when to complete a DNR?

[Tybee]

i had to fact check myself as I could recall talking with my doctor recently about this.

https://pubmed.ncbi.nlm.nih.gov/2751179/

Wow, and by the way, hate the title (I'm 70): "Outcomes of cardiopulmonary resuscitation in the elderly

Patients: Five hundred and three consecutive patients aged 70 and over who received cardiopulmonary resuscitation.Measurements and main results: Of 503 patients, 112 (22%) survived initially but only 19 (3.8%) survived to hospital discharge. The poorest outcomes were for patients with unwitnessed arrests (1 of 116 survived), terminal arrhythmias such as asystole and electromechanical dissociation (1 of 237 survived), and patients with cardiopulmonary resuscitation lasting more than 15 minutes (1 of 360 survived). Only 2 (0.8%; CI, 0.0% to 2.0%) of 244 patients with out-of-hospital cardiopulmonary arrests left the hospital alive. "

Nonetheless, we've talked it over and decided to not fill out the DNR at this time, and reconsider later.

[rosarugosa]

I feel like these forms need to be reviewed and potentially updated often in our age group. I recently completed a MOLST form for myself, after some discussion with my sister. We agreed that my wishes at age 68 may very well be different at age 78, and also depending on my mental and physical health at that point in time.

[bae]

i had to fact check myself as I could recall talking with my doctor recently about this.

https://pubmed.ncbi.nlm.nih.gov/2751179/

Note that the actual situation, for out-of-hospital events, is considerably more nuanced than the numbers in that report.

As I mentioned above, my remote community has the highest survival rate in the country for those sorts of events. But not because we are lucky.

We have:

- a large portion of the civilian population trained well in CPR, and how to do team-CPR
- our fire/rescue/ems services here are world-leading in delivering high-performance CPR, to the point where we are often used as the testing ground for new protocols
- our 911-dispatch system is trained and practiced at delivering "CPR over the phone" - teaching a civilian over the phone how to do good CPR in real-time once they've called 911
- we have an incredible density of AEDs in the community
- we have a well-oiled system to air-evac patients to a higher level of care once they are stabilized enough to be flown. We can often get you to definite care *faster* if you drop on the street here, than if you did so in downtown Seattle.

It would be useful for you perhaps to investigate how your own community deals with these situations.

[Tybee]

Note that the actual situation, for out-of-hospital events, is considerably more nuanced than the numbers in that report.

As I mentioned above, my remote community has the highest survival rate in the country for those sorts of events. But not because we are lucky.

We have:

- a large portion of the civilian population trained well in CPR, and how to do team-CPR
- our fire/rescue/ems services here are world-leading in delivering high-performance CPR, to the point where we are often used as the testing ground for new protocols
- our 911-dispatch system is trained and practiced at delivering "CPR over the phone" - teaching a civilian over the phone how to do good CPR in real-time once they've called 911
- we have an incredible density of AEDs in the community
- we have a well-oiled system to air-evac patients to a higher level of care once they are stabilized enough to be flown. We can often get you to definite care *faster* if you drop on the street here, than if you did so in downtown Seattle.

It would be useful for you perhaps to investigate how your own community deals with these situations.

These are amazing facts! I particularly like the training of the 911 operators, such a brilliant idea.

[bae]

These are amazing facts! I particularly like the training of the 911 operators, such a brilliant idea.

911 operators are often the first First Responder :-). I've spent days over there watching their operations and training, it is a very cool profession.

Ours have saved lives just by walking people through what to do over the phone, before my Fire/Rescue agency even shows up on-site.

Much respect for them!!!

[pinkytoe]

My niece is a 911 operator. Loves her job but says there are long hours of boredom mixed with high stress situations where the caller is dependent on her instructions and calming efforts.