- DNR (Do Not Resuscitate)/COLST (Clinician Order for Life-Sustaining Treatment)
- DNR/COLST orders are portable, out-of-hospital medical orders used to instruct medical providers and emergency responders about any treatment limitations for an individual. DNR/COLST orders are the outcome of a shared decision-making process between a patient (or their agent, guardian or surrogate, if the patient lacks decision-making capacity) and their clinician (MD, DO, PA or APRN). They are based on an individual’s current medical condition and their goals and values. DNR/COLST orders are not advance directives. If emergency responders are called, they cannot withhold any treatments unless there is a DNR/COLST order in place and clearly displayed for EMTs/EMS to find.
- DNR/COLST orders address the following medical treatments:
- Cardiopulmonary resuscitation (CPR)
- Breathing machines (intubation and ventilation)
- General guidelines for medical treatments
- Artificial feeding and fluids
- Antibiotics
- If you are certain that you would not want one or more of these treatments regardless of the medical situation you are in, it is important to have a discussion with your clinician to see if a DNR/COLST order is right for you.
- Do Not Resuscitate (DNR) order is a written order by the patient’s clinician directing health care providers not to attempt resuscitation.
- Clinician Orders for Life-Sustaining Treatment (COLST) is a clinician’s order(s) for treatment. This may include limitations on treatment or medical interventions. It may also include a DNR order.
Read the Advance Directives for Health Care Rule
DNR/COLST Clinician Order Form & Instructions
- In the out-of-hospital setting (out-patient), DNR/COLST orders must be issued on the Vermont DNR/COLST form below. Properly executed DNR/COLST orders do not expire but should be reviewed when there is a change in the patient's health status, care setting, or goals. DNR/COLST orders and other similar portable medical orders (MOLST, POLST) properly completed in another state will be honored in Vermont.
- In the hospital, medical orders are documented in the patient's medical record, in a facility-specific manner. The Vermont DNR/COLST form should only be used if a patient is being discharged with a treatment limitation in place. DNR/COLST orders should not be completed for patients who have no limitations of treatment.
- The DNR/COLST form was updated in June 2022.
Approved DNR Medical ID Vendors
Individuals may wish to purchase wearable Do Not Resuscitate (DNR) identification. The Health Department has approved the following vendors: