This pamphlet provides an overview on Do Not Resuscitate (DNI) orders. A comparison of DNI and DNR orders is included.
Indiana USLegal Pamphlet on Do Not Intubate - DNI
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US-PMPH-05
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FAQ
A Do Not Intubate order means that chest compressions and cardiac drugs may be used during a patient's care, but that no breathing tube will be placed within the patient.
DNR means that no CPR (chest compressions, cardiac drugs, or placement of a breathing tube) will be performed. A DNI or Do Not Intubate order means that chest compressions and cardiac drugs may be used, but no breathing tube will be placed.
DNI's only apply to situations where a patient has no pulse or is not breathing, but they do not restrict any other clinically indicated care. There does not need to be a formal advance directive or living will to have DNR and DNI orders in place.
Conclusions: Conflation of DNR and DNI into DNR/DNI does not reliably distinguish patients who refuse or accept intubation for indications other than cardiac arrest, and thus may inappropriately deny desired intubation for those who would accept it, and inappropriately impose intubation on patients who would not.
A patient has the option to be Full Code, DNR (Do Not Resuscitate), DNI (Do Not Intubate) or both DNR and DNI.
A natural reaction to medicine's use of CPR and MV was the advent of advance directives and more specific Do-Not-Resuscitate (DNR) and Do-Not-Intubate (DNI) orders meant to protect a patient's ability to remain autonomous with their end of life decisions. 1.
During CPR, airway interventions range from compression-only CPR with or without airway opening, mouth-to-mouth ventilation, mouth-to-mask ventilation, bag-mask ventilation (with or without an oropharyngeal airway) or advanced airways (supraglottic airways (SGAs) and tracheal intubation using direct or video
DNR means that no CPR (chest compressions, cardiac drugs, or placement of a breathing tube) will be performed. A DNI or Do Not Intubate order means that chest compressions and cardiac drugs may be used, but no breathing tube will be placed.
It is an emergency rescue technique that was developed to save the life of people who are generally in good health. NOTE: If you do not have a DNR orders, health care providers will begin CPR in an emergency.