Massachusetts Comfort Care/Do Not Resuscitate Order Verification Program
When an ambulance is called for, the crew must often make split-second decisions about treatment, especially when a patient is not breathing or has no pulse. In Massachusetts, ambulance services, EMTs and paramedics are required to resuscitate a person who has undergone cardiac or respiratory arrest unless they are immediately made aware that the person does not want to be resuscitated. Because of the urgent nature of their tasks, they are not permitted to receive verbal information, and they need to see a specific form. A validly-completed Comfort Care/Do Not Resuscitate (CC/DNR) form is the only way that ambulance services, EMTs and paramedics are allowed to verify that a patient has a valid DNR. The form is available at http://www.mass.gov/eohhs/docs/dph/emergency-services/comfort-care-form.pdf. If a properly executed CC/DNR Order Verification Form is not seen by the responding ambulance services, EMTs and paramedics, they are required to resuscitate the patient, even if the patient’s wishes are in some other written form or told to them. If ambulance services, EMTs and paramedics are shown a properly executed CC/DNR form for the patient, they will provide only palliative care (oxygen and medication to relieve pain) to the patient during transportation to the hospital.
The form must be completed in its entirety and signed by an attending physician, authorized physician’s assistant or authorized nurse practitioner, in accordance with the instructions on the form. If a physician’s assistant or nurse practitioner signs the form, the name of the supervising physician must be on the form for it to be validly executed.