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Verbal DNR and BHP patch

Question #: 359

Question:

VSA patient with a verbal DNR from spouse. In a PCP/ACP split crew situation would the expectation be for the ACP to do the patch to the BHP to authorize the honouring of the verbal DNR or can it be either crew member depending on whom is most available in the situation? Basically, should the ACP generally be patching even if it is for things within the PCP scope of practice "just in case" the BHP wants to discuss other, expanded treatment options?

Answer:

[In this specific care context, it is appropriate for both PCP and ACP to patch to the BHP to cease resuscitation and honour the verbal DNR.

Should the BHP recommend a different management plan requiring ACP scope, you can transition the discussion with the BHP from PCP to ACP.]

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