If a patient with a valid DNR/POLST indicates a desire to receive life-resuscitating treatment, what action must EMS take?

• A. The DNR/POLST order is INVALID; document revocation and relay to subsequent providers.
• B. The order remains valid and resuscitation continues.
• C. EMS must contact the patient's physician for permission to revoke.
• D. The revocation is only valid if there is a hospital physician's order.

Answer: (B)

DNR/POLST orders are binding medical directives that guide EMS decisions about resuscitation. They stay in effect until they are properly revoked through the appropriate process, typically involving a physician order or a formally documented revocation. A patient’s verbal wish to receive life-sustaining treatment does not by itself revoke a valid DNR/POLST in the field. Therefore, if the order is still valid, EMS must continue to treat in accordance with it and not initiate CPR, preserving the patient’s previously documented preferences. In practice, this means the order remains valid and resuscitation is not started unless a proper revocation is documented. This protects patient autonomy while ensuring that changes to directives are handled through the correct medical authorization pathways.