Peri-operative Management of Do-Not-Resuscitate Orders in the State of Wisconsin

Peri-operative Management of Do-Not-Resuscitate Orders in the State of Wisconsin - #33

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A summary of the risk factors, incidence, and survival associated with intraoperative cardiac arrest.

Patient with DNR orders in peri-operative period

Surgical procedure performed on geriatric patient with previously instituted DNR orders

  1. Identify the Wisconsin legislation pertaining to patient’s and healthcare provider’s rights in regards to do-not-resuscitate (DNR) orders in the peri-operative period
  2. Identify the Froedtert Hospital policy regarding DNR orders in the peri-operative period
  3. Identify the recommendations by American Society of Anesthesiologist and American College of Surgeons regarding DNR orders in the peri-operative period
  1. Ewanchuk, M and Brindley, PG. (2006). Ethics Review: Perioperative do-not-resuscitate orders-doing ‘nothing’ when ‘something’ can be done. Critical Care. 10(4):219. http://ccforum.com/content/10/4/219. Accessed April 20, 2013.
  2. Guarisco, KK. (2004). Managing do-not-resuscitate orders in the perianesthesia period. J of PeriAnesthesia Nursing. 19(5): 300-307.
  3. Ball, KA. (2009). Do-not-resuscitate orders in surgery: Decreasing the confusion. AORN Journal. 89(1): 140-150.
  4. Girotra, S, Nallanothu, BK, Spertus, JA, Li, Y, Krumholz, HM, and Chan, PS. (2012). Trends in survival after in-hospital cardiac arrest. New England Journal of Medicine. 317: 1912-1920.
  5. Cohn, S. (2013, April 19). Personal interview.
  6. Froedtert Health (2010). Do Not Resuscitate DNR (CPM.0063) Milwaukee, WI.
  7. American Society of Anesthesiologists. (2008). Ethical Guidelines for the Anesthesia Care of Patients with Do-Not-Resuscitate Orders or Other Directives that Limit Treatment.
  8. American College of Surgeons. Statement on Advance Directives by Patients: "Do Not Resuscitate" in the Operating Room. http://www.facs.org/fellows_info/statements/st-19.html. Accessed March 11, 2013.
This GFF ___ my competence in geriatrics.

Olivia Mac, Robert Biechler MD, Thomas Ebert MD, Arthur Derse MD JD

Medical College of Wisconsin, Milwaukee, Wisconsin