Question: In a setting where you arrive on scene and you are presented with a patient who is unconscious and is hypotensive, the patient has a valid DNR. Can you still administer fluids to this patient or does that fall under the same category as inserting an OPA/NPA and BVM to a patient with a DNR?

Thanks for your question. We receive a lot of questions surrounding patients with valid DNRs. Please review the DNR standard found at: www.lhsc.on.ca/About_Us/Base_Hospital_Program/No.108V.1.0DNRStandard.pdf

Situations involving end of life can be very complicated, and its very hard, if not impossible, to capture a patients wishes for their care on a single form.

The ideal scenario would be that the patient would have some more specific advanced directive outlining their wishes in terms of IV Fluid. IV Fluid is not listed as a therapy that paramedics are not to provide a patient with a valid DNR and could be considered in the hypotensive patient as long as the other conditions of the medical directive are met. As an example a patient in septic shock could have an altered LOC from poor perfusion and despite the DNR benefit from IV fluid.

Uncategorized

Bag Valve Mask (BVM), Do Not Resuscitate (DNR), Intravenous Therapy (IV), Oropharyngeal Airway (OPA)

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