What is a Do Not Attempt Resuscitation (DNAR) form?
A Do Not Attempt Resuscitation form is a form issued and signed by a doctor. This lilac coloured form tells your medical team not to attempt cardiopulmonary resuscitation (CPR). The form is lilac so that is easily recognised and verifiable. It allows healthcare professionals to make decisions quickly about how to treat you. For those living in their own homes, there is a tear off slip at the bottom of the lilac form which is kept in a Lions bottle.
The Do Not Attempt Resuscitation form is not a legally binding document. It helps you to communicate to those involved in your care that CPR shouldn’t be attempted. These forms exist because without one, healthcare professionals will always attempt CPR.
The form only covers CPR, so if you have a Do Not Attempt Resuscitation (DNAR) form you’ll still be given all other types of treatment for your condition as well as treatment to ensure you’re comfortable and pain-free.
If you decide to have one, it’s a good idea to also make an Advance Decision (Living Will) refusing CPR. This will mean that your wishes are more likely to be followed if you later lack capacity to make decisions.
What is CPR?
CPR stands for cardiopulmonary resuscitation. It’s an emergency treatment used to restart a person’s heart and breathing if they stop. CPR includes:
- chest compressions (repeatedly pushing firmly on the chest)
- inflating the lungs (by inserting a tube into the windpipe or by placing a mask over the mouth and nose)
- defibrillation (using electric shocks to correct the heart’s rhythm)
In many cases CPR isn’t successful at restarting a person’s heart and breathing. If you have a long-term or chronic condition or a terminal illness then it’s much less likely to work. The methods used in CPR can have side effects such as bruising, cracked or broken ribs and/or punctured lungs. Following successful CPR, some patients will still be very unwell and need more treatment. Many will never get back to the level of health they had before the arrest.
When will a DNAR form be issued?
Your doctor will assess whether or not CPR is likely to be successful. If they think that CPR won’t work then they won’t attempt it. A DNAR form will then be added to your medical records to reflect this. You must be told if this is the case. If you lack capacity, the decision is normally discussed with your family.
If your healthcare team say that CPR won’t work but you still feel that you would like them to attempt it, you should talk to them about your feelings.
Sometimes your doctor may not be unclear about whether or not CPR would be successful. They then consider whether attempting resuscitation would be in your best interests. It might mean that you could enjoy your life for a longer amount of time. However, sometimes when CPR is given people need to spend a long time in intensive care, or are left severely disabled by brain damage due to poor blood supply during the cardiopulmonary arrest. In these circumstances attempting CPR might not be in your best interests. The doctor will discuss this with you.
Your opinion is very important in making this decision. Sometimes in this situation, people decide that they do not want CPR. If a decision is made not to attempt CPR, then a DNAR form will be added to your medical records to reflect this.
You don’t have to talk about CPR if you don’t want to, and you shouldn’t be put under pressure to make a decision. If your heart and breathing stop, your healthcare team will decide whether to attempt CPR. They consider the likelihood of CPR being successful and the likelihood of you making a healthy recovery afterwards.