Cardiopulmonary Resuscitation Directives

Cardiopulmonary Resuscitation Directive (DNR) is an advance medical directive pertaining to the administration of cardiopulmonary resuscitation, which is a medical order  based on informed consent, signed by or on behalf of an individual and a physician, a physician assistant, or a nurse practitioner, directing emergency medical services personnel to not perform resuscitative measures in the event of a respiratory or cardiac arrest or malfunction.

Minnesota

The "No CPR" form is a simple & clear alternative to a "Do Not Resuscitate" (DNR) form, and has been reviewed and approved by the Medical Direction Standing Advisory Committee for use in the pre-hospital setting.

• No CPR Form

Source:  The Minnesota EMSRB  http://www.emsrb.state.mn.us/

South Dakota

• Cardiopulmonary Resuscitation Directive 34-12F - defines terms and criteria for DNR Directives.
• EMS cardiopulmonary resuscitation directives 44:05:06-defines terms and criteria for EMS personnel.
• comfort ONE Patient Information Form - view Cardiopulmonary Resuscitation Directive form.

To request forms please complete the on-line application: comfort ONE form request

Source:  South Dakota Emergency Medical Services http://www.state.sd.us/dps/ems/