If a person codes at Walmart..

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And they do not have their POLST form on them, will the EMS listen to the next of kin, say patient's spouse? If she knows the patient's wishes?

Specializes in Emergency & Trauma/Adult ICU.
I'm just a student, so I might be misunderstanding this completely.

If a person coded in front of me in Wal-Mart, I would immediately have someone call 911 while I began CPR.

Getting sued for this because the person is a DNR? I wouldn't know or think to check unless they had it tattooed on their forehead.

Is this not covered under the Good Samaritan Law?

Yes, it would likely be covered. Any litigation, even if attempted, likely wouldn't go very far.

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Paramedic here. It depends on the state and local protocols and medical director. When we have a patient in cardiopulmonary arrest in my system, we require proof to be with the patient in order to withhold resuscitation.

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Specializes in Hospice.
I would want the police to verify this. It is a strange world and this could just be a boyfriend or girlfriend posing as a spouse because they thought that is what your waated.

For those who haven't worked or at least not for very long in health care, you may not know all the drama and family skeletons which come out into the open during a crisis. Imagine all of your nastiest dark family secrets being tossed out at each other and all involved. Some want to keep Mom's SS check coming in. Some want the family house and all the jewels. Some just want Mom kept alive out of guilt. Some wish she was dead long ago and may even have been abusing her.

A signed paper helps but even with that you may still be witness to all the stuff which should be better left deep in a closet.

Agreed! Even in a hospital the family can over turn a DNR status if they are the POA and the patient is not in a legally sane frame of mind.

I had admitted a patient for COPD, he coded a few nights later and we had successfully resuscitated him. I called the wife to let her know and inform her he was being transferred to the ICU. She went CRAZY on me stating he had a signed DNR on his chart. Uhm, NO he didn't. Wife was screaming that he had signed it in ER, no record of it at all. Wife came in and signed a DNR form. The patient a few days later admitted to the doctor that he wanted to be a full code and that him and his wife had been having troubles at home for years.

:nailbiting:

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Specializes in HH, Peds, Rehab, Clinical.

Isn't that the whole purpose of wearing an identifying bracelet? Who carries around paperwork saying, "if I drop, let me lie there"?

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Specializes in HH, Peds, Rehab, Clinical.

And how is a well-meaning by-stander, volunteer EMT or career firefighter supposed to know that your wishes are to be left alone upon collapse in a public place? You expect them to search your person and belongings before beginning CPR? Honestly....

Yes, if they code me and I don't happen to have my POLST Form on me, then I will sue for assault and battery!! Do Not Resuscitate me under any circumstances. I worked 13 years in ICU I do not want to me coded.
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Specializes in HH, Peds, Rehab, Clinical.

No tattoos in some states for children. Even with parental consent/approval!!

Most states want a signed form. Anyone can get a DNR tatoo...even your child if old enough.

There are a couple of companies which do issue bracelets and have a copy of the DNR scannec. But this might take ahile to verify or have access for the download.

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Specializes in HH, Peds, Rehab, Clinical.

Do you have a POA or next of kin with you EVERY time you step outside of your home?

It is so very wrong for them not to listen to the next of kin who would make decisions if I were unable to make the decisions. Why wouldn't they listen to my next of kin if we happen to not have the POLST paper or MPOA papers with me? We always listened to the next of kin whenenver they were unable to make decisions in the old days. I just can't believe they would code me if my next of kin was telling them not to. Of course my family knows not to call 911 in the first place. But say one of my hospice patients is at Walmart and the doc still has not signed the DNR. Why can't the paramedics listen to the next of kin? Its so unfair to code someone who does not want to be coded.
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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

If a person drops dead at Walmart the emergency personnel are obligated by law to act in good faith and administer life saving measures available. EMS is not allowed/obligated to follow a DNR status (an in hospital form) unless an out of hospital "comfort care/DNR" is active.

Many states are instituting these out of hospital DNR/Medical Orders for Life Sustaining Treatment orders which there is an identifying bracelet/tag that is worn and must be on the patient at all times. Unless you get a MD to sign this when there is no life threatening/end of life issue...you are a full code unless signs of prolonged death (rigor) is present. Living wills are not recognized in al states and do not necessarily have to be followed in emergency out of hospital situations. MOLST and Comfort Care DNR Verification

Medical Orders for Life Sustaining Treatment (MOLST) and Comfort Care DNR Verification

The Massachusetts Medical Orders for Life Sustaining Treatment (MOLST) and Comfort Care/Do Not Resuscitate Order Verification (CC/DNR) forms are statewide standardized forms issued by the Massachusetts Department of Public Health, which patients and their health care providers can use to document the results of discussions they have had regarding appropriate life-sustaining treatment. These are the only documents that ambulance services and their EMTs and paramedics can immediately recognize and honor as an actionable order (in the case of MOLST) or verification of such an order (CC/DNR form) regarding the use or limitation of use of life-sustaining treatments for their patients. Massachusetts is currently transitioning to use of the MOLST form, but EMS personnel will continue to encounter patients with CC/DNR forms. At this time, patients may have either form, and as long as the form is current and valid, EMS personnel may honor either document.

So your next of kin can say you are a DNR until they are blue in the face (and they want your inheritance or don't like you) and your family can sue on your behalf but the law is on the EMS side.
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Specializes in Clinical Research, Outpt Women's Health.

I don't think the paramedics would have time to establish for certain that the person is legal next of kin and can be trusted to voice the victim's wishes. Family dynamics being what they are. It would be wrong to put them in that position. Carry the paperwork or deal with the consequences.

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Specializes in Hospital Education Coordinator.

tattoos is art, not a legal document. For all I know it is your SO's initials.

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Specializes in Emergency & Trauma/Adult ICU.

OP, if you as a long-time ICU nurse have never witnessed families overriding a patient's previously expressed wishes ... or family members disagreeing vehemently about code status, I'd be flabbergasted. In my experience it happens DAILY.

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Specializes in Med/Surg, Ortho, ASC.
OP, if you as a long-time ICU nurse have never witnessed families overriding a patient's previously expressed wishes ... or family members disagreeing vehemently about code status, I'd be flabbergasted. In my experience it happens DAILY.

I also was flabbergasted at OP's posts, and went back to read some of his/her other posts. He/she said they had "worked in ICU" so perhaps it was as a tech or CNA prior to becoming a nurse. I can't fathom any other reason for some of the expressed views. Even then, I would have imagined a greater understanding of DNR policies, etc.

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