This pamphlet provides an overview on Do Not Resuscitate (DNI) orders. A comparison of DNI and DNR orders is included.
Puerto Rico USLegal Pamphlet on Do Not Intubate - DNI
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FAQ
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.
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.
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.
A patient has the option to be Full Code, DNR (Do Not Resuscitate), DNI (Do Not Intubate) or both DNR and DNI.
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.
Refusing resuscitation is not the same thing as refusing intubation. It is important for you and your loved ones or caregivers to understand the difference so you can make informed end-of-life decisions. Some do not intubate policies include intubation, while others treat the two orders as separate.
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.
Strictly defined, a do not resuscitate/do not intubate (DNR/DNI) status indicates a patient does not want to receive CPR or intubation in the event of cardiopulmonary arrest.