What to do when a DNR patient codes?

When a DNR (Do Not Resuscitate) patient codes (goes into cardiac/respiratory arrest), healthcare providers focus on comfort measures (Code Comfort), respecting the patient's wishes by not performing CPR, intubation, or defibrillation, but instead managing symptoms like pain and distress, involving palliative care, chaplains, and family to ensure a peaceful transition, as per their legal Advanced Directive or POLST (Portable Medical Order for Life-Sustaining Treatment).


What happens when a DNR patient codes?

A do-not-resuscitate (DNR) order is a type of advance directive. Having a DNR order means you don't want treatments like cardiopulmonary resuscitation (CPR) used on you if your heart or breathing stops. Under ordinary circumstances, healthcare providers will do everything they can to try to save your life.

What can you do for a DNR patient?

For DNR patients, take just a moment to collect yourself. Assess your patient... pulse, resp, pupillary response, etc... Then go get your Charge or a senior nurse and have then assist you with the process. Do your best to remain calm and give the patient what they wanted, which is a quiet, peaceful death.


What to do if a patient starts coding?

3 Things To Do When A Patient Codes
  1. Check carotid pulse.
  2. If there is no pulse, begin chest compressions.
  3. Secure airway.


Can you give oxygen to a DNR patient?

Yes, you can absolutely give oxygen to a patient with a Do Not Resuscitate (DNR) order; a DNR only stops CPR and intubation, not other comfort care like oxygen, BiPAP, suctioning, or pain medication, as these help relieve distress without prolonging the dying process. Medical protocols often include oxygen, high-flow nasal cannula, or CPAP/BiPAP as standard care for breathing support for comfort in DNR patients, focusing on alleviating symptoms like shortness of breath.
 


What is a Code Status (Full Code vs DNR)?



Do you intubate a DNR patient?

Yes, a standard Do Not Resuscitate (DNR) order generally includes intubation and other advanced airway management as part of the "Do Not Resuscitate" mandate, meaning healthcare providers will not place a breathing tube if your heart or breathing stops; however, specific orders like Do Not Intubate (DNI) exist for patients who want other life-saving measures (like chest compressions) but specifically refuse a breathing tube, offering more nuanced end-of-life choices.
 

What are the 5 rules that must be followed when oxygen is in use?

When using oxygen, always keep it away from heat/flames (no smoking, 5+ ft away), avoid flammable products (aerosols, petroleum jelly), don't use sparking electronics (hairdryers), secure tanks upright, and use only water-based products on skin near the cannula to prevent fire hazards. Oxygen is not flammable but makes other things ignite easily and burn hotter.
 

What is full code vs DNR?

Full Code means a patient wants all life-saving measures, like CPR, defibrillation, and intubation, if their heart stops or they stop breathing, aiming to live as long as possible. A DNR (Do Not Resuscitate) order means the patient refuses CPR and resuscitation, opting for comfort care (palliative care) to allow natural death, though they might still accept other treatments like antibiotics or fluids. Essentially, Full Code is maximum intervention, while DNR is a directive to not intervene with resuscitation when the body shuts down. 


What's worse, code red or code blue?

Code Red – In most cases, a code red means that a fire has broken out. Hospital staff will then execute their fire response. Code Blue – A code blue typically means that a patient has gone into cardiac arrest or is experiencing a medical emergency.

What is the most serious code in a hospital?

The most serious hospital codes usually involve active threats to life and safety, like Code Silver (active shooter/weapon), which triggers lockdowns and immediate armed response, and Code Red (fire), requiring rapid evacuation/containment, but Code Black (bomb threat) is also extremely critical, often leading to full evacuation, while Code Blue (cardiac arrest) is an immediate life-or-death medical emergency for patients, with each color demanding swift, specific action to save lives from internal or external dangers. 

What are the protocols for DNR?

DNR protocols typically require the signing of an out-of-hospital DNR order by both the clinician and patient (or the patient's surrogate) and the use of a special identifier (eg, a bracelet or brightly colored form) that is worn by or kept near the patient.


What are the 3 C's of emergency response?

The 3 C's of emergency response, used in first aid and disaster preparedness, stand for Check, Call, Care, guiding bystanders to first assess the scene for safety, then call emergency services (like 911), and finally provide appropriate care until professional help arrives, ensuring their own safety first.
 

Do you do CPR on a DNR patient?

A do-not-resuscitate (DNR) order tells medical professionals not to perform CPR.

What to do when a patient is DNR?

A DNR order does not mean "do not treat." Rather, it means only that CPR will not be attempted. Other treatments (for example, antibiotic therapy, transfusions, dialysis, or use of a ventilator) that may prolong life can still be provided.


Does coded mean died?

In medical slang, "coded" means a patient's heart or breathing has stopped (cardiac or respiratory arrest), triggering an emergency "code blue" response with CPR and resuscitation efforts, but it doesn't always mean they died, as the team tries to revive them; they might survive, but it often signifies a very serious event or death. The goal of "running a code" is to bring the patient back from the brink of death, though outcomes vary. 

Can a first aider ignore a DNR?

Paramedics take over once they arrive on the scene. First aiders should hand over any DNR documents they find. Paramedics have the training to authenticate these documents and will adjust their care based on the confirmed instructions, ensuring respect for the patient's wishes.

What is code grey in a hospital?

In a hospital, a Code Grey (or Code Gray) usually signals a combative or violent person, meaning a patient, visitor, or staff member is aggressive or threatening, creating a safety risk, and requires a response from security and clinical staff to de-escalate and manage the situation. While definitions vary, it generally focuses on aggressive behavior from an unarmed individual, with security called to help resolve it safely, often using non-physical means.
 


How many patients survive code blue?

Code blue survival rates for in-hospital cardiac arrests (IHCA) vary, but generally range from 15-25% surviving to hospital discharge, with some studies showing lower rates (under 10% nationally in older data) and others seeing improvements, with pediatric patients often having higher survival than adults. Factors like patient age, underlying conditions (cancer, sepsis), location (ward vs. ICU), arrest rhythm (shockable vs. non-shockable), and faster, more effective team response significantly impact outcomes, with rapid response teams showing promising results.
 

What are the 4 colors of triage?

This advanced triage system involves a color-coding scheme using red, yellow, green, white, and black tags: Red tags - (Immediate) are used to label those who cannot survive without immediate treatment but who have a chance of survival. Yellow tags - (observation) for those who require observation.

What happens when a DNR code?

A do-not-resuscitate order, or DNR order, is a medical order written by a health care provider. It instructs providers not to do CPR (cardiopulmonary resuscitation) if a patient's breathing stops or if the patient's heart stops beating.


Does intubation mean end of life?

No, intubation does not automatically mean death; it's often a life-saving procedure to support breathing for critically ill or injured patients, providing oxygen and removing fluids, though it carries risks and survival depends on factors like age and underlying health. While some patients are too weak to recover, intubation helps many overcome severe respiratory failure from conditions like pneumonia or trauma, allowing time for recovery, but it's a serious intervention with potential complications. 

What are the four types of codes?

There are four types of coding:
  • Data compression (or source coding)
  • Error control (or channel coding)
  • Cryptographic coding.
  • Line coding.


What should you not use while on oxygen?

While on oxygen, you should not use open flames, smoking materials, oil/petroleum-based products (like Vaseline), aerosols, or spark-producing electrical items (hair dryers, razors), as oxygen makes fire burn hotter and faster, creating a major fire hazard; stick to water-based products and keep equipment away from heat/sparks.
 


What is the oxygen mask rule?

When you fly on an airplane, the flight attendant instructs you to “put your oxygen mask on first,” before helping others. Why is this an important rule for ensuring survival? Because if you run out of oxygen yourself, you can't help anyone else with their oxygen mask.

What are three special precautions that must be observed when a patient is receiving oxygen?

When a patient receives oxygen, three crucial precautions are: strictly prohibiting smoking/open flames, ensuring proper ventilation and keeping equipment away from heat/sparks, and avoiding petroleum-based products like Vaseline, using only water-based lubricants to prevent fire hazards, as oxygen supports combustion. You must also manage tubing to prevent tripping and secure cylinders.