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APPENDIX
OutofHospital DoNotResuscitate Protocol
I. Implementation
Any patient diagnosed with a terminal condition may initiate an OutofHospital
Donor Resuscitate Order. The original Texas OutofHospital
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How to fill out out-of-hospital do-not-resuscitate protocol
How to fill out out-of-hospital do-not-resuscitate protocol:
01
Obtain the appropriate forms from the relevant healthcare agency or organization responsible for managing do-not-resuscitate protocols. These forms may be available online or in physical copies.
02
Read the instructions carefully to understand the requirements and guidelines for filling out the protocol. This may include information on who can complete the form, any legal considerations, and specific sections to be filled out.
03
Provide the necessary personal and contact information. This typically includes the patient's name, date of birth, address, and emergency contact details. It's important to ensure accuracy in these details.
04
Indicate the healthcare professional or medical provider responsible for overseeing the do-not-resuscitate protocol. This could be the attending physician, healthcare proxy, or another authorized individual.
05
Specify the circumstances in which resuscitation would not be desired. This could include information about medical conditions in which resuscitation would be futile or not in line with the patient's wishes.
06
Sign and date the form. It may be required for both the patient and the healthcare professional overseeing the protocol to sign and date the document.
07
Submit the completed form to the appropriate healthcare agency or organization responsible for maintaining do-not-resuscitate protocols. Follow any additional instructions provided, such as making copies for personal records or notifying healthcare providers.
Who needs out-of-hospital do-not-resuscitate protocol:
01
Individuals with chronic or terminal illnesses who have made a considered decision with their healthcare providers to forego resuscitation efforts outside of a hospital setting.
02
Elderly individuals who may have expressed their preferences for end-of-life care and wish to have a do-not-resuscitate protocol in place.
03
Individuals with certain medical conditions that may make resuscitation ineffective or not aligned with their goals of care, such as advanced cancer or end-stage organ failure.
04
Patients who have discussed their preferences with their healthcare providers and have been deemed appropriate candidates for an out-of-hospital do-not-resuscitate protocol.
05
Anyone who wishes to ensure that their end-of-life wishes regarding resuscitation efforts are respected, even if they are not currently facing a life-threatening situation. It is advisable to consult with healthcare professionals or legal experts to understand the specific requirements and eligibility criteria for an out-of-hospital do-not-resuscitate protocol in a particular jurisdiction.
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