The E. Prior to issuing a Durable DNR Order, the ] physician shall explain to the patient or the person authorized to consent on the patient's behalf, the alternatives available , including issuance of a Durable DNR Order [ for response in the event of cardiac or respiratory arrest ]. If the option of a Durable DNR Order is agreed upon, the physician shall have the following responsibilities:.
Explain [ when ] the [ circumstances under which qualified health care personnel may follow a ] Durable DNR [ Form is valid Order ]. Obtain the signature of the patient or the person authorized to consent on the patient's behalf on all three forms [ , : ] the [ patients patient's ] copy, medical record copy, and the copy used for obtaining [ Alternate ] DNR [ Jewelry jewelry ].
Make sure that the [ issuing ] physician's name is clearly printed and the form is signed. The necklace or bracelet must contain the following information:. Qualified health care personnel shall comply with the following general procedures and published Virginia Durable DNR Order Implementation Protocols when caring for a patient who is in cardiac or respiratory arrest and who is known or suspected to have a Durable DNR Order in effect.
Initial assessment and intervention. If the patient is within a qualified health care facility [ or in transit between qualified health care facilities ] , any qualified health care personnel may honor [ a written physician's order that contains the items noted in 12VAC a do not resuscitate determination, signature and the date of issue, the signature of the patient or, if applicable, the person authorized to consent on the patient's behalf an Other DNR Order as set forth in 12VAC ].
Verify, through driver's license or other identification with photograph and signature or by positive identification by a family member or other person who knows the patient, that the patient in question is the one for whom the Durable DNR Order [ Form , Alternate DNR jewelry, ] or other Other DNR Order was issued.
Resuscitative measures to be withheld or withdrawn. In the event of cardiac or respiratory arrest of a patient with a valid Durable DNR Order [ Form ] , Alternate Durable DNR [ Jewelry jewelry ] , or Other DNR Order under the criteria set forth above in subsection B of this section , [ the following procedures should be withheld or withdrawn by ] qualified health care personnel [ shall withhold or withdraw cardiopulmonary resuscitation CPR ] unless otherwise directed by a physician physically present at the patient location [ :.
CPR shall include: ]. Endotracheal Intubation or other advanced airway management including supra-glottic devices such as the LMA, or other airway devices that pass beyond the oral pharynx, such as the Combi Tube, PTL etc.
Procedures to provide comfort care or to alleviate pain. Airway management excluding intubation or advanced , including positioning, nasal or pharyngeal airway management placement ;. If the patient is a minor or is otherwise incapable of making an informed decision, the expression of the desire that the patient be resuscitated by the person authorized to consent on the patient's behalf shall so revoke the qualified health care personnel's authority to follow a Durable DNR Order or other DNR Order If a patient is able to, and does, express to a health care provider or practitioner the desire to be resuscitated in the event of cardiac or respiratory arrest, such expression shall revoke the provider's or practitioner's authority to follow a Durable DNR Order or Other DNR Order.
In no case shall any person other than the patient have authority to revoke a Durable DNR Order or Other DNR Order executed upon the request of and with the consent of the patient himself. If the patient is a minor or is otherwise incapable of making an informed decision and the Durable DNR Order or Other DNR Order was issued upon the request and with the consent of the person authorized to consent on the patient's behalf, then the expression by said person to a health care provider or practitioner of the desire that the patient be resuscitated shall so revoke the provider's or practitioner's authority to follow a Durable DNR Order or Other DNR Order ].
The expression of such desire to be resuscitated prior to cardiac or respiratory arrest shall constitute revocation of the order; however, a new order may be issued upon consent of the patient or the person authorized to consent on the patient's behalf. The provisions of this section shall not authorize any qualified emergency medical services personnel or licensed health care provider or practitioner who is attending the patient at the time of cardiac or respiratory arrest to provide, continue, withhold or withdraw treatment if such provider or practitioner knows that taking such action is protested by the patient incapable of making an informed decision.
No person shall authorize providing, continuing, withholding or withdrawing treatment pursuant to this section that such person knows, or upon reasonable inquiry ought to know, is contrary to the religious beliefs or basic values of a patient incapable of making an informed decision or the wishes of such patient fairly expressed when the patient was capable of making an informed decision. When following a Durable DNR Order or [ other Other ] DNR Order for a particular patient [ admitted to a qualified health care facility ], qualified health care personnel shall document [ care rendered or withheld as required by facility policies and procedures.
Like a Do Not Resuscitate DNR order, the form tells emergency medical personnel and other health care providers whether or not to administer cardiopulmonary resuscitation CPR in the event of a medical emergency. An Advance Care Directive, is also called a living will. It lets people know your wishes with regards to your healthcare and treatment should you become seriously ill or injured and unable to make decisions yourself. A valid Advance Care Directive must be followed.
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