this post was submitted on 09 Sep 2024
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"I call a cab 'cause a cab will come quicker." - Flavor Flav
Fun fact. I slashed my wrist with a broken bottle at a party once. Had someone call an ambulance. They said nothing major hit. Wrapped me up. Asked if I wanted a ride.
I said no cause it's dumb money. Then I asked how to pay them. They said they only charge for rides. It blew my mind. My potentially life saving call didn't cost me anything. (Its over $1,000 for an ambulance ride).
I told them I'm good now and got a ride to the ER. Expensive stitches after waiting for hours. I should've taken off the bandage and walked in dripping blood.
It blows my mind that calling an ambulance could ever cost money.
When you need an ambulance, seconds could mean the difference between life and death.
Putting a decision in front of it that could financially ruin you or the person you're helping is absolutely bonkers.
Yep. I was 20 years old nearly living check to check. A medical bill of $1,000+ on top of the hundreds for the ER would've stung bad.
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"I SAVED YOUR LIFE !"
"You ruined my death"
Incredible
is that a quote from somewhere cause i swear it sounds familiar
Incredibles
First responder here. The DNR doesn't mean a damn thing until it is literally in your hands. Until that time you respond as though there is no DNR. If you're wrong and they did have one but just didn't have it on hand then you accidentally save someones life, you're still legally in the clear, and I guess they can just die sometime later. But if the DNR turns out not to be real/legitimate and you didn't act just because you were told there was one then you just killed someone and you're completly fucked.
If you have a family member that has a DNR then be damn sure everyone knows where that thing is because unless you have it physically there when they are dieing then it doesn't mean anything.
Of course in places like nursing homes there is a different procedure. They know who has one on file and they will usually tell dispatch about it before the ambulance is even sent. But if it happens just in your home or someplace then the ambulance crew can't just take your word for it; they need the document in hand.
The DNR doesn’t mean a damn thing until it is literally in your hands.
How does the DNR get into the first responder's hand in practice? Do you get an emergency call and drive there as fast as you can through red lights with your siren on only to be greeted by a relative that made the call handing you the DNR document?
But if the DNR turns out not to be real/legitimate
Are you responsible for validating its legitimacy while in the field, when every second counts?
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Sometimes, yes, many times a family member may call EMS to hand them the DNR, this ensures proper procedures are followed when dealing with the body, less mess, and a quicker certification of death. It may also be important in situations where the person is influencial or rich and ensures you cannot be accused of foul play.
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No, DNRs have certain things that make them official, signatures and notarized markings. Usually one person will begin life saving measures while the ither verifies the DNR. EMS never work alone.
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For the first question. The responders will act exactly as if there is no DNR until you give it to them. Yes, that sometimes means wasted effort but it's better than the alternative.
For your second question, by legitimate I basically just mean that it's not written in crayon on a piece of notebook paper or something. Generally speaking the forms are pretty standard and issued by the healthcare provider. Generally you're just looking for a physicians signature and a date. Some states also allow DNR medical jewelry. The exact specifics on the DNR do vary a lot based on state and county so the local responders will know what they need for their area. As far as every second counting goes, that's why you have a whole ambulance crew.
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What if I just avoid people who look like they're dying?
Not illegal, good samaritan laws protect you either way. However, there is a “duty to rescue” if:
1: You created the hazard that lead the person into danger, you must provide rescue.
2: A special relationship exists. Spouses must rescue each other, parents must rescue children, employers must rescue employees, property owners to invitees but not trespassers.
3: In some jurisdictions you have a duty to notify, which is usually calling the police, but you do not have to take any measures to help them beyond that. Only 10 states require this and is never actually enforced.
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i asked my first aid instructor about DNR and he responded with a very firm "you didn't see it".
Only medical professionals are bound by a DNR for a good reason.
And we are only bound by a DNR IF we have the actual document in hand. Or as EMS, if CPR has already been started when we arrive, we are automatically obligated to continue. If it ain't written down, it never happened. Nursing homes are supposed to provide the documents any time we transport such a patient as part of their medical history papers. And yes, we treat and transport a lot of such patients with a DNR that needs to go to a hospital for some reason.
Worst case scenario, entering a home with family gathered and grandma has a heart attack. And half the family wants me to start CPR and the other half tries to tell me grandma to let grandma go. I will ask them if they have the documents and they don't answer me because they are too busy fighting each other to respond to me. And my poor driver is trying to literally breakup a fight while I'm doing CPR.
Source: A very old and happily retired medic
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yeah that makes perfect sense.
non-medical professionals should not care about DNR orders, bracelets, whatevers. Because what if it's fake and you can't tell the difference from a real one? You could, unknowingly, help someone commit a murder, or let a temporarily unstable person die, sure you'd be innocent, but guilt and trauma doesn't care about your innocence
And even then, it's not a piece of paper that you can just accept like a death coupon. It has to be signed and not contentious, and things need to line up very correctly.
My Dad had a DNR in his legal name, but the nursing staff and his room all used the common shortening of that name. Because the names didn't line up when things went bad and there was no one with authority to clarify they, correctly, operated under the assumption that they did not have an order.
At one point EMS providers couldn't even make the call, it could only be done by the medical facility. I'm pretty sure that's no longer the case anywhere in the US though.
I was gonna call this cap because CPR that long after collapse has infinitesimally small odds, but I looked it up and turns out I'm wrong. CPR anyone you see down!
My understanding was always that CPR isn't meant to revive someone its meant to keep them viable for revival by people with better training/equipment.
If you're really good at CPR they often regain consciousness while you are doing chest compressions and complain. Every time you pause, they die again
The way I heard it if they can't fight you off they still need CPR, so keep at it no matter what they say.
That ain't "being really good" - That's being stupidly lucky. I spent 20 years in the back of the bus, and I never had a revival on scene or in the rig. Nor did I ever meet anyone who ever made such a claim.
Quite often patients that are brought in with CPR in progress are called dead by the ER Doctor after another 20 or 30 minutes of effort or they do get a patient back and keep them going for another few days or a week or so. Only for the patient to finally die in hospital.
But, every so often someone surprises the hell out of us and actually survives and goes on to live for years. This is why we try as hard and as best we can to keep you alive. Because there is always a chance.
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Yeah, basically you're trying to force some circulation through the brain by manually pumping the heart - which is as much about clearing the waste buildup out of the brain as it is getting fresh oxygen to the brain, and also about preventing clots (which will later cause aneurysms when the blood starts flowing normally). Everything else is essentially expendable/repairable/replaceable.
Even the breathing part isn't very important, though the initial check to make sure the airway is clear is very important. If you're doing the chest compressions right, you'll force some airflow through the lungs anyway. The important part is getting the blood to circulate. Having stagnant blood sitting in the brain is really bad.
The current CPR procedure recommends 100-120 chest compressions of at least 2" (5cm) per minute. You are going to hurt them. You may crack their ribs. You need to compress the heart through their ribs and muscle and other tissue that's in the way. Even if you're in good physical shape, it is an exhausting thing to do. It's definitely something worth learning to do correctly - take a class if you can! You can absolutely save someone's life if their heart stops.
The class with a mannequin is really important to experience firsthand. Like to see that you should really start calling the emergency services and put them on speaker after you’ve assessed the situation and before you start CPR. And to know how hard you have to do it. It doesn’t take incredible skill, the modern mannequins will rate your performance, as long as you go fast enough and don’t stop it’s good. I was in shape at the time and I found it easy enough if you use your weight to help, I don’t think I could keep going hard for more than five minutes though.
That's why they recommended doing it in a group. You start getting tired, slowing down, not pushing down 5cm, etc so you hand off to someone else. It's a workout.
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They also talk about snow. The cold slows down bodily functions.
Nobody is dead until they are warm and dead.
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NTA, if he wanted to die he should've done it behind closed doors
In cancer world this is why patients are instructed to print in large letters “AMBULANCE” on an envelope pasted to their fridge. It informs anyone coming to their house to not resuscitate . So likewise it Should be on neighbour to inform everyone of his DNR before calling a lawyer or laying any blame. You have no ability to see his chart as a bystander. He should own that. Nothing was stopping him from going around and informing his neighbours to not try to resuscitate if he expected any less. And that is on him.
In cancer world
Worst amusement park ever
Could have been worse. He could have been from a culture in which saving someone’s life means that you become responsible for them for the rest of their life. Then you’d have had to rig up some kind of situation in which he saves your life so you become even.
Do you have a real life example of a currently existing culture with such a practice?
Because I feel like you've seen a few too many movies.
Couldn't find anything on "blood debt" or "life debt", with the closest being a reddit article that references a Kung-Fu movie in 70s that popularises the idea
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Leave a crate of vodka on his porch
I mean, it sounds like that's exactly what the miserable bastard wants.
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I don't really understand DNR. Why not get medically assisted suicide? Or heck, just end your own life?
Seems better than dying a painful, gradual death as your organs shut down from cancer or something.
Because you aren't allowed medically assisted suicide. The democratic government mandates a rough and tough death for you, because a merciful death is too awful for a fucking voter to think any more on than " Oh no, no death please. I don't want to talk about this anymore, go away or I call the police."
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DNR is more for unexpected death. Planned death, such as suicide (whether medically assisted or not), still requires a DNR.
The only way a DNR is applicable is if the party who is performing the life saving is aware of the order (generally medical professionals). Unless you have it tattooed on you or something, how could a random person know not to try to save your life.
If the green text in the OP is true, I have no idea what their lawyer was thinking. There's no way to win that argument.
By the time paramedics arrived, the patient was alive by way of this passerby resuscitating them already. Even if the paramedics were aware of the DNR, it no longer applies because the patient is alive. So reasonable measures to keep them alive are appropriate. As long as they don't flatline again, the paramedics are in the clear.
I'm any case, DNR has a place. Including for those that don't want to die, but understand the aftermath of CPR is pretty unpleasant (broken ribs, for a start). So rather than suffer through the recovery from CPR, they have a DNR, so that if they go, that's it.
They're not in pain, nor seeking death, they just don't want to suffer through the trauma and recovery of CPR and related procedures.
This is very separate from palliative care, though most of the time they overlap. Palliative care is basically comfort care for people near death. Often palliative patients have a DNR, but not always.
Additionally, on the subject of palliative care, anyone who is not of sound mind, cannot consent to medically assisted suicide, and nobody can consent for them. So in any case where there is a mental aspect, such as dimentia, Alzheimer's, etc, such procedures are impossible. Even a power of attorney cannot consent on their behalf, one of few things that a POA cannot do on the patients behalf.
Beyond that, medically assisted suicide isn't legal everywhere.
We don't know where the poster is.
Palliative care, DNR, and medically assisted suicide are all parts of the equation, all with different purposes, frequently related, and often are administered together.
Source: my father died in January of 2022. He long started his desire to not become a burden like his mother was (Alzheimer's). His most frequent statement on this was that if he were to go "that way" to simply "hand him a gun and he would take care of the rest". By the time my brother and I realized he had "gone that way", he was too far gone to be able to do that, and too far gone to pass the required psychiatric exam to be eligible for medical assistance in the matter. He had to be put in a care home and we quickly got him a DNR. He was in there for... I think 5+ years? Before passing away "naturally". For us, he died a long time prior to his body giving out, and we would visit his corpse in the nursing home from time to time.
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Life insurance might not pay out for suicides. If he has family or anyone else mentioned in his policy he may not want to jeopardise that. No idea if that applies to OP's neighbour, but it's one potential reason.
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Rule of acquisition 285: No good deed ever goes unpunished.
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