Western Lane Ambulance District (WLAD) Paramedics frequently respond to patients suffering critical medical emergencies such as heart attacks or strokes, where lives are hanging in the balance and within seconds decisions are made that can permanently effect the rest of the patient’s life.
For the emergency medical patient, these decisions concerning care for themselves or their loved ones can be a very trying event. In order to uncomplicated this stressful time as much as possible for both the paramedics and the patient, it is crucial to understand the Physician Orders for Life-Sustaining Treatment (POLST) Form.
Henry Hanf, WLAD District Manager explains, “it’s very important for people who have life threatening illnesses to have a POLST form handy when they call us. If not, it can be very confusing, difficult and frustrating for first responders to know the patient’s wishes otherwise. They have to make split second decisions under extremely stressful conditions and the POLST forms are a crucial and effective tool for our paramedics in these unfortunate circumstances.”
The POLST form is divided into 5 sections. Section A is designed to express a person’s wishes if their heart were to stop beating and whether they want CPR, defibrillation, intubation and medication or not.
Section B is designed to address medical interventions, or intensity of treatment such as comfort measures only verses limited interventions such as IV fluids or cardiac monitor. Or a patient may chose full medical treatment including advanced airway procedures and full variety of medications.
Section C deals with artificially administered nutrition. This would be nutrition administered intravenously or placement of a feeding tube to allow nutrition to be introduced to the person’s stomach.
Section D is documentation that the POLST form has been discussed and signed by the appropriate person who is the patient. The bottom line is an acknowledgement the form is submitted to the POLST registry.
Section E is to be signed by the Primary Care Physician/ Nurse Practitioner or Physician Assistant.
The hope is that the POLST information helps with this emotionally trying event. It is understood that though this is not a discussion that anyone wants to have about themselves or their loved ones, it is an important step to being sure a patient or a family member’s wishes are met.
“It is important to pick up the POLST form from your Doctors office or the local hospital. We have to know what you want us to do in these situations. Place the form on the refrigerator or some other visible sight, or have someone on scene available to give it to the paramedics, ” Hanf said.
For more information on the Oregon POLST registry, visit their website at www.orpolstregistry.com or call toll free 877-367-7657.