7 AAC 16.010. Do-not-resuscitate protocol

(a) This section establishes the do-not-resuscitate (DNR) protocol for physicians and other health care providers for the purposes of AS 18.12.035 (b). In implementing the protocol, the physician or other health care provider must comply with applicable state and federal laws and regulations related to the provision of or withholding of care.

(b) Unless exempted under (c) of this section, the physician or other health care provider must first clearly confirm the identity of the patient by one of the following methods:

(1) the patient communicating the patient's name;

(2) the patient's hospital or other institutional identification arm band;

(3) the patient being personally known to the physician or other health care provider;

(4) the patient's driver's license or credit card; or

(5) another person having identified the patient.

(c) If a patient is unconscious or otherwise unresponsive to questions regarding the patient's identity, the physician or other health care provider may rely solely on the department approved DNR necklace or bracelet worn by the patient without using further methods to identify the patient.

(d) Once the patient's identity is established under (b) of this section or not required to be established by (c) of this section, the physician or other health care provider shall examine the patient, patient's available medical records, and other sources to determine the patient's DNR status. DNR status may be established only through the following items:

(1) a department-approved DNR form for the patient;

(2) a department-approved DNR card for the patient;

(3) a department-approved DNR necklace or bracelet worn, or carried, by the patient;

(4) a DNR identification for the patient that is executed or issued in another state, a territory, or a possession of the United States that meets the requirements of AS 18.12.090 ;

(5) an attending physician's DNR order, when

(A) the order is in writing and a copy has been provided or seen by the physician or other health care provider; or

(B) a verbal order has been issued directly to the physician or health care provider by the attending physician.

(e) The physician or other health care provider shall immediately proceed with patient assessment and care, including cardiopulmonary resuscitation, until the information required under (b) - (d) of this section is obtained. Cardiopulmonary resuscitation (CPR) need not be started or continued if the physician or other health care provider determines that it would be futile or a competent qualified patient declines CPR.

(f) After establishing that the patient is a qualified DNR patient under AS 18.12 and this chapter, the physician or health care provider may not attempt CPR for a patient who does not have a pulse or is not breathing. The DNR order does not affect other care or services that the physician or other health care provider has determined are appropriate for the patient and may lawfully be performed by that provider.

(g) The qualified DNR patient or the patient's attending physician may revoke the patient's DNR status at any time and in any manner in accordance with AS 18.12.

History: Eff. 10/10/96, Register 140

Authority: AS 18.12.035 (b)

AS 18.12.037

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