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Summary: Unit Name
Date/Time UVA HEALTH SYSTEM
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Name RESUSCITATIVE STATUS ORDER
HIST# AND PHYSICIAN NOTE
SERV
MD:
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PLACE PRINTED ORDER IN RED PAGE PROTECTOR IN FRONT OF CHART
RESUSCITATIVE ORDERS
OPTION ONE
[]FULL CODE (INCLUDES CHEST COMPRESSIONS,ENDOTRACHEAL INTUBATION &
ACLS GUIDELINES) (Call Code 12 Team 4-2012)
OPTION TWO
[]DO NOT RESUSCITATE (NO RESUSCITATIVE MEASURES WILL BE INITIATED. NO
INTUBATION WILL BE DONE. INCLUDES PATIENTS WITH DURABLE DNR ORDERS)
OPTION THREE
[]SELECT SPECIFIED RESUSCITATION MEASURES (CALL CODE 12 per unit guidelines 4-2012)
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