A 59-year-old man is unconscious with slow, shallow breathing and a weak pulse. The family says he has terminal brain cancer and does not wish to be resuscitated; they cannot locate a DNR order. What is the appropriate action?

• A. Begin treatment and contact medical control as needed.
• B. Transport the patient without providing any treatment.
• C. Decide on further action once the DNR order is produced.
• D. Honor the patient's wishes and withhold all treatment.

Answer: (A)

The main idea here is that in an emergency, if there is no valid DNR or advance directive present, you provide life-sustaining care and obtain guidance from medical control. Without a documented DNR, you cannot assume the patient would refuse resuscitation, even if there’s a terminal illness and family members request it. Begin life-supporting actions appropriate to the situation (airway management, assisted breathing, circulation support, and urgent transport as needed) and reach out to medical control to confirm the plan or to locate any hidden directives. Only if a valid DNR order is located would you withhold resuscitation; until then, you act to preserve life.