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July 2024

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Have You Made Your Plan for an End-of-Life Emergency?

Latir Volunteer Fire Department

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

During an EMS training, Latir Volunteer Fire Department members reviewed scenarios and protocols for emergencies where a patient’s condition is so severe that the person could die. We talked about advance directives, including a do not resuscitate (DNR) order. These documents are important to have ready, which is why we want to share this helpful information with you, our valued community.

An advance directive is a form and authorization that allows you to direct physicians and other hospital medical providers to withhold or withdraw life-sustaining treatment when you are in the hospital. Advanced directives allow you to tell doctors, close family members, and/or friends what you wish to be done in the event you need life-saving treatment. These directives are filed at your hospital, not kept at home.

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 if there is a life-threatening decline during your procedure. These directives can include your wishes regarding feeding tubes, respirators, or other life-extending methods.

We don’t often think of formalizing our preferences for such emergencies that happen in our home. It is prudent to make plans with your family for these circumstances and communicate your decisions to all family members, as well as to close friends and neighbors.

A DNR order is a separate document that should be kept at home. For the DNR to be valid and legally binding, it must be the original document that is completed, signed, and dated by you and your physician. A DNR is most frequently written when you have an incurable illness or condition. It is critical to note that a handwritten letter created and signed by you cannot and will not be upheld by EMS responders. The document must be legally correct.

If there is a medical emergency in your home, and no legally executed DNR is visible or immediately accessible to EMS responders, they must begin cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) to attempt to keep you alive. If you do have a valid DNR form, but no one at the scene can find it, then by law, first responders must perform the life-sustaining treatments they deem necessary.

EMS medical director for the state of New Mexico Kimberly Pruett, M.D. 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 too, adding, “Critical emergencies are very stressful for everyone involved. Having advance directives in place alleviates the heavy burden on the family to make those tough decisions in the moment.”

Below are some resources you can consult to help you get started.