Crimmins T J
Hennepin County Medical Center, Minneapolis.
Minn Med. 1991 Jun;74(6):33-5.
To summarize, the MMA will provide a standard DNR form and guidelines for implementation in local communities. Local physicians, nursing home administrators, and ambulance service operators need to agree on an established set of guidelines that long-term care facilities, hospices, and private homes will follow to inform ambulance personnel of DNR orders. Ambulance medical directors should instruct ambulance staff on the proper implementation and use of DNR orders. The decision to write a DNR order rests with the attending physician, based on disclosure and consent of the patient, family, or proxies. Full implementation of a prehospital DNR system will reduce the suffering that patients and family members endure when inappropriate and unnecessary cardiopulmonary resuscitation is given by ambulance personnel. A similar program, administered by the county health department, has been successful in the west metropolitan Twin Cities area for the past five years. The model offered by the MMA to individual physicians and their medical societies may be modified to meet local needs. This community emergency medical services DNR program helps ensure the provision of appropriate ambulance service based on patients' individual needs and requests.
总之，明尼苏达医疗协会（MMA）将提供一份标准的“不要进行心肺复苏”（DNR）表格及在当地社区实施的指导方针。当地医生、养老院管理人员和救护车服务运营商需要就一套既定的指导方针达成一致，长期护理机构、临终关怀机构和私人住宅将遵循这些方针，以便向救护人员通报DNR医嘱。救护车医疗主任应指导救护人员正确实施和使用DNR医嘱。开具DNR医嘱的决定由主治医生做出，这基于患者、家属或代理人的披露和同意。院前DNR系统的全面实施将减少患者及其家属在救护人员进行不适当和不必要的心肺复苏时所遭受的痛苦。由县卫生部门管理的类似项目在过去五年里在双子城西部大都市地区取得了成功。MMA向个体医生及其医学协会提供的模式可进行修改以满足当地需求。这个社区紧急医疗服务DNR项目有助于确保根据患者的个人需求和请求提供适当的救护车服务。
