Comfort Care DNR Order Verification Protocol (Comfort and Care DNR)
- The Comfort Care DNR is designed to allow EMTs and first responders to honor a DNR order in an out-of-hospital setting.
- Before 1999, when Massachusetts implemented its Comfort Care DNR protocol, there was no mechanism to enable EMT’s and other first responders to recognize DNR orders in a non-hospital setting. So EMT personnel were always obligated to perform full resuscitation measures when they encountered a patient unable to convey directions regarding medical treatment.
- The Comfort Care DNR protocol provides for a statewide, uniform DNR verification protocol.
- The purpose of the Comfort Care DNR is to: (a) provide a verification of DNR orders to enable EMTs and first responders to honor DNR orders, (b) clarify the role and responsibilities of EMTs and first responders at the scene and/or during transport of patients who have a valid current DNR order, (c) avoid resuscitation of patients who have a current and valid DNR, (d) provide for palliative/comfort care measures for patients with a current Comfort Care DNR order verification form.
- Comfort Care DNR order verification forms must be completed and signed by the patient’s physician, authorized Physician’s Assistant or Nurse Practitioner.
- The patient must post the Comfort Care DNR where any EMT or first responder can easily find it. (Usually the patient’s refrigerator, or taped to the patients bedroom door. The Department of Public Health stopped issuing Comfort Care DNR bracelets in 2007, but the Department’s approved form contains bracelet inserts that can be used in generic wrist bracelets.
- The Comfort Care DNR Order Verification form can be accessed by anyone, in downloadable format from the Massachusetts Department of Public Health/Office of Emergency Medical Services website, at: http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/oems/comfort-care/public-health-oems-comfort-care-verification.html. But the form must be fully completed and signed by the attending physician, authorized nurse practitioner or authorized physician assistant as proscribed by the regulations.