw that on him, you can bet your sweet bum I would be triple checking all charts and with family members to look for his DNR paperwork, and if I couldn't find it I'd be getting with the social worker for a consult (ASAP if he was circling the drain).
this doesn't apply to patients but each person should decide while in good health what they want done to prolong life, organ harvesting
communicate your wishes to all of family, designate a person who will make hard decisions when you are not able , let them know of any health issues which would make organ harvesting undesirable
I got it after coding a 67 YOM, down for 17 minutes before CPR was started, by FD before I arrived. He was in a systole for 40 minutes. When we arrived at the ER, he had a pulse of 90 and a BP of 130 on a dopamine drip. Three hours later he was dead with bilateral chest tubes and multiple broken ribs. He should not have been worked. He was dead. Leave him alone.
IMHO, we work far to many codes. We treat our pets better than the elderly. Would you let your pet suffer for months or even years? How many people have you seen, that are full codes, that would literally break apart with the brutality of pointless CPR?
I have been in EMS for 12 years. I have coded more people than I care to remember. I am in VA, and my tattoo cannot be honored. However a DNR bracelet can be honored. How do you know it is my bracelet?
I plan to get a Doc to sign and date my tattoo on my 50th birthday. I have had several agree to do this.
I am serious about my tattoo. If you code me, I had better have full function or not enough function to call a lawyer.
I currently live in MD and you have to have a special bracelet and the paperwork to be DNR. My dad always threatened to get DNR tatooed on his chest and threatened to come back and haunt us if we coded him-LOL. He had asbestosis and knew once he was vented, he would never come off of it. (He lived in WVA)
RedCell
436 Posts
Having a DNR tatooed on your chest probably looks pretty cool, but it is about as useful as dudes who have "Organ Donor" listed on their driver's license. Unless the family gives final consent with sigs, Old man rivers' cant donate his favorite kidney or have the junior resident pop off the blower and let him meet Jesus if he is clinically brain dead.