June 1, 2005
UNIFORM DO- NOT- RESUSCITATE ORDER FORM
SPRINGFIELD, Ill. – Dr. Eric E. Whitaker, state public health director, today announced that the new Illinois Department of Public Health (IDPH) Uniform Do-Not-Resuscitate (DNR) Order Form is available to Illinois citizens. The form allows an individual, in consultation with a health care professional, to make an advance decision that cardiopulmonary resuscitation (CPR) should not be attempted if his or her heart and/or breathing stops. CPR refers to various medical procedures used in an effort to restart a person’s heart and/or breathing. In the absence of a DNR Order, health care professionals will begin CPR when an individual’s heartbeat and/or breathing stop.
“This Uniform DNR Order Form does not take the place of an advance directive, such as a health care power of attorney or living will, but can be used in conjunction with such a document,” said Dr. Whitaker. “The Uniform DNR Order Form, when properly completed, instructs emergency medical crews, physicians, nursing home and hospital personnel that you do not want them to use CPR to restart your heart and/or breathing.”
The Department revised the state’s DNR Order Form, in accordance with Illinois law, to create a uniform document, which must be honored in nursing homes and hospitals, and by emergency medical services ( EMS) personnel. The new Uniform DNR Order Form was developed by the Department with the extensive input and consensus of a Task Force that included representatives from the physician, hospital, nursing home, hospice and emergency medical services communities.
“Before completing a DNR Order, you should discuss this option with your health care professional, based on your personal views; your current health, views regarding resuscitation in the event of an unforeseen accident, CPR during surgery and life support mechanisms, and your wishes regarding organ donation. This form gives an individual the additional freedom to decide what medical treatment fits his or her beliefs and wishes.” An individual should not fill out a DNR Order if he or she wants all resuscitation efforts administered under all circumstances, and an individual is never required to complete a DNR Order as a condition of treatment or against his or her wishes.
The IDPH Uniform DNR Order Form now differentiates between “full cardiopulmonary arrest” and a “pre-arrest emergency.” A DNR Order should be completed only when an individual does not want CPR attempted in the event of full cardiopulmonary arrest. The DNR Order Form identifies two options for individuals to choose from in the event of a “pre-arrest emergency” – meaning, breathing is labored or stopped but the heart is still beating. The first option is “Do Attempt Resuscitation”, which means CPR will be attempted if breathing is labored or stopped. The second option is “Do Not Attempt Resuscitation” which means the individual does not want CPR attempted if breathing has become labored or stopped but the heart is still beating.
Measures to promote a patient’s comfort and dignity will be provided, even if a DNR Order means that CPR will not be administered. In addition, there is a space available on the IDPH Uniform DNR Order Form for an individual to give “other instructions” regarding application of the DNR Order under certain circumstances, like accidents or during surgery.
The IDPH Uniform DNR Order Form requires the written consent of the person (or his or her legally authorized representative), and the signature of two witnesses and the individual’s physician. The original DNR Order should be kept safely in the person’s home to present to EMS personnel upon an emergency call. The physician should also have a copy in the patient’s medical files. Any adult may submit a DNR form by giving consent personally or with another person legally authorized to act on the individual’s behalf.
The IDPH Uniform DNR Order Forms are available via the Departments’ website at www.idph.state.il.us or by calling (217) 785-2080.
of Public Health
535 West Jefferson Street
Springfield, Illinois 62761
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