Chapter DHS 125

DHS 125.04(1) (1) The bracelet shall be a clear, standard hospital-type bracelet at least 3/4 of an inch in width.

DHS 125.04(2) (2) The identifying information placed in the bracelet shall be printed on a bracelet insert form supplied by the department. The bracelet insert form as supplied by the department shall have on it, preprinted in blue, the words “Do Not Resuscitate” and the state seal of Wisconsin.

DHS 125.04 Note Note: Copies of the bracelet insert form may be obtained from the EMS Section, Division of Health, P.O. Box 309, Madison, WI 53701-0309.

DHS 125.04(3) (3) The physician who has issued the do-not-resuscitate order shall complete or direct another person to complete the bracelet information by printing on the bracelet insert form in size 8 or greater font all of the following information:

DHS 125.04(3)(a) (a) On the left half of the form, the patient’s name, address, date of birth and gender.

DHS 125.04(3)(b) (b) On the right half of the form, the physician’s name, business phone number and original signature.

DHS 125.04 History History: Cr. Register, July, 1997, No. 499, eff. 8-1-97.

DHS 125.05 DHS 125.05 Following do-not-resuscitate orders.

DHS 125.05(1) (1) General requirement. Emergency health care personnel shall follow a do-not-resuscitate order, as evidenced by a patient wearing a do-not-resuscitate bracelet, unless the order is invalidated by a condition under sub. (3). If there is any doubt about honoring a do-not-resuscitate bracelet, emergency medical services practitioners and emergency medical responders shall contact the medical control hospital and emergency health care facility staff shall contact the director of emergency services.

DHS 125.05(2) (2) Procedure. Emergency health care personnel shall carry out the following procedure in the emergency care setting:

DHS 125.05(2)(a) (a) Assess the patient.

DHS 125.05(2)(b) (b) If the patient is pulseless and non-breathing, check the patient’s wrist for a do-not-resuscitate bracelet.

DHS 125.05(2)(c) (c) If no do-not-resuscitate bracelet is found on the patient’s wrist, provide usual care.

DHS 125.05(2)(d) (d) If a do-not-resuscitate bracelet is found on the patient’s wrist, and the bracelet is not defaced, do not undertake life support measures. Provide comfort care.

DHS 125.05 Note Note: Examples of comfort care include, but are not limited to, administration of oxygen, clearing the airway, controlling bleeding, positioning for comfort, providing emotional support, providing pain medication and splinting.

DHS 125.05(3) (3) Conditions invalidating a do-not-resuscitate order. Any of the following conditions, as set out in s. 154.19 (3) (b), Stats., invalidates a do-not-resuscitate order and therefore the obligation of emergency health care personnel to be bound by it and to honor the do-not-resuscitate bracelet on the patient’s wrist or with the patient:

DHS 125.05(3)(a) (a) The patient has revoked the do-not-resuscitate order by doing any of the following:

DHS 125.05(3)(a)1. 1. Expressing to an emergency medical services practitioner, emergency medical responder, or emergency health care facility staff member the desire to be resuscitated. When this is done, emergency health care personnel shall promptly remove the do-not-resuscitate bracelet.

DHS 125.05(3)(a)2. 2. Defacing, burning, cutting or otherwise destroying the do-not-resuscitate bracelet.

DHS 125.05(3)(a)3. 3. Removing the do-not-resuscitate bracelet or asking another person to remove it.

DHS 125.05(3)(b) (b) The do-not-resuscitate bracelet appears to have been tampered with or removed.

DHS 125.05(3)(c) (c) The emergency medical services practitioner, emergency medical responder, or emergency health care facility staff member knows that the patient is pregnant.

DHS 125.05(4) (4) Patient desire not to be resuscitated is controlling. If a member of the patient’s family or a friend of the patient requests that resuscitative measures be taken, that person’s request does not supersede the do-not-resuscitate order for the patient if the patient is wearing a valid do-not-resuscitate bracelet and has not revoked the order under s. 154.21, Stats.

DHS 125.05(5) (5) Documentation of patient contact and removal of patient.

DHS 125.05(5)(a) (a) Even if resuscitation is not attempted, the emergency medical services practitioner, emergency medical responder or emergency health care facility staff member shall document the patient contact in the patient’s medical record or the ambulance run report form, as appropriate.

DHS 125.05(5)(b) (b) Local protocols shall determine the procedure for removing the patient from the emergency care setting.

DHS 125.05(6) (6) Violations. An emergency medical services practitioner, emergency medical responder or emergency health care facility staff member who does any of the following is subject to the penalties set forth in s. 154.29 (1) or (2), Stats.:

DHS 125.05(6)(a) (a) Willfully conceals, defaces or damages a patient’s do-not-resuscitate bracelet without the patient’s consent.

DHS 125.05(6)(b) (b) With the intent to cause withholding or withdrawal of resuscitation contrary to the wishes of a patient, falsifies, forges or transfers a do-not-resuscitate bracelet to that patient or conceals the patient’s revocation of a do-not-resuscitate order.

DHS 125.05(6)(c) (c) Withholds personal knowledge of a patient’s revocation of a do-not-resuscitate order.

DHS 125.05 History History: Cr. Register, July, 1997, No. 499, eff. 8-1-97; CR 20-067: am. (1), (3) (a) 1., (c), (5) (a), (6) (intro.) Register December 2021 No. 792, eff. 1-1-22.