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February 2024

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Have you Made a Plan for an End-of Life Emergency?

By Cynthia Najim, Latir Volunteer Fire Department

While we don’t like to think of it, death is a fact of life. Whether you are currently facing an illness or are fit and vital, death can happen at any time. It is best to be prepared.

In our August EMS training, Latir Volunteer Fire Department deputy EMS chief Raynelle Sanchez Cordova led team members through scenarios and protocols for emergencies in which a patient’s condition is life-threatening. We talked about Advance Directives, including a Do Not Resuscitate (DNR) order. These documents are so important that we wanted to share this information with you, our valued community.

An advanced directive is a form and authorization that allows you to direct EMS responders and physicians to withhold or withdraw life-sustaining treatment. An advance directive is most frequently used when you have an illness that is irreversible or incurable. It allows doctors, close family members, and or/friends know what you wish to happen, should you need life-saving treatment. If you don’t have an advance directive, EMS responders and doctors may use cardiopulmonary resuscitation (CPR) and machines, such as respirators, to keep you alive.

If you are scheduled for surgery in the hospital, for instance, you are required during check-in and registration to complete and sign a form to declare whether you want to be resuscitated in the event of a life-threatening decline during the procedure.

At home, we often don’t think of formalizing our preferences for such emergencies. It is prudent, however, to make plans with your family for these circumstances and communicate your decisions to all family members and even to close friends and neighbors.

Advance directives must be completed, signed, and dated by you and your physician to be valid and legally binding. A handwritten letter created and signed by you cannot and will not be upheld by medical professionals. Once these directives have been formally prepared, it is crucial to keep them in a place where they are readily accessible to EMS responders. Raynelle suggested posting them on the refrigerator. That way, if you are alone during the emergency and unable to speak for yourself, your instructions are known and will be followed. If you have a valid DNR form, for example, but no one at the scene can find it, then by law, first responders must perform the life-sustaining treatments they deem necessary.

Kimberly Pruett, M.D., and medical director for Taos County EMS, bears the ultimate responsibility for emergency medical procedures carried out on any scene. She has the overriding word. Dr. Pruett remarked, “While it is hard to think of death and dying, we physicians and responders are very appreciative when people have taken the time to be clear on what they want at the end of their life. We want to honor their wishes.” She also emphasized how advance planning is an enormous benefit to the family. “Critical emergencies are very stressful for everyone involved,” she added. “Having advance directives in place alleviates the heavy burden on the family to make those tough decisions in the moment.”

Your planning should also outline your wishes regarding your remains and your possessions. There are specific steps and authorizations to be considered for funerals, cremations, wills, living wills, trusts, and other essential instructions. Below are some resources to help you get started. An attorney can help you through this process.