Should I ask for a DNR in every scenario where I may use what's contraindicated? If I were to show up for an unconscious but not VSA female and her husband is on scene and doesn't mention the DNR, should I assume they want treatment and continue with inserting an OPA and bagging if necessary or should I ask for a DNR before starting treatment? Would I get in trouble in this scenario if I treated this patient without the husband saying anything and then once we got to the hospital found out they had a DNR?
The default treatment in an arrest or peri-arrest situation is to initiate resuscitation. The wording within the DNR Standard training bulletin (2007) is when a valid DNR form is presented to the paramedic and within the Standard in the most recent BLS, In a situation where a paramedic obtains a Valid MOH DNR Confirmation. Therefore, it is not the expectation that paramedics must ask for it in all scenarios. The decision to inquire can be left to your clinical judgment.
Importantly, the default, if you are not presented with a valid DNR form, is to manage the patient with all available treatments. If there was no notification of a DNR, you certainly would not get into trouble for managing the patient.