Do Not Resuscitate Orders

Violation of pt autonomy and self-determination if DNR orders are not reconsidered and honored for the periop period.

Increasing numbers of pts have some form of advance directive.

Approximately 15% of surgical pts have DNR orders.

Resuscitation preferences can change based on pt status and prognosis.

DNR orders do not become automatically suspended or continued when a pt goes to surgery.

Intraop arrests tend to have better outcomes because they are witnessed, acted upon quickly, and are often due to reversible causes.

Pts with DNR orders often undergo vascular access procedures, gastrostomy tube placement, tracheostomy, palliative procedures, repair of pathologic fractures, and surgery for emergent conditions (e.g., bowel obstruction, appendicitis).