Question: I was just wondering if we have a patient with a valid DNR are we still allowed to Bolus if they fit our protocol or is this considered an advanced life saving technique?

 Thanks for the question. In terms of the DNR Standard, IV fluid is not listed as being contra-indicated or forming part of the cardiopulmonary resuscitation as defined in section 1. With this in mind, it is recommended that IV fluid be administered when appropriate for patients with or without a valid DNR.

As an example, consider the patient who is hypotensive from sepsis. IV fluid resuscitation may be truly life saving for this patient and should be provided.

It is essential however to review local policies with individual facilities as to the extent of limitations of care as requested by patients. In some situations, you may be confronted by specific local documentation which would request no IV therapy (however this should be the minority of cases).

A copy of the DNR Standard can be found here: http://www.lhsc.on.ca/About_Us/Base_Hospital_Program/No.108V.1.0DNRStandard.pdf

Cardiac/Circulation,DNR,Intravenous and Fluid Therapy,Miscellaneous

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