II. Types: Do Not Resuscitate (DNR) or Do Not Attempt Resuscitation (DNAR)

  1. Order prohibits Cardiopulmonary Resuscitation (CPR)
    1. Includes Do-Not-Intubate (DNI)
    2. Implementation varies by state (e.g. DNR as outpatient)
    3. Independent of Advance Directive
  2. Do Not Attempt Resuscitation (DNAR)
    1. Reflects the significant likelihood that Resuscitation will fail (for ROSC or survival to discharge)

III. Types: Provider's Orders for Life Sustaining Treatment (POLST)

  1. Background
    1. Initially created in Oregon (1991), and has now expanded to 42 states as of 2018
  2. Indications
    1. Patients in Nursing Homes, Assisted Living, and Life Expectancy <12-24 months
  3. Description
    1. Single page portable doument that transfers between care systems
    2. Unlike abstract Advanced Directives, POLST is composed of actionable orders related to end of life
    3. Addresses multiple medical interventions (DNR/DNI, comfort care, antibiotics, nutrition)
    4. Form travels with patient and copies sent to EMR, EMS, facilities and family

IV. References

  1. Olson (2010) Park Nicollet Primary Care Update CME, Minneapolis, MN
  2. Orman and Abbott in Herbert (2018) EM:Rap 18(2): 13-4

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Related Studies

Ontology: Daunorubicin (C0011015)

Definition (NCI) An anthracycline antineoplastic antibiotic with therapeutic effects similar to those of doxorubicin. Daunorubicin exhibits cytotoxic activity through topoisomerase-mediated interaction with DNA, thereby inhibiting DNA replication and repair and RNA and protein synthesis.
Definition (NCI_NCI-GLOSS) The active ingredient in a drug used to treat acute leukemias and some other types of cancer. It blocks a certain enzyme needed for cell division and DNA repair, and it may kill cancer cells. It is a type of anthracycline antibiotic and a type of topoisomerase inhibitor.
Definition (MSH) A very toxic anthracycline aminoglycoside antineoplastic isolated from Streptomyces peucetius and others, used in treatment of LEUKEMIA and other NEOPLASMS.
Definition (CSP) anthracycline antibiotic produced by Streptomyces coeruleorubidus or Streptomyces peucetius and used as an antineoplastic.
Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH D003630
SnomedCT 35300007, 372715008
English Dauno Rubidomycine, Dauno-Rubidomycine, Daunomycin, Daunorubicin, Rubidomycin, Rubomycin, 5,12-Naphthacenedione, 8-acetyl-10-((3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy)-7,8,9,10-tetrahydro-6,8,11-trihydroxy-1-methoxy-, (8S-cis)-, DNM, Rubomycin C, DRB, Daunorrubicina, DNR, (8S-cis)-8-Acetyl-10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy-1-methoxy-5,12-naphthacenedione, Leukaemomycin C, daunorubicin (medication), DAUNORUBICIN, Daunorubicin [Chemical/Ingredient], dnm, rubidomycin, drb, rubomycin, DAUNOrubicin, daunorubicin, RUBOMYCIN C, 5,12-Naphthacenedione, 8-acetyl-10-[(3-amino-2,3,6-trideoxy-alpha-L-lyxo-hexopyranosyl)oxy]-7,8,9,10-tetrahydro-6,8,11-trihydroxy-1-methoxy-, (8S-cis)-, L-lyxo-Hexopyranoside, 3beta-acetyl-1,2,3,4,6,11-hexahydro-3,5,12-trihydroxy-10-metldioxo-1a-naphthacenyl 3-amino-2,3,6-trideoxy-,alpha-, DAUNOMYCIN, Daunorubicin (product), Daunorubicin (substance), daunomycin
Swedish Daunorubicin
Czech daunorubicin
Finnish Daunorubisiini
Japanese ルビドマイシン, ダウノルビシン, ダウノマイシン, ルボマイシン
Italian Rubidomicina, Daunomicina, Dauno-rubidomicina, Daunorubicina
Croatian Not Translated[Daunorubicin]
Spanish daunorubicina, daunorrubicina (producto), daunorubicina (producto), daunorrubicina, daunorubicina (sustancia), daunorrubicina (sustancia), Daunomicina, Daunorrubicina, Rubidomicina, Rubomicina
Polish Daunorubicyna, Rubidomycyna
French Daunorubicine
German Daunomycin, Daunorubicin, Rubidomycin, Rubomycin
Portuguese Daunomicina, Daunorrubicina, Rubidomicina, Rubomicina