Do-Not-Resuscitate (DNR) Information

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Under Subchapter III of Wis. Stat. Chapter 154, (exit DHS) an attending physician may issue a do-not-resuscitate order for a "qualified patient," as defined in  Wis. Stat. s. 154.17 (4). (exit DHS) 

A "qualified patient" means a person who is at least  18 years old and who either has a terminal condition or has a medical condition such that, were the person to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful in restoring cardiac  or respiratory function, the person would experience repeated cardiac or pulmonary failure within a short period before death occurs, or resuscitation would cause significant physical pain or harm that would outweigh the possibility the resuscitation would successfully restore cardiac or respiratory function for an indefinite period of time."  “Resuscitation” means cardiopulmonary resuscitation or any component of cardiopulmonary resuscitation, including cardiac compression, endotracheal intubation and other advanced airway management, artificial ventilation, defibrillation, administration of cardiac resuscitation medications and related procedures. “Resuscitation” does not include the Heimlich maneuver or similar procedure used to expel an obstruction from the throat.

As defined in Wis. Stat. s. 154.17 (2), (exit DHS) a do-not-resuscitate order directs emergency medical technicians, first responders and emergency health care facilities personnel not to attempt cardiopulmonary resuscitation on the person for whom the order is issued if that person suffers cardiac or respiratory arrest.  The purpose of a do-not-resuscitate order is to ensure that medical care provided in the emergency department and out-of-hospital settings is consistent with the patient's desire and the attending physician's authorization.

DNR Bracelets

There are two types of Do Not Resuscitate (DNR) bracelets available to identify a person with a valid DNR order. One is a plastic ID bracelet which looks like a hospital identification band and is free. The other is a metal bracelet which is available from MedicAlert© for a fee. Both have been used in Wisconsin since 1995 and require a completed DNR form DPH 4763 to be completed by the physician. 

The plastic Do Not Resuscitate Bracelet is free of charge and should be obtained directly from the physician. With the hospital type bracelet the physician signs an official insert containing the preprinted logo of the State of Wisconsin. The insert must include the physician’s name, business telephone number and signature. 

Per Wisconsin Statute 154, (exit DHS) Medic Alert® is the only State of Wisconsin  authorized vendor for a permanent type metal bracelet. The metal bracelet (from MedicAlert®) displays the internationally recognized symbol Staff of Aesculapius on the front and the words “Wisconsin-Do-Not-Resuscitate-EMS” and the qualified patient’s first and last 
name engraved on the back. There is still room on the back of the bracelet to add other health concerns and Medic Alert’s® 
24 hour emergency phone number. 

The metal DNR bracelet is purchased, for a cost, through Medic Alert® and there is also an initial membership which is waived after the first year of membership. Any person who chooses to have a metal bracelet but is not able to afford the fees, can apply for a sponsored membership and metal DNR bracelet. Please review the Medic Alert Sponsorship Program (PDF, 14 KB) for more information.   For more additional information on cost and fee information for a metal bracelet please see the MedicAlert© website at http://www.medicalert.org. (exit DHS)

Before receiving either bracelet, the attending physician must counsel the patient, the legal guardian, or health care agent of an incapacitated patient. The counseling session should include written information about DNR procedures and documents to be placed in the patient’s file noting the qualifying medical condition that warrants the DNR order.  

The patient, patient’s guardian, or health care agent who signed the DNR order can revoke the DNR order by expressing to emergency health care personnel the desire that the patient be resuscitated, or by removing, or asking someone to remove the bracelet. The attending physician must then be notified as soon as possible.

Order forms for either bracelet can be obtained from the physician, or from the Wisconsin Department of Health Services, Division of Public Health, Bureau of Communicable Disease and Emergency Response by calling (608) 266-1568 or via e-mail to helen.pullen@wisconsin.gov. 

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Last Revised: October 21, 2011