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Although I’ve never worked anywhere with a formal policy for accepting verbal do-not-resuscitate orders in the field, I’ve certainly done it.  It’s almost a necessity–so few people that go into cardiac arrest have written DNR orders at all (let alone accessible), you can either accept verbal DNRs from family, or you can constantly abuse corpses.  It’s one of the things that really needs to be covered better in the paramedic curriculum:  I consider myself barely schooled in all the legal and ethical nuances, despite covering these issues multiple times across four years of medical school.

Los Angeles County is one of the few places that have a policy for accepting verbal DNRs, and the effects of their policy were recently studied.  Most of the results are pretty uninteresting, basically confirming much of the common wisdom:  only 6% of patients had a written DNR, family members of the patient were more common at home than in public or at nursing homes, and other dry, boring statistics.  For me, the really attention getting statistic was this (emphasis mine):

Of the 897 cardiac arrests, 492 occurred at home, 111 in a public place, and 93 in a nursing home (location was unknown for 201).

What kind of data collection system are they using that more than 20% of tripsheets cannot be used to determine what kind of location the patients were found in?  I realize that “type of location” is probably the least important piece of data on any given tripsheet, but I still find it striking and odd–particularly since Pennsylvania, as backwards as it otherwise is, has been collecting this specific data point since its first optical-scan tripsheets more than a decade ago (and continues to do so with the electronic documentation mandate).  I guess this just goes to show that there are more data tripsheet types in heaven and earth than are dreamt of in my philosophy.