Please don't tattoo 'DNR' on your body

[MillCreek]

https://gizmodo.com/unconscious-patient-with-do-not-resuscitate-tattoo-caus-1820881602

http://www.nejm.org/doi/full/10.1056/NEJMc1713344?af=R&rss=currentIssue

If this situation was presented to me, I would have done pretty much what the medical staff ended up doing: provide medical care until such time as we got more clarity on the wishes of the patient.  Given the legal and ethical requirements around DNR orders, I am not sure that a DNR tattoo, without other supporting documentation or next of kin, carries much weight.

[Firethorn]

I'm thinking that it darn well should.  Getting a tattoo is a big step forward from "merely" signing some papers.

If I change my mind, I'd get the tat altered.

[MillCreek]

I'm thinking that it darn well should.  Getting a tattoo is a big step forward from "merely" signing some papers.

If I change my mind, I'd get the tat altered.

If your tattoo has the necessary legal boilerplate and signature of witnesses as required by law, I would be happy to honor it.

[BobR]

My take is this type of tattoo is not done in jest. It took a conscious decision to put it on there. I would have argued to honor it and let him make the celestial transfer. I would bet one person planted the seed of doubt in the health care team and so they decided to take the safe approach and ignore his wishes.

bob

[Hawkmoon]

DNR = "Dead Right Now"

or "Do Not Return" (ro where? Dunno)

or "Down Right Nuts"

[dogmush]

My take is this type of tattoo is not done in jest. It took a conscious decision to put it on there. I would have argued to honor it and let him make the celestial transfer. I would bet one person planted the seed of doubt in the health care team and so they decided to take the safe approach and ignore his wishes.

bob

There's a link in that gizmodo article to a guy that did it in jest.  

Regardless of the patients earnestness, it doesn't fulfill the legal requirements to let yourself die.

As you all know, your life is not yours to take willy-nilly. It belongs to the state, and there are forms to be filled put before you can end it.

[Angel Eyes]

What if the patient has "Do Not Resuscitate" tattooed on his chest and "Please Resuscitate" tattooed on his back?   Does the hospital staff flip the body and see if it comes up heads or tails?

[BobR]

What if the patient has "Do Not Resuscitate" tattooed on his chest and "Please Resuscitate" tattooed on his back?   Does the hospital staff flip the body and see if it comes up heads or tails?

Would only assess the back in time to do anything if he were a trauma. Otherwise it might take a while to get there. 

"The assessment isn't complete until you roll the patient".*

*TNCC (Trauma Nursing Core Course) mantra you never forget.

bob

[Fly320s]

If your tattoo has the necessary legal boilerplate and signature of witnesses as required by law, I would be happy to honor it.

How many people carry copies of their standing DNR orders?  Unless the patient is known to the staff, and has a DNR order on record at the hospital, I doubt any medical staff would know about a DNR order.  Some random guy off the street with DNR on his chest seems to be a much more immediate and clear request than having a DNR order on file somewhere.

I know the staff and hospital will always cover their butts first, but that tattoo on the chest makes a good argument.  Even if the tattoo was a joke, the idea of "play stupid games, win stupid prizes" seems to apply.

[BlueStarLizzard]

How many people carry copies of their standing DNR orders?  Unless the patient is known to the staff, and has a DNR order on record at the hospital, I doubt any medical staff would know about a DNR order.  Some random guy off the street with DNR on his chest seems to be a much more immediate and clear request than having a DNR order on file somewhere.

I know the staff and hospital will always cover their butts first, but that tattoo on the chest makes a good argument.  Even if the tattoo was a joke, the idea of "play stupid games, win stupid prizes" seems to apply.

While I agree with the sentiment, I wouldn't want to be a part of the medical staff when that lawsuit came in.

[dogmush]

How many people carry copies of their standing DNR orders?  Unless the patient is known to the staff, and has a DNR order on record at the hospital, I doubt any medical staff would know about a DNR order.  Some random guy off the street with DNR on his chest seems to be a much more immediate and clear request than having a DNR order on file somewhere.

I know the staff and hospital will always cover their butts first, but that tattoo on the chest makes a good argument.  Even if the tattoo was a joke, the idea of "play stupid games, win stupid prizes" seems to apply.

In FL it's common to see DNR's posted in doors or Windows where responding paramedics will see them. My elderly ex-neighbor had hers posted in such a fashion, and it saved some time when they ambulance showed for the last time.

[Ben]

  Even if the tattoo was a joke, the idea of "play stupid games, win stupid prizes" seems to apply.

Except for the $10mil lawsuit filed by the grieving family with evidence of the images all over friendface stating it was a joke. I agree with the Darwinistic aspect if it was a joke, but I understand why a hospital wouldn't want to take the chance in a litigious society where you can get millions for tripping on a watermelon pallet.

It IS a very good point about "How many carry DNR paperwork?"  My paperwork is pretty much "just let me die", but how would a hospital know that if I were hit by a bus? Eventually they would find out, but not until they potentially put me through a bunch of painful "lifesaving" measures that had me looking like a Borg.

Edit: BSL and Dogmush touched on my points as a typed.

[MillCreek]

How many people carry copies of their standing DNR orders?  Unless the patient is known to the staff, and has a DNR order on record at the hospital, I doubt any medical staff would know about a DNR order.  Some random guy off the street with DNR on his chest seems to be a much more immediate and clear request than having a DNR order on file somewhere.

I know the staff and hospital will always cover their butts first, but that tattoo on the chest makes a good argument.  Even if the tattoo was a joke, the idea of "play stupid games, win stupid prizes" seems to apply.

Washington, and many other states, are very big on the POLST orders.

PS: I forgot to add that some forward-looking states are creating electronic POLST registries so we can look them up: http://www.orpolstregistry.org/  and http://www.caredirectives.org/

[freakazoid]

Can't imagine the backlash if they decided to follow a random tattoo and not resuscitate him, and then find out later it was just some joke tattoo.

[MillCreek]

Can't imagine the backlash if they decided to follow a random tattoo and not resuscitate him, and then find out later it was just some joke tattoo.

This is what I do for a living, and this is why I would not honor such a tattoo.

[Hawkmoon]

Washington, and many other states, are very big on the POLST orders.

POLST = ?

[MillCreek]

POLST = ?

http://polst.org/

[BobR]

http://polst.org/

We tell people with these to post them prominently on their refrigerator so EMS can find it and to also bring with them to any ER visit.

bob

[MillCreek]

^^^They are also often printed on neon-colored paper so as to be easy to spot.

[Firethorn]

Except for the $10mil lawsuit filed by the grieving family with evidence of the images all over friendface stating it was a joke. I agree with the Darwinistic aspect if it was a joke, but I understand why a hospital wouldn't want to take the chance in a litigious society where you can get millions for tripping on a watermelon pallet.

Of course, they can also sue for millions because you didn't honor their request.

You're screwed no matter what you do.

[freakazoid]

Of course, they can also sue for millions because you didn't honor their request.

You're screwed no matter what you do.

One of the choices can always be reversed. 

[Fly320s]

^^^They are also often printed on neon-colored paper so as to be easy to spot.

Are EMTs trained to look for those papers?  Or to look for DNR/MedAlert bracelets?

[BobR]

Are EMTs trained to look for those papers?  Or to look for DNR/MedAlert bracelets?

I know they are here in WA, as well as scooping up any medicine bottles they can find lying around.

bob

[MillCreek]

Are EMTs trained to look for those papers?  Or to look for DNR/MedAlert bracelets?

Yes to both.

[Scout26]

DNR = "Dead Right Now"

or "Do Not Return" (ro where? Dunno)

or "Down Right Nuts"

Department of Natural Resources