Edit, Download, and Sign the Pennsylvania Do Not Resuscitate Order Guidance

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How do I fill this out?

To fill out the Out-of-Hospital Do-Not-Resuscitate Order, begin by filling in the patient's name and the attending physician's information. Ensure the selection criteria are met, including conditions like being terminally ill. Finally, sign the form along with any necessary witnesses or surrogates as required by law.

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How to fill out the Pennsylvania Do Not Resuscitate Order Guidance?

  1. 1

    Fill in the patient's name and attending physician information.

  2. 2

    Confirm eligibility criteria for issuing the DNR order.

  3. 3

    Ensure signatures from all required parties.

  4. 4

    Review the completed form for accuracy before submission.

  5. 5

    Store or display the DNR order as required by law.

Who needs the Pennsylvania Do Not Resuscitate Order Guidance?

  1. 1

    Terminally ill patients who wish to refuse resuscitation efforts.

  2. 2

    Patients with end-stage medical conditions to maintain comfort.

  3. 3

    Individuals with a living will directing their medical care preferences.

  4. 4

    Surrogates of patients who are unable to make medical decisions.

  5. 5

    Healthcare providers needing a legal directive for patient care decisions.

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Sharing your completed PDF is simple with PrintFriendly. Once your DNR order is ready, you can easily send it to your healthcare providers or family members via email. Make sure your loved ones are informed about your medical care preferences by sharing the document promptly.

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Editing the Out-of-Hospital Do-Not-Resuscitate Order on PrintFriendly is user-friendly and straightforward. You can enter necessary information directly into the PDF fields and make any adjustments easily. Use our intuitive interface to ensure that your document reflects current medical instructions accurately.

  1. 1

    Open the PDF document in PrintFriendly.

  2. 2

    Click on any field to enter or modify the information.

  3. 3

    Review each section to ensure accuracy.

  4. 4

    Save the changes and your edited document.

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What are the instructions for submitting this form?

To submit the Out-of-Hospital DNR Order, provide a completed copy to your healthcare provider, ensuring they have immediate access to it. You may also want to keep a copy in a clearly accessible location within your house. If applicable, provide copies to family members and any relevant healthcare facilities.

What are the important dates for this form in 2024 and 2025?

The Out-of-Hospital Do-Not-Resuscitate Order is effective from January 28, 2007. Patients should be informed that the order remains valid until revoked or upon the patient's death. Always check for any pertinent updates to regulations surrounding the DNR orders in Pennsylvania.

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What is the purpose of this form?

The Out-of-Hospital Do-Not-Resuscitate Order serves as a legal document that allows patients to refuse resuscitation efforts under specific conditions. It is designed to ensure that healthcare providers respect the wishes of patients regarding their end-of-life care. This form is an essential tool for enabling patients and their surrogates to make informed decisions about life-sustaining treatment.

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Tell me about this form and its components and fields line-by-line.

This form contains essential fields that need to be filled by the patient and attending physician.
fields
  • 1. Patient's Name: The full name of the patient requesting the DNR order.
  • 2. Attending Physician Statement: The physician's confirmation of the patient's eligibility for DNR.
  • 3. Patient's Statement: The patient's own decision regarding resuscitation efforts.
  • 4. Surrogate's Statement: Certification from the surrogate of their authority to execute the order.
  • 5. Signatures: Required signatures from the physician, patient, and surrogate if applicable.

What happens if I fail to submit this form?

Failing to submit the Out-of-Hospital DNR Order may lead to unwanted resuscitation efforts during a medical emergency. This could cause unnecessary distress for the patient and their family members. Therefore, it is crucial to ensure that the DNR order is filled out and accessible.

  • Unwanted Resuscitation: Patients may undergo life-saving procedures against their wishes.
  • Legal Complications: Without a signed DNR order, healthcare providers may face legal dilemmas.
  • Emotional Stress: Family members may experience trauma if their loved ones are resuscitated against their discussed wishes.

How do I know when to use this form?

You should use the Out-of-Hospital DNR Order if you or a loved one wishes to refuse resuscitation in an out-of-hospital setting. This is particularly relevant for individuals with terminal illnesses or end-stage medical conditions. It is a proactive step to ensure that your healthcare preferences are respected.
fields
  • 1. End-of-Life Care Planning: To make clear medical care decisions in advance.
  • 2. Healthcare Directives: To guide healthcare providers about the patient's wishes.
  • 3. Surrogate Decision Making: To empower legally designated individuals to act on behalf of the patient.

Frequently Asked Questions

What is the purpose of the Out-of-Hospital DNR Order?

The DNR order allows patients to refuse resuscitation efforts in case of a cardiac or respiratory arrest.

Who can issue the Out-of-Hospital DNR Order?

Only an attending physician can issue and sign the DNR order for the patient.

How do I submit this form once completed?

You can provide the completed DNR order to your healthcare provider and ensure it is accessible.

Can a patient revoke the DNR order?

Yes, a patient has the right to revoke the DNR order at any time as long as they communicate their wish.

What should I include in the DNR order?

Make sure to fill in patient details, physician confirmation, and all required signatures.

Is the DNR order valid in all healthcare settings?

The DNR order is valid in out-of-hospital settings and must be honored by EMS providers.

What happens if the DNR order is not signed?

Without a signature from the attending physician, the DNR order is not valid.

Do I need a witness to sign the DNR order?

Witness requirements may vary by jurisdiction; check local laws for specific details.

Can family members review the DNR order?

Yes, family members should be informed of the DNR order for compliance with the patient's wishes.

What is included in the DNR order regarding pregnant patients?

Specific criteria must be met if the patient is pregnant, ensuring the safety of both mother and unborn child.

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