The patient's care plan should include details specifying actions in the POLST applies in all circumstances, including whether CPR should be initiated if a patient is choking.
This should be noted in the POLST, or a statement should be included in the POLST with any exceptions.
Bedside caregivers and supervisors should be familiar with this detail in the patient care plan and POLST. In most circumstances, if the patient’s heartbeat stops during a witnessed choking incident or other accident, the LPN should perform first aid measures.
If the person has no pulse or becomes nonresponsive, begin cardiopulmonary resuscitation (CPR) even if the POLST indicates DNAR. Continue CPR until licensed staff or emergency medical responders arrive.
The patient may want to refuse CPR under all circumstances including choking or accidents. This may be appropriate for patients with advanced dementia at risk for aspiration, patients with osteoporosis, or other conditions and situations in which chest compressions or other CPR interventions may cause more harm than benefit to the patient.