How would/could paramedics know if you had an Advance Decision?

[TheEasterPangolin]

Does anyone know what would happen in an accident situation like a road accident, heart attack out and about etc, if you have made an Advance Decision ? How would or could anyone know if you didn’t want to be resuscitated? Or wouldn’t they? I get that in controlled situations like a hospital admission the medics would have access to your medical records but an ambulance crew wouldn’t would they? I’ve googled but I can’t seem to find an answer. Does anyone know what happens in such a situation?

ultimately although Advance Decisions are legally binding, it will always be down to the clinician’s judgement in the event they don’t know about it an an emergency situation and can’t ask the patient themselves. They have to act in the patients best interests based on the information available to them. The charity Compassion in Dying has done some research into this though and I think are working with ambulance services to try and improve how they get access to key patient information in emergency situations. https://compassionindying.org.uk/resource/the-role-of-ambulance-trusts-in-respecting-peoples-end-of-life-wishes/

Based on my experience of my grandfather’s death (which is a while ago so things may have changed), if an ambulance is called then they must do everything they can to save life. Only a doctor is authorised to ask them to stop. My aunt was distraught she’d called them as my grandfather didn’t want to resuscitate and had done the paperwork. She didn’t realise this. The ambulance team very kindly halted so she could call his GP and accepted the GPs authorisation on the phone to stand down.

I have one and keep one in the car, in my handbag etc should anything happen. Also on my phone in the 'medical details'/emergency contact before unlocking.

I know it's not foolproof. They would be said to be acting in good faith, so if you were alone and something happened, not sure much can be done about that if you were resuscitated for example, against your wishes.

There’s a scheme which is known to paramedics, you put your info in the fridge & have a sticker on the door. It’s called Message in a Bottle & run by Lions International. Your chemist might have the bottles, they have a green lid on them.

Page 26 and 27 of should answer your questions www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/Advance-Decisions-to-Refuse-Treatment-Guide.pdf

When my parents were nearing the end of their lives, and were frequent-fliers with the ambulance service, they both had ReSPECT forms filled out and pinned to the kitchen noticeboard. At times when I was there when the paramedics arrived, I pointed it out to them (I think they usually asked) and it was taken with them to hospital.

You can put emergency health info accessible through the lock screen on your phone, but I am not sure how often or at what stage any one might check that. There are also medical alert bracelets and pendants which can carry that kind of information.

I presume that if paramedics arrive and find someone in cardiac arrest or very seriously ill or injured, they would start life-saving measures immediately and ask questions later rather than searching the phone/fridge/house for a ReSPECT form or similar.

Advance Decisions need to be lodged with the GP. Family should be informed that this has happened and provided with a copy so that they can inform Paramedics etc. My Mum had a form of cancer for 10 years, she survived a major event (resus x 4 and 12 weeks in critical care when she was not expected to survive). When she recovered, amazing everyone, her consultant discussed with her removing her DNR and this was done. On the day she died, some years later the Paramedics were called and I asked if they would need to attempt resus, they said that they would as there was no DNR in place. I informed them that I would prevent this, in a non violent way as she was so very poorly and the outcome would be prolonging her pain and suffering, she had so much chemo, radiotherapy and so much treatment and they told me that they would call the Police if I prevented resus. I had discussions with my Dad who also agreed that enough was enough. It became very quickly obvious that she was at end of life and so they called a senior Paramedic. They left and Mum died very soon afterwards. It was a horrible and very traumatic time and the only comfort I have gained from the experience is that I was there to advocate for Mum when she had no voice. Please, please set up your advance decision and advance statement so that your family does not have to experience what I had to with my lovely Mum.

Thank you everyone. I had no issues with my parents as I lived nearby and each had made it clear to me what they wanted. My DF needed to be resuscitated after his final heart attack . I was on the ward at the time and was able to tell the doctors he wanted resuscitation which is what they did even though it wasn’t successful. I know equally my DM didn’t want treatment to continue . I live alone with no family nearby so if I collapsed on the street I want to do everything I can to make sure I’m not given CPR. I can see from some pp’s replies , that paramedics may not currently have access to someone’s wishes even if they’re on their records and may carry out CPR or other life saving treatments.

I like the idea of wearing a medic alert bracelet and keeping a copy of the Advance decision in my bag, car etc . I guess that’s the best chance even though it’s not guaranteed that CPR wouldn’t be carried out in an emergency situation if you were alone at the time . Thanks for answering everyone.