NREMT Paramedic Cognitive ExamOperationsMedium
A paramedic is called to the home of a 78-year-old female who has a 'Do Not Resuscitate' (DNR) order. The patient is pulseless and apneic. Her family states they want 'everything done.' What is the most appropriate action for the paramedic?
- AHonor the valid DNR order and provide comfort care.
- BAttempt to convince the family to adhere to the patient's wishes.
- CBegin full resuscitative efforts immediately as per family request.
- DContact medical control for guidance on the validity of the DNR.
Show answer & explanationAnswer & explanation
Correct answer: A. Honor the valid DNR order and provide comfort care.
A valid DNR order must be honored. While family wishes are important, the patient's documented wishes, when legally valid, take precedence. The role of the paramedic is to respect the patient's autonomy as expressed through the DNR.
Why the other options are wrong
- B. It is not the paramedic's role to persuade the family, but to calmly explain the DNR and provide comfort care.
- C. This would disregard the patient's valid legal document and violate ethical principles.
- D. Contacting medical control is appropriate if there is doubt about the DNR's validity, but if it is clearly valid, it should be honored.
Do Not Resuscitate (DNR) Order
A legal document or order signed by a patient or their legal proxy and a physician, instructing healthcare providers not to perform cardiopulmonary resuscitation (CPR) or other life-sustaining measures.
- Must be legally valid (signed, current, specific to the patient).
- Takes precedence over family wishes if valid.
- Paramedics must honor valid DNRs.
Memory trick: Patient's will, not family's thrill, keeps the legal bill still.