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Yesterday my aunt died at home unexpectedly. Her daughter found her not breathing, called my mom and 911. She had a DNR order. My mom was instructed to slide her off the chair and lie her flat on the floor and start CPR. Then when the paramedics arrived.....they HAD TO preform CPR for 20 minutes. Regardless of a DNR wish.<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> My aunt was only alone for about an hour (she had been out with her sister for the day) and I think probably passed away peacefully. But when the paramedics arrived....it was a circus of trying to revive her. It was very disturbing. That was not her wishes.<br><br>
Did anyone else know that the paramedics MUST preform CPR?<br><br>
Prehaps my mom shouldn't have called 911....but really didn't know who else to call.....
 

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Unless your mom told them, the dispatchers didn't know she was a DNR. So they just started with their protocol, which is CPR.<br><br>
In my experience and knowledge (I worked in the ER for close to 7 years), if CPR has already been started, the paramedics have to continue it. I'm not sure about an obligatory time limit. The medics had to either transport to the ER while continuing CPR or call the ER MD and let him/her give an order to stop on the scene.
 

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The trick with a DNR is you can't just tell them they have it - you have to provide it/show it to them as *soon* as they get their. Otherwise, they have to do cpr & other heroic life saving stuff... its the law. Cause' what if they really didn't have a dnr? They can't just take your word for it, they have to SEE it. Sorry your aunt had to go through that!!
 

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my son had minor surgery 2 wks ago and i learned that a DNR does not apply on the operating table.
 

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Here, once CPR is started it can't be stopped until they get to a hospital. I also think that if the medics are called, they <i>have</i> to perform at least CPR until the patient is transfered to the hospital and the patient is not breathing.<br><br>
In that case I would probably call her doctor first, if said doctor insisted on 911 I would likely just say "she's dead".
 

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<div>Originally Posted by <strong>MusicianDad</strong> <a href="/community/forum/post/15360915"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Here, once CPR is started it can't be stopped until they get to a hospital.</div>
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Yes, exactly. It can't be stopped without a doctor's order.
 

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My mom died at my house and she had a DNR however when she died we did not call 911- rather the funeral home as we were prepared for her to die. I suppose if 911 had be called, I would expect to show the DNR- how would they know? And I'm wondering why the relative started CPR if the DNR was known.
 

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Wow, I took care of my grandma before she died, and every time we had to call for an ambulance, they always asked, "Does she have a DNR?" and we'd hand them the folder. Even if they were just transporting her to the dr or the hospital, they'd ask for it just based on her age/condition.<br><br>
Now, I did find it weird that we had to call the Sheriff's office so they could come out and take a report since she died at home.
 

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My neighbor's son recently died at home and they were specifically told by the home care nurses not to call 911 if he was already dead. They would try to revive him no matter what, even with the dnr. Thankfully he passed peacefully in his sleep and they were able to call the nurse to come.
 

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In texas the rules are:<br><br>
Once CPR is started, the paramedics must continue until a doc pronounces them dead.<br><br>
A DNR must be provided in order for them to not do CPR, because DNRs can be modified to exclude certain procedures (i.e. it is OK to give meds but not chest compressions). They make DNR medic alert bracelets.<br><br>
Your DNR must be an Out of Hospital DNR (different from a hospital DNR), it requires your signature, and a doctor's signature.<br><br>
If you die, and have a DNR the family can just call the police. If the patient is enrolled in Hospice, you just call hospice.<br><br>
The DNR can be revoked at any time, without a doctors signature
 

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Paramedic here.<br><br>
Typically, one calls 911 in an EMERGENCY. We like to <span style="text-decoration:underline;">DO</span> things in an emergency, hence starting our CPR protocols. We paramedics love to be busy fixing things, like sudden death.<br><br>
However, in my region, we DO honour DNRs, provided that we see an original copy, signed by the doc and patient or power of attorney, that is less than a year old. Not a photocopy. Not an assurance that "it's here somewhere ... I thought it was beside the bed!"<br>
If there is even the tiniest doubt, we do CPR, run our full protocol and transport. We typically stop CPR after half an hour regardless.<br><br>
In the event of an expected death, it's probably better to call your family doctor who signed the original DNR and who knows the person's wish not to be resuscitated, or to follow the plan that you arranged as a family.<br><br>
We emergency types like to get all up in your business. Better to leave us out of it if you or your loved ones want a peaceful, at-home death. Rather like having a peaceful at-home birth. Better not to have us cowboys crash your party.<br><br>
I am sorry to hear about your auntie's passing, and that the events after were less that ideal.
 

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Mmmm... i'm agreeing with starling&diesel here- it's kind of like a home birth- if you don't want an intervention, don't make the call.<br><br>
I'm all for home birth and home death, but don't expect emergency paramedics to understand that (or even be legally able to recognise that) when you make the emergency call. They have a clearly defined role that should be understood.
 

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Discussion Starter #13
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<div>Originally Posted by <strong>alicia622</strong> <a href="/community/forum/post/15360980"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">My mom died at my house and she had a DNR however when she died we did not call 911- rather the funeral home as we were prepared for her to die. I suppose if 911 had be called, I would expect to show the DNR- how would they know? And I'm wondering why the relative started CPR if the DNR was known.</div>
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The relative (my mom) didn't completely do CPR, she could not lift my aunts body on to the floor. So she listened to instructions to keep the airway clear until paramedics got there. The 911 operator was quite insistant that my eldery mom lift her eldery sister onto the floor and lay her flat.
 

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<div>Originally Posted by <strong>aussiemum</strong> <a href="/community/forum/post/15362532"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Mmmm... i'm agreeing with starling&diesel here- it's kind of like a home birth- if you don't want an intervention, don't make the call.<br><br>
I'm all for home birth and home death, but don't expect emergency paramedics to understand that (or even be legally able to recognise that) when you make the emergency call. They have a clearly defined role that should be understood.</div>
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Yes, I totally understand that paperwork must be shown. Definitely.<br><br>
My aunt died suddenly and totally unexpectedly. But her wishes were DNR.<br><br>
My mom actually had to be helped by the paramedics because she was hyperventilating and passing out (the shock of finding her sister dead was too much for her).<br><br>
She wishes the papers were kept in a place that she could have remembered where it was in an emergency....like on the front of the fridge.<br><br>
I am not saying the paramedics weren't doing their job....they were. But.....if you know someone's wishes....please make sure the paper work is ready and available......<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad">
 

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<div>Originally Posted by <strong>starling&diesel</strong> <a href="/community/forum/post/15362238"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Paramedic here.<br><br>
Typically, one calls 911 in an EMERGENCY. We like to <span style="text-decoration:underline;">DO</span> things in an emergency, hence starting our CPR protocols. We paramedics love to be busy fixing things, like sudden death.<br><br>
However, in my region, we DO honour DNRs, provided that we see an original copy, signed by the doc and patient or power of attorney, that is less than a year old. Not a photocopy. Not an assurance that "it's here somewhere ... I thought it was beside the bed!"<br>
If there is even the tiniest doubt, we do CPR, run our full protocol and transport. We typically stop CPR after half an hour regardless.<br><br>
In the event of an expected death, it's probably better to call your family doctor who signed the original DNR and who knows the person's wish not to be resuscitated, or to follow the plan that you arranged as a family.<br><br>
We emergency types like to get all up in your business. Better to leave us out of it if you or your loved ones want a peaceful, at-home death. Rather like having a peaceful at-home birth. Better not to have us cowboys crash your party.<br><br>
I am sorry to hear about your auntie's passing, and that the events after were less that ideal.</div>
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I have a question....my aunt hadn't been breathing in almost an hour. Does a paramedic always have to preform CPR? Like....even if the person was dead for say....10 hours? I am just curious.....
 

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<div>Originally Posted by <strong>momtoS</strong> <a href="/community/forum/post/15362902"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">The 911 operator was quite insistant that my eldery mom lift her eldery sister onto the floor and lay her flat.</div>
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Oh dear! Bad call taker! The last thing we want is for your poor wee mom to get injured. So sorry that happened.<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>momtoS</strong> <a href="/community/forum/post/15362915"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">My mom actually had to be helped by the paramedics because she was hyperventilating and passing out (the shock of finding her sister dead was too much for her).<br><br>
She wishes the papers were kept in a place that she could have remembered where it was in an emergency....like on the front of the fridge.<br><br>
I am not saying the paramedics weren't doing their job....they were. But.....if you know someone's wishes....please make sure the paper work is ready and available......<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"></div>
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Again, your poor mom. How hard for her, all around.<br><br>
There's a pilot project happening in one of the cities near hear called the Vial of Life. A large pill bottle is kept in the inside of the fridge door, with all medication listed and any directives or levels of intervention. If only something like that were universal. I cannot tell you how many times we've started CPR while the family searches for the paperwork. So sad.<br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>momtoS</strong> <a href="/community/forum/post/15362917"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I have a question....my aunt hadn't been breathing in almost an hour. Does a paramedic always have to preform CPR? Like....even if the person was dead for say....10 hours? I am just curious.....</div>
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If the person is obviously dead (signs of rigor, lividity or blood congestion, decay of any kind, decapitation, bisection) we don't start CPR. If we knew for absolutely sure that she had not been breathing in over an hour, we wouldn't start CPR. But the protocols are different from region to region, which is frustrating when trying to make a plan for your family.<br><br>
I am so sorry that the system was such a gong show for your family, especially at such a hard time. My apologies on the behalf of over-eager, bumbling paramedics everywhere. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

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When my Grandma passed away, we all knew it was coming. It took a very long time and it was horrible. We kinda had hospice but not really, it sounds weird I know, they came out once and awhile to make sure everyone was ok, and they were available if we needed to talk or whatever.<br><br>
When she died, we called hospice, a nurse came out, called the sheriff and then the funeral home came and took her body.<br><br>
I am really sorry for your loss.
 

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momtoS, that sounds awful for your mom! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"><br><br>
I have heard of similar problems with 911 though - a friend who came home and found her boyfriend had hanged himself (I won't give the gory details but it was obvious that a few hours had passed.) She called 911 and the person on the phone wanted her to cut him down and start CPR.
 

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<div>Originally Posted by <strong>momtoS</strong> <a href="/community/forum/post/15362902"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">The relative (my mom) didn't completely do CPR, she could not lift my aunts body on to the floor. So she listened to instructions to keep the airway clear until paramedics got there. The 911 operator was quite insistant that my eldery mom lift her eldery sister onto the floor and lay her flat.</div>
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That must have been really difficult for your mom. I'm sorry for the loss of your aunt. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/candle.gif" style="border:0px solid;" title="Candle">:
 

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When my mom was dying the hospice nurse cautioned us not to call 911. At that time, in California, they would have been required to try to bring her back. It's hard. The laws are often not matched to the situations.<br><br>
I'm sorry for your loss and for the difficult situation.
 
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