How do Do Not Resuscitate (DNR) orders and MOLST forms affect EMS treatment decisions?

How do Do Not Resuscitate (DNR) orders and MOLST forms affect EMS treatment decisions?

• A. DNR orders require no verification; EMS should always proceed regardless.
• B. DNR/MOLST guide or restrict resuscitation; verify authenticity and scope; honor valid orders; seek guidance if uncertain.
• C. DNR orders only apply after hospital admission.
• D. MOLST forms are irrelevant to EMS.

Answer: (B)

DNR orders and MOLST forms are legal medical orders that translate a patient’s wishes into actions for EMS, so responders know when to initiate or withhold life-sustaining treatment in the field. They guide and restrict resuscitation and other interventions, but only if they are authentic, applicable to the current situation, and within their scope. Before acting, EMS must verify the order’s authenticity (signatures, patient and physician identifiers, date or expiration) and confirm the scope—what is specifically allowed or refused, and whether it covers emergency care in the prehospital setting. If the orders are valid and applicable, they should be honored, and care should align with the patient’s stated preferences, including focusing on comfort if that is what the MOLST or DNR specifies. If there is any doubt about the order’s validity, applicability, or current patient status, EMS should seek guidance from medical control. These forms are not irrelevant to EMS and do not become irrelevant after hospital admission; MOLST forms are designed to travel across care settings and guide decisions in the field, and DNR indicates that CPR should not be performed if a cardiac or respiratory arrest occurs. When no valid order is found, standard resuscitation should be considered or initiated, depending on local policy and guidance.

DNR orders and MOLST forms are legal medical orders that translate a patient’s wishes into actions for EMS, so responders know when to initiate or withhold life-sustaining treatment in the field. They guide and restrict resuscitation and other interventions, but only if they are authentic, applicable to the current situation, and within their scope. Before acting, EMS must verify the order’s authenticity (signatures, patient and physician identifiers, date or expiration) and confirm the scope—what is specifically allowed or refused, and whether it covers emergency care in the prehospital setting. If the orders are valid and applicable, they should be honored, and care should align with the patient’s stated preferences, including focusing on comfort if that is what the MOLST or DNR specifies. If there is any doubt about the order’s validity, applicability, or current patient status, EMS should seek guidance from medical control.

These forms are not irrelevant to EMS and do not become irrelevant after hospital admission; MOLST forms are designed to travel across care settings and guide decisions in the field, and DNR indicates that CPR should not be performed if a cardiac or respiratory arrest occurs. When no valid order is found, standard resuscitation should be considered or initiated, depending on local policy and guidance.