This pamphlet provides an overview on Do Not Resuscitate (DNI) orders. A comparison of DNI and DNR orders is included.
Idaho USLegal Pamphlet on Do Not Intubate - DNI
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US-PMPH-05
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A natural reaction to medicine's use of CPR and MV was the advent of advance directives and more specific Do-Not-Resuscitate (DNR) and Do-Not-Intubate (DNI) orders meant to protect a patient's ability to remain autonomous with their end of life decisions. 1.
Full Code: defined as full support which includes cardiopulmonary resuscitation (CPR), if the patient has no heartbeat and is not breathing. DNR: The patient does not want CPR the person has no heart beat and is not breathing, but may want other life-sustaining treatments.
DNR means that no CPR (chest compressions, cardiac drugs, or placement of a breathing tube) will be performed. A DNI or Do Not Intubate order means that chest compressions and cardiac drugs may be used, but no breathing tube will be placed.
DNR means that no CPR (chest compressions, cardiac drugs, or placement of a breathing tube) will be performed. A DNI or Do Not Intubate order means that chest compressions and cardiac drugs may be used, but no breathing tube will be placed.
Conclusions: Conflation of DNR and DNI into DNR/DNI does not reliably distinguish patients who refuse or accept intubation for indications other than cardiac arrest, and thus may inappropriately deny desired intubation for those who would accept it, and inappropriately impose intubation on patients who would not.
A DNR can also be valid if: (1) it is not contrary to the directions of a patient who was competent at the time the patient conveyed the directions; (2) in the reasonable medical judgment of the patient's attending physician, the patient's death is imminent, regardless of intervention of CPR; and (3) the DNR order is
Conclusions: Conflation of DNR and DNI into DNR/DNI does not reliably distinguish patients who refuse or accept intubation for indications other than cardiac arrest, and thus may inappropriately deny desired intubation for those who would accept it, and inappropriately impose intubation on patients who would not.
A Do Not Intubate order means that chest compressions and cardiac drugs may be used during a patient's care, but that no breathing tube will be placed within the patient. Intubation involves a doctor inserting a flexible plastic tube through the nose or mouth into the trachea (windpipe) to help with breathing.
Choosing a Do Not Intubate Order DNI's only apply to situations where a patient has no pulse or is not breathing, but they do not restrict any other clinically indicated care. There does not need to be a formal advance directive or living will to have DNR and DNI orders in place.
When you request a Do Not Resuscitate (DNR) order, your doctor may ask you whether or not you also want a Do Not Intubate (DNI) order. The two are separate because you can have trouble breathing before your heartbeat or breathing stops. If your breathing problems continue, your heart or lungs may go into full arrest.
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