Do Not Resuscitate Order

A do not resuscitate order (DNRO) is a one-page, easily-identifiable form developed by the Florida Department of Health, is only intended to identify a patient whose health care provider has directed paramedics and emergency medical technicians (EMTs) not to resuscitate the patient in the event of respiratory or cardiac arrest.

The DNRO is different from do not resuscitate (DNR) directions, advance directives, and physician orders for life sustaining treatment (POLST). A DNR, advance directive, or POLST is any written direction from a health care provider to all other providers who treat the patient. A DNR, advance directive, or POLST often includes a combination of directions for when to administer or withhold treatments and procedures for end-of-life, chronic, and terminal illness care. Hospital, facility, and hospice personnel may review the DNR, advance directive, or POLST together with the patient’s other medical records to provide appropriate care.

• The DNRO is a specific, limited direction to paramedics and EMTs only. Paramedics and EMTs are not required to review and interpret any other type of DNR, advance directive, or POLST document.
• A DNRO and any copies of the DNRO must be printed with a full-page yellow background or be printed on yellow paper, or they will not be valid. Any shade of yellow is acceptable.

A DNRO is used by someone who does not wish to have respiratory or cardiac resuscitation, like CPR, in the event of cardiopulmonary failure.

If you are not sure if a DNRO would be appropriate for you, or you would like additional information, consult your health care provider and your attorney.

An individual who has decided to forego resuscitative treatments and procedures in the event of the individual’s respiratory or cardiac arrest should consider completing a DNRO. The completed DNRO will be part of the patient’s prescribed medical treatment plan and must be signed by the patient’s physician, osteopathic physician, advanced practice registered nurse who is registered for autonomous practice, or physician assistant.

Copies that are reproduced with the full-page yellow background or printed on any shade of yellow paper are also valid.

The DNRO developed by the Florida Department of Health, identified on the bottom left corner of the document as “Form DH 1896, Revised 02/2024, Incorporated by Rule 64J-2.018, F.A.C.,” is intended to be used by presenting it to an EMT or paramedic upon their arrival to treat the patient in a setting other than a hospital, health care facility, or hospice. The EMT or paramedic must keep the DNRO with the patient during transport.

Hospitals, facilities, and hospice may honor the DNRO, but the Florida Department of Health does not regulate these facilities and the forms they use. Many types of DNR direction documents, advance directives, and POLST forms are available. When entering a hospital, health care facility, or hospice, consult your health care provider and the facility’s risk management and legal offices concerning the use of a DNRO and other health care directions.

A properly completed DNRO form will be signed by the competent patient or the patient’s representative, and by a Florida licensed physician, osteopathic physician, advanced practice registered nurse who is registered for autonomous practice, or a physician assistant, and will have a full-page yellow background or be printed on any shade of yellow paper.

Copies that are reproduced with the full-page yellow background or printed on any shade of yellow paper are also valid.

No. The DNRO should simply be signed by the competent patient or the patient’s representative at the same time that it is signed by the patient’s health care provider. This is usually done in the presence of the patient’s health care provider.

Keep your DNRO in a noticeable, easily accessible place. It should be readily available in the event of an emergency to ensure that your wishes will be honored.

A copy of the DNRO or the reduced-size DNRO (see the bottom of the DNRO form) may be completed and removed, and carried by the patient with their photographic identification, such as in a wallet.

Copies that are reproduced with the full-page yellow background or printed on any shade of yellow paper may be carried by a family member or friend, provided to the patient’s health care provider or local hospital, and secured to the patient’s refrigerator where the DNRO will be readily visible to emergency responders.

The DNRO is only directed to paramedics and EMTs who are certified in Florida. The Department of Health does not regulate EMTs and paramedics in other locations and so cannot direct them to honor a DNRO.

Check the law in the area where you will be to determine if a particular form of DNR, advance directive, or POLST is honored in that area. Florida does not prohibit patients from having both the DNRO and other forms of medical directions addressing resuscitative care.

If the patient who created the DNRO is competent, the patient can revoke the DNRO by expressing a contrary intent either orally or in writing, such as saying or writing: “I revoke my DNRO and desire resuscitation or CPR.”

A competent patient can also revoke the DNRO by physically destroying it, by failing to present it to paramedics or EMTs, or by signing an order from a physician, autonomous advanced practice registered nurse, or physician assistant that directs paramedics and EMTs to resuscitate the patient.

If you intend to revoke your DNRO, be sure to notify any health care provider, hospital, facility, hospice, and person to whom you provided a copy.

Yes. Attached to the bottom of the DNRO is a reduced-size duplicate of the larger DNRO, described as a “DNRO device.” You may remove this DNRO device from the form, laminate it, and carry it in your wallet next to your identification, or wear it on a necklace, clipped to a key chain, or pinned to your clothing or bedding so it will be with you.

The full-size DNRO is still valid if the reduced-size DNRO device is not completed or if it is removed. As long as the reduced-size DNRO is properly completed and signed, any printed wording on the DNRO device and any copies is legible, and the DNRO device and any copies are reproduced on yellow paper, they are all valid.

Call 911 even if the patient has a DNRO. Paramedics and EMTs will provide support and assistance to family and caregivers and work to keep the patient comfortable. Emergency medical services are also available to transport the patient to the hospital even if resuscitation will not be initiated.

Emergency medical services, paramedics, and EMTs are members of the community who provide appropriate care and support in many capacities, including comfort care measures such as oxygen administration, hemorrhage control, and pain management.

Yes. Copies are as valid as the original if they accurately reproduce the signatures, the printed wording is legible, and the copies are printed with a full-page yellow background or are reproduced on any shade of yellow paper.

No. A properly completed DNRO does not expire.