This pamphlet provides an overview on Do Not Resuscitate (DNI) orders. A comparison of DNI and DNR orders is included.
Wyoming USLegal Pamphlet on Do Not Intubate - DNI
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US-PMPH-05
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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
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.
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.
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.
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.
A patient has the option to be Full Code, DNR (Do Not Resuscitate), DNI (Do Not Intubate) or both DNR and DNI.
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.
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.
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 ventilator keeps oxygen flowing into and out of the lungs when patients are unable to breathe on their own. A patient can sign a DNI and continue to benefit from oxygen therapy and non-invasive ventilation, such as through BiPAP.
