I’ve been asked a few times recently about what to do if a patient arrives for a dental appointment and says they have a DNACPR.  It’s potentially a difficult situation but it doesn’t need to be as long as you understand what it means and what it doesn’t mean.

 

What is a DNACPR?

DNACPR stands for ‘Do Not Attend Cardio-Pulmonary Resuscitation’.

 

What does it mean?

For the person involved it means that if their heart stops beating ie they have a cardiac arrest, they will be allowed a natural death rather than cardio-pulmonary resuscitation being attempted.

 

What doesn’t it mean?

It doesn’t mean that the person won’t receive any other treatment.  It doesn’t mean that they won’t receive First Aid, therefore if, for example, they choke, fall or have a low blood sugar, we treat these First Aid incidents.

 

Why do people have one?

When someone has life limiting illness their Doctor, GP or Community Matron may talk to them about the likely success of any resuscitation attempt should their heart stop.  In consultation it may be agreed that if their heart stops that no attempt will be made to restart it.  I’m a firm believer that just because we can attempt to resuscitate virtually anyone, doesn’t necessarily mean that we should.

 

What do you do if your patient has one?

If you work in a dental practice and a person tells you they have a DNACPR I would recommend that you ask to see it and take a copy for their records.  The document should be signed and dated by the health professional responsible for their care.  They may have a review date, in which case ensure you see an up to date copy once it’s been reviewed; that may mean asking the patient to bring it with them each time they attend.

 

What do you do if they collapse?

If you have a copy of the document and they collapse not due to a First Aid situation then I would phone 999 and ask for an ambulance, then explain to the call handler what has happened.

If you are unsure of the cause, or have not seen a copy of the document I would start CPR and let the paramedics know when they arrive.

 
I hope you found this useful, you may also find these previous blogs useful:-

End of Life Decisions
Decisions relating to Resuscitation