A Pennsylvania do not resuscitate form is a medical order stating that CPR should not be performed if a patient is in cardiac or respiratory arrest. DNRs must be ordered by the physician (see sample below). The Pennsylvania Orders for Life-Sustaining Treatment (POLST) Form offers the patient a DNR and other choices for end-of-life care if they have a pulse and/or are breathing.
A Pennsylvania do not resuscitate form is a medical order stating that CPR should not be performed if a patient is in cardiac or respiratory arrest. DNRs must be ordered by the physician (see sample below). The Pennsylvania Orders for Life-Sustaining Treatment (POLST) Form offers the patient a DNR and other choices for end-of-life care if they have a pulse and/or are breathing.
The patient and the attending physician must sign the DNR.[1] The patient’s health care surrogate or other legally authorized representative may sign on their behalf.
An attending physician or medical director may use the Pennsylvania Do Not Resuscitate Supply Order Form to order DNR forms, bracelets, and ID necklaces.
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