Guidelines for perioperative do-not-resuscitate policies.
This paper reviews some of the difficulties in implementing perioperative reevaluation of do-not-resuscitate (DNR) orders and suggests several strategies for perioperative DNR policies. Policies should be written, designed and implemented at the level of the institution, and be sufficiently flexible to permit the tailoring of the perioperative DNR order to the individual patient. Policies should unambiguously state that reevaluation is required, delineate responsibilities for reevaluating the DNR order, state all the available options, define the necessary documentation, and list resources for help.
Waisel
David B
DB
Department of Anesthesiology, Bader 3, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. david.waisel@tch.harvard.edu
Burns
Jeffrey P
JP
Johnson
Judith A
JA
Hardart
George E
GE
Truog
Robert D
RD
D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D016134:Organizational Policy; D010820:Physicians / Q000523:psychology; D017410:Practice Guidelines as Topic; D016414:Resuscitation Orders / Q000941:ethics / Q000331:legislation & jurisprudence; D013514:Surgical Procedures, Operative; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence