Book 35 - EMS Field Manual - LAFD Training

A Section 1: Field Procedures 1 Protocols
PREHOSPITAL DO-NOT-RESUSCITATE (DNR) ORD'ERS
Resuscitation shall begin immediately and paramedics shall contact the base hospital for further
direction if there is any objection or disagreement by family members or caretakers about withholding
resuscitation; or if prehospital personnel have any reservations about the validity of the DNR order.
For patients who are a pulseless and apneic with valid DNR orders, EMT-Is and EMT-Ps shall
provide for their comfort, safety, and dignity by using the following appropriate supportive measures:
EMT-IS:
+ Maintain Airway (Oropharyngeal 1 Nasopharyngeal Airways) and Suctioning
+ Administer Oxygen
+ Control External Hemorrhage
+ Apply Dressings, Bandages, and Slings
+ Immobilize Skeletal Injuries
+ Position of Comfort
E M T - P s : (In addition to the above)
+ Visualize airwaylremove foreign bodies by means of a laryngoscope and Magill forceps
+ Contact base hospital if IV access andlor pain medication is necessary
* In the event of deterioration of the patient's vital signs, level of consciousness, or of
cardiopulmonary arrest, continue transporting to the designated receiving facility (even
though it may not be the most accessible). Transport to the patient's requested treating
facility.
* If the patient's caretaker is unable to provide care, advise transport.
(A private ambulance may be suggested.)
* Generally, emergency transport is not necessary but left to the discretion of EMS personnel.
(Emergency transportation may be necessary for such cases as hemorrhage, unmanaged
airway, severe pain, etc.). (DHS, Reference # 8 15)
Revised: 121200 1 PAGE 2 OF 2