What happens if a firefighter or police officer arrive on scene to vitals sign absent patient and the patient does not have a valid Ministry of Health Do Not Resuscitate Confirmation Form (MoH DNR) but the family is adamant that the patient does not want resuscitation?  

A firefighter or police officer should initiate resuscitation on a patient who is VSA if there is NO valid MoH DNR Confirmation Form presented on scene, paramedics are also required to abide by this. 

Firefighters or police officers should initiate and continue resuscitation efforts even if a family member is refusing resuscitation. Firefighters and police officers should explain that they have an obligation to provide resuscitation efforts in absence of the MoH DNR Form.  

This is a very challenging call, and we understand the ethical dilemma that a firefighter or police officer may be faced with.  There has been ongoing advocacy by the Provincial EMS Medical Directors to change what paramedics can recognize as a valid DNR.  It is our hope that these changes are adopted in the future by the MoH and if sot is we will use this as a framework to shape what firefighters and police officers can also use to confirm DNR wishes of patients.  Until that time and if faced with a case such as this, the key to this is going to be accurate documentation and explanation for withholding resuscitative efforts. 

When can a firefighter or police officer not perform resuscitation on a vitals sign absent patient?  

If at any point the firefighter or police officer determines that continuing to or attempting resuscitation could result in verbal or physical confrontation. If this occurs the firefighter must ensure to report the family refusal to the paramedics who are arriving on scene and include a detailed report of the incident in their MAR.  

Where can firefighters or police officers find information on how to handle this difficult and complex call in their Medical Directive Handbook?  

Firefighters and police officers can refer to the Guidelines for Expected Death in the Home When there is No DNR Confirmation Form in the Guidelines and Policy Section of the SWCPM Medical Directive Handbook.