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About EMSTAR

Nonhospital DNR This bracelet spells it out
About DNR

DNR stands for "Do Not Resuscitate." A DNR order means that if cardiac arrest occurs - if your heart stops beating and you stop breathing - cardiopulmonary resuscitation (CPR) will not be performed to revive you. A consent to a DNR order, whether in a hospital or nonhospital setting, is a type of advance instruction you may give about your treatment. Any adult may request a DNR order.

When you are unable to decide about your own medical care, and have appointed a health care agent under the health care proxy law, that person should decide about CPR and other treatments for you. When you are sick and unable to tell your doctor that you want a DNR order written, but have not appointed a health care agent, a family member or close friend can decide about CPR for you under one of four special circumstances. A family member or someone close to you may consent to a DNR order only if TWO physicians determine that you are too ill to decide for yourself and one of the following circumstances exists:

• you are terminally ill with no hope of recovery;
• you are permanently unconscious;
• due to your medical condition, you would be harmed more than helped by CPR; or
• resuscitation would be medically futile.

You may ask your doctor to sign a New York State Department of Health Nonhospital Order Not To Resuscitate (form DOH-3474, PDF format). A Nonhospital Order Not to Resuscitate may be issued while you are hospitalized to take effect after your discharge. It may also be issued if you are not in a hospital. That means that at home, or elsewhere outside the hospital setting (including in an emergency room), emergency medical services personnel will NOT perform CPR on you. But they can't withhold CPR unless they are sure you have a valid DNR order.

Under state law, emergency medical services personnel who are presented with a valid DNR form, signed by your doctor, or who identify a standard DNR bracelet on you, must comply with the DNR order.

A DNR bracelet should bear the traditional medical symbol on the front and DO NOT RESUSCITATE in big block letters on the back. DNR bracelets alert emergency medical services personnel that a valid nonhospital DNR order is in effect. You can have a valid nonhospital DNR order without wearing a DNR bracelet - the bracelet is purely voluntary. Under the law, a bracelet may not be issued unless you first present the proper form, signed by your doctor.

DNR bracelets may be obtained from most companies that sell medical identification bracelets, provided they have a copy of your New York DNR form (DOH-3474) on file. Some bracelet sources include:

• Appomattox Drug Store, PO Box 489, Appomattox, VA 24522. Telephone 1-800-330-7225 ex. 102, or order on-line at http://www.diabeticdrugstore.com/dept.asp?dept_id=400
• Medic Alert Foundation International, Attn DNR, 2323 Colorado Avenue, Turlock, CA 95382 Phone: 1-888-633-4298, 3, 1 or ask for DNR. http://www.medicalert.org/Main/advancedirectives.aspx
• Medical Identification Jewelry (on-line orders only) at http://www.medicalidalertbracelet.com/product.asp?dept_id=401&sku=010-001&dnr=y or http://www.medicalidalertbracelet.com/default.asp

EMSTAR does not endorse any specific vendor.

A DNR bracelet may be worn only if you have been issued a valid Nonhospital Order Not to Resuscitate, signed by your doctor. Your doctor MUST use form DOH-3474.

You, or anyone who consents to a DNR order on your behalf, can remove the order by telling doctors, nurses or others about the decision. This need not be done in writing. Once informed of your wishes, your physician must record the DNR revocation in your chart, cancel the DNR order and make diligent efforts to retrieve all copies of your DNR form, as well as your DNR bracelet.

New York's Health Care Proxy Law allows you to appoint someone you trust - for example, a close friend or family member - to decide about your medical treatment if you lose the ability to decide for yourself. You can obtain a copy of the form at http://www.health.state.ny.us/nysdoh/hospital/healthcareproxy/intro.htm, and follow the links at the bottom of the page. This includes the instructions for completing the form.

0702
State of New York
Department of Health
11/94 Revised 6/04

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