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N.J.A.C. 6A:16, Programs to Support Student Development
"Do Not Resuscitate order" or "DNR order" means a written directive signed by the parent or guardian of a student who, after consultation with the pediatrician and other advisors, declines emergency administration of cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) to the student.
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Introduction to the POLST Form
www.health.pa.govIntroduction to the POLST Form Pennsylvania – Orders for Life Sustaining Treatment (POLST) is a medical order that gives ... DNR/Do Not Attempt Resuscitation (Allow Natural Death) ... for information about Out-of Hospital Do-Not-Resuscitate orders, bracelets and necklaces. POLST forms may be obtained online from the Pennsylvania Department of ...
EMERGENCY MEDICAL SERVICES PREHOSPITAL DO NOT …
emsa.ca.govNot Resuscitate (DNR) Form (together with an enrollment form and the appropriate fee). Although optional, use of a wrist or neck medallion facilitates prompt identification of the patient, avoids the problem of lost or misplaced forms, and is strongly encouraged.
Authorized Durable Do Not Resuscitate Order Form ...
www.vdh.virginia.govThe Durable Do Not Resuscitate (DDNR) Order and its regulations have been developed to carry out the intent of applicable Virginia law that provides a person the opportunity to execute a DDNR Order that comports with his/her wishes. Applicability The DDNR form may be honored by any "qualified health care personnel," which is defined as any ...
DO-NOT-RESUSCITATE (DNR)/PRACTITIONER ORDERS ST L …
www.idph.state.il.usReviewing a Do Not Resuscitate (DNR)/POLST Form This DNR/POLST form should be reviewed periodically and if: • The patient is transferred from one care setting or care level to another, • o r thei saub n lc g p ’ , • or the patient’s treatment preferences change, • or the patient’s primary care professional changes.
THE B.U.R.P.S LIST
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Tennessee - POST Form
eforms.comBox Only When not in cardiopulmonary arrest, follow orders in CARDIOPULMONARY RESUSCITATION (CPR): Patient has no pulse and is not breathing. Resuscitate (CPR) Do Not Attempt Resuscitation (DNR / no CPR) (Allow atural eath) B, C, and D. Section B Check One Box Only MEDICAL INTERVENTIONS. Patient has pulse and/or is breathing.
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marylandmolst.orgThe DNR A-1, DNR A-2 (DNI) and DNR B options will be authorized by this original order form, a copy or a fax of this form, or a bracelet or necklace with the DNR emblem. EMS providers or medical personnel who see these orders are to provide care in accordance with these orders and the applicable Maryland Medical Protocols for EMS Providers ...
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www.health.ny.govNonhospital Order Not to Resuscitate (DNR Order) DOH-3474 (8/20) *For individuals with an Intellectual or Developmental Disability (I/DD), the non-hospital DNR must be signed by a physician. For individuals with an I/DD who do not have capacity and do not have a health care proxy, the physician must ensure compliance with SCPA Section 1750-b.
Vermont Advance Directive for Health Care
vtethicsnetwork.orgal wishes. NOTE: If you DO NOT want CPR, a breathing machine, a feeding tube, or antibiotics, please discuss this with your doctor, who can complete a DNR/COLST order (Do Not Resuscitate/Clinician Order for Life Sustaining Treatment) to ensure that you do not receive treatments you do not want, especially in an emer-gency.