DNR (Do Not Resuscitate) Orders: Definition, Scope, and Common Misconceptions

DNR stands for Do Not Resuscitate. It is a medical order, not a blood test result.

What DNR Means

• In the event of cardiac or respiratory arrest, no CPR (chest compressions, intubation, defibrillation, ACLS drugs) will be performed.
• Patient will receive comfort care: oxygen, suction, pain management, positioning.
• Does not mean "do not treat." All other care continues (antibiotics, fluids, dialysis, surgery if indicated).

Types

• In-Hospital DNR: Written by attending physician after discussion with patient/surrogate. Documented in chart.
• Out-of-Hospital DNR / POLST / MOLST: Portable, brightly colored form for home, nursing facility, EMS. Signed by clinician + patient/surrogate.

Indications

• Terminal illness, advanced frailty, dementia, patient values (quality over prolongation).
• CPR success low in these contexts (<5–10% survival to discharge; often with neurologic injury).

Key Points

• Requires informed consent (or surrogate per advance directive).
• Revocable at any time by patient.
• Not a blood test, lab value, or diagnostic code.