And we are only bound by a DNR IF we have the actual document in hand. Or as EMS, if CPR has already been started when we arrive, we are automatically obligated to continue. If it ain’t written down, it never happened. Nursing homes are supposed to provide the documents any time we transport such a patient as part of their medical history papers. And yes, we treat and transport a lot of such patients with a DNR that needs to go to a hospital for some reason.

Worst case scenario, entering a home with family gathered and grandma has a heart attack. And half the family wants me to start CPR and the other half tries to tell me grandma to let grandma go. I will ask them if they have the documents and they don’t answer me because they are too busy fighting each other to respond to me. And my poor driver is trying to literally breakup a fight while I’m doing CPR.

Source: A very old and happily retired medic