64J-2.018. Do Not Resuscitate Order (DNRO) Form and Device

(1) As used in this rule:

(a) “Do Not Resuscitate Order” and “DNRO” mean DH Form 1896, Do Not Resuscitate Order, 02/2024, which is incorporated by reference and available from the Department at www.floridahealth.gov/about/patient-rights-and-safety/do-not-resuscitate/_documents/dnro-updated-form-bw.pdf and at www.flrules.org/Gateway/reference.asp?No=Ref-17066.

(b) “Do Not Resuscitate Order Device” and “DNRO Device” mean that portion of DH Form 1896, Do Not Resuscitate Order, 02/2024, consisting of a reduced-size reproduction of the DNRO below the line indicated by “Cut along line and fold in half to create DNRO Device (wallet card).”

(c) “Original” means the completed DNRO or DNRO Device on yellow paper that bears the manual signatures of the patient or authorized person and the patient’s health care provider. Any shade of yellow is acceptable.

(d) “Copy” means a counterpart produced from the original, by means of photography, including enlargements and miniatures; by mechanical or electronic rerecording, including in an electronic medical record; by chemical reproduction; or by other equivalent technique that accurately reproduces the completed original, including any manual handwriting, signatures, and the yellow background of the original. Any shade of yellow is acceptable.

(2) A DNRO or DNRO Device is not a substitute for any other oral or written order of a health care provider authorized by law to direct that cardiopulmonary resuscitation or any life-prolonging procedure be withheld or withdrawn.

(3) A DNRO or DNRO Device is not a substitute for an advance directive, living will, or declaration, as those terms are defined by section 765.101, F.S.

(4) An emergency medical technician (EMT) or paramedic shall withhold or withdraw cardiopulmonary resuscitation from a patient:

(a) Upon the presentation of an original or a copy of an original DNRO, an original or a copy of an original DNRO Device, or any full size, reduced size, or previous version thereof; or

(b) Upon the EMT’s or paramedic’s observation of such original or copy, or of an original or copy that is worn or carried on the patient’s person so as to be readily apparent to emergency medical services providers.

(5) An EMT or paramedic is not required to withhold cardiopulmonary resuscitation if:

(a) The original or copy of the DNRO is not on yellow paper (of any shade); or

(b) The content is altered from the original; or

(c) Any printed wording on the DNRO is not legible.

(6) The DNRO must be signed by the patient’s physician, osteopathic physician, autonomous advanced practice registered nurse, or physician assistant and by:

(a) The patient or the patient’s surrogate, proxy, or minor’s principal, as those terms are defined in section 765.101, F.S.; or

(b) A guardian as defined by section 744.102, F.S., or an agent as defined by section 709.2102, F.S., who is expressly authorized to make health care decisions for the patient.

(7) An EMT or paramedic shall verify the identity of the patient by reviewing the patient’s driver license or other photo identification, or upon receipt of an oral statement made by a witness in the patient’s presence.

(8) During each transport, the EMT or paramedic shall:

(a) Ensure that the DNRO or DNRO Device accompanies the patient to the receiving facility or agency; and

(b) Provide to the patient comforting, pain-relieving and any other medically indicated care other than respiratory or cardiac resuscitation.

(9) The patient may revoke the DNRO at any time by orally expressing a contrary intent, by expressing a contrary intent in writing, by failing to present the DNRO to the EMT or paramedic, by physically destroying the DNRO, or by a writing signed in the same manner as the DNRO.

Rulemaking Authority 401.45(5) FS. Law Implemented 401.45(3), 464.0123(3)(a)5 FS. Art. I, Sec. 23, Fla. Const. History–New 11-30-93, Amended 3-19-95, 1-26-97, Formerly 10D-66.325, Amended 2-20-00, 11-3-02, 6-9-05, Formerly 64E-2.031, Amended 10-10-24.