This pamphlet provides an overview on Do Not Resuscitate (DNI) orders. A comparison of DNI and DNR orders is included.
Massachusetts 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. Intubation involves a doctor inserting a flexible plastic tube through the nose or mouth into the trachea (windpipe) to help with breathing.
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.
When you request a Do Not Resuscitate (DNR) order, your doctor may ask you whether or not you also want a Do Not Intubate (DNI) order. The two are separate because you can have trouble breathing before your heartbeat or breathing stops. If your breathing problems continue, your heart or lungs may go into full arrest.
Do not resuscitate order They do this with cardiopulmonary resuscitation (CPR). A DNR is a request not to have CPR if your heart stops or if you stop breathing. You can use an advance directive form or tell your doctor that you don't want to be resuscitated. Your doctor will put the DNR order in your medical chart.
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.
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.
Choosing a Do Not Intubate Order 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.
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.
In medical terms, a DNI means that patients do not want a breathing tube inserted into their trachea, via the nose or mouth, to restore normal breathing. If the patient's breathing remains impaired, the tube remains in place and is eventually connected to a ventilator to maintain breathing.
A DNR order does not mean "do not treat." Rather, it means only that CPR will not be attempted. Other treatments (for example, antibiotic therapy, transfusions, dialysis, or use of a ventilator) that may prolong life can still be provided.