Do Not Resuscitate (DNR) Confirmation Forms are becoming increasingly common in the prehospital setting, and first responders may be presented with one during the management of a cardiac arrest.

Before withholding or discontinuing resuscitation, first responders must verify that the DNR Confirmation Form is valid. The following four elements must be present:

• A unique serial number located in the upper right-hand corner of the form.
• The patient’s identifier (name), ensuring the form belongs to the patient in cardiac arrest.
• The form must be completed by an authorized healthcare professional, including a physician (MD), Registered Nurse (RN), Registered Nurse (Extended Class) [RN(EC)], such as a Nurse Practitioner, or a Registered Practical Nurse (RPN).
• All required sections of the form must be fully completed.

If a valid DNR Confirmation Form is presented and all of the above criteria are met, resuscitation should not be initiated. If resuscitation has already begun, it should be discontinued once the valid DNR Confirmation Form has been verified. It is important to remember that the firefighters may be presented with a physical copy of the DNR, but a photocopy or digital copy of the DNR are also acceptable