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Lthcare Institution: I, the undersigned, attest that the above named person has a valid Do Not Resuscitate order which was written on: By , M.D. and is retained in this person s medical record at the above location. Signature of M.D. or R.N. Printed Name Dat.

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Related content

Forms - CT.gov
Connecticut State Department of Public Health. CT.gov Home ... "Do Not Resuscitate" (DNR)...
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(PDF) Development of a Statewide Protocol for the...
Major modifications included applicability of the Farmington, CT 06030-1930; bracelet...
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Locations | UL
Connecticut: 100 Corporate Drive Suite 120: Windsor: Connecticut, 06095: Telephone:...
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Did you know that there are two different types of DNR orders that can be chosen? The first is the DNR Comfort Care (DNRCC) and the other is the DNR Comfort Care- Arrest (DNRCC-Arrest).

Under the EMSA/CMA approved Prehospital DNR Form, do not resuscitate (DNR) means no chest compressions, defibrillation, endotracheal intubation, assisted ventilation, or cardiotonic drugs. 2. The patient should receive all other care not identified above for all other medical conditions ing to local protocols.

How a Patient Obtains a DNR Bracelet: A patient, or the patient's authorized representative, can obtain a DNR bracelet only by requesting one from the patient's personal physician, or the attending physician at the health care facility where the patient resides.

A physician may override a DNR if the patient's medical conditions have changed or believe that the DNR was made in error. Similarly, a patient may override the DNR if they believe it was written in error or they simply change their mind.

Bottom Line: Health care providers may be held liable if they fail to follow a patient's DNR or MOLST orders. To prevent this type of lawsuit, make sure your institution has training and procedures in place for handling DNR/MOLST orders.

DNR bracelets help show that a person has a valid DNR order. Before the patient gets a bracelet, the attending health care provider counsels either: The patient. The patient's legal guardian.

Generally, a DNR order should not be entered into the patient's medical record without concurrence of the parents. However, a DNR order may be entered by the patient's physician without parental permission if CPR is determined to be physiologically futile or non-therapeutic, in ance with Paragraphs E and F below.

A DNR order may be invalidated if the immediate cause of a respiratory or cardiac arrest is related to trauma or mechanical airway obstruction. b) Death has been declared by the patient's physician or the coroner.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232